| Background and ObjectiveClinical study on this topic in myasthenia gravis(MG)patients with spleen qi deficiency as the research object.The clinical retrospective analysis of the investigation of MG patients included with the general situation,clinical course,Osserman typing,concomitant disease,clinical symptoms,chinese medicine etc.Experimental study on spleen deficiency syndrome model rats as the research object.To observe the changes of spleen deficiency in skeletal muscle of rats with mitochondrial succinate dehydrogenase(SDH)activity,peroxisome proliferator activated receptor γ coactivator-1α(PGC-1α),and to explore the mechanism of energy metabolism disorder of spleen deficiency syndrome.By observing the changes of the index after the Si jun zi decoction treatment,further study on the effect of strengthening spleen and invigorating Qi medicine of spleen deficiency syndrome,objective to provide experimental basis for elucidating the mechanism of strengthening spleen and invigorating Qi medicine.MethodsClinical study of the collected cases were from Guangzhou University of Chinese Medicine from 2010 January to 2015 February,95 definite diagnosis cases of MG patients with spleen deficiency syndrome.The clinical retrospective analysis of the investigation of MG patients included with the general situation,clinical course,Osserman typing,concomitant disease,clinical symptoms,Chinese medicine etc.Summarized the pathogenesis of MG,course of disease,prognosis,treatment characteristics.Experimental study on the selection of SPF grade 42 SD rats,which were randomly divided into 2 groups,10 rats in the normal group,32 rats in model group.The model rats were given subcutaneous injection of reserpine 0.5mg/kg/d,normal group rats were injected with the saline,a total of 8 days of continuous injection.Observed the general condition of rats,determination of urinary D-Xylose excretion rate,to assess whether the model was successfully established on rat model of spleen deficiency syndrome.Randomly selected,7 rats in the normal group,14 rats in the model group,the model rats were randomly divided into Si jun zi decoction group,spleen deficiency group,7 rats in each group.The Si jun zi decoction group with Si jun zi decoction orally,the dose of lOg/10ml/kg.Spleen deficiency group and normal group rats were fed with normal saline,1 time a day,for 3 weeks,Record the general condition of rats.Detected the rat urinary D-Xylose excretion rate 3 weeks after,killed the rats,extracted of skeletal muscle mitochondria,detected the expression of rat skeletal muscle mitochondrial SDH activity,mRNA and protein of PGC-1 alpha,observed the change of index after the treatment of Si jun zi decoction.Results1、There were 20 cases male,75 were female in MG Spleen deficiency syn drome in hospitalized patients,male to female ratio was 1:3.75,the ageof onset was 40.15 ± 17.24 years,the peak incidence was between 21 and 30 yea rs old.The shortest of course of disease was 1 year,the longest was 10yea rs,the averaged was 6.34 ± 5.82 years.The type Ⅱb was the most in the cli nical classification of Osserman type,type Ⅰ and type Ⅱ were a considera ble number of cases;Symptoms associated with a thymoma was most common,fo llowed by thymic hyperplasia;MG common main symptoms was ptosis,followed by limb weakness,dysphagia,dysarthria;The common symptoms of traditional Chinese Medicine were lassitude,dysphagia,mental fatigue;Paletongue,tongu e with thin white fur,pulse fine was most common;Traditional Chinese medi cine Astragalus,Codonopsis,Atractylodes,ficus hirta of strengthening s pleen and invigorating Qi medicine were the highest frequency.2、After the start of the model,model group rats appeared mental fati gue,anorexia,emaciation,curling,weight loss and other symptoms of spleen deficiency,the urinary D-Xylose excretion rate decreased significantly co mpared with the normal group(P<0.05);Three weeks after the end of giving medicine,Si jun zi decoction group rats spleen deficiency symptomsgradual ly improved,the urinary D-Xylose excretion rate increased significantly c ompared to spleen deficiency group.3、Comparison of the activity rat skeletal muscle mitochondria SDH:Com pared with the normal group,the skeletal muscle mitochondrial SDH activit y in spleen deficiency group rats decreased significantly(P<0.01);Compar ed with the model group,the skeletal muscle mitochondrial SDH activity in Sijunzitang group rats increased significantly(P<0.05)with statistical significance.4、Comparison of the expression of rat skeletal muscle mitochondria PG C-1α mRNA:Compared with the normal group,spleen deficiency group rats ske letal muscle mitochondria PGC-1α mRNA expression decreased significantly(P<0.01);Compared with the spleen deficiency group,Si jun zi decoction g roup rats skeletal muscle mitochondria PGC-1α mRNA expression increased(P<0.05)with statistical significance.5、Comparison of the expression of rat skeletal muscle mitochondria PG C-1 protein:Compared with the normal group,spleen deficiency group rats s keletal muscle mitochondria PGC-1α protein significantly decreased(P<0.01);Compared with the spleen deficiency group,Sijunzitang group rats skele tal muscle mitochondria PGC-1α protein expression increased(P<0.05)with statistical significance.Conclusion1、The incidence of MG was women than men,21-30 years old was the peak incidence:the type Ⅱb was the most in the clinical classification of Osserman type,type Ⅰ and type Ⅱ a considerable number of cases;Symptoms associated with a thymoma was most common;The clinical symptoms ptosis,lassitude,pale tongue,thin white fur,fine pulse as the main manifestation of spleen deficiency syndrome.Traditional Chinese medicine Astragalus,Codonopsis,Atractylodes,Ficus hirta of strengthening spleen and invigorating Qi medicine were the highest frequency,in addition with Bu shen yi jing,Xing qi hua shi medicine in traditional Chinese Medicine.Cautious life,regular diet,cold prevention,good mood,developing a good life habit,enhance immunity,infection control,regular medication,do not arbitrarily change or withdrawal the dosage.The Good doctor prevent treatment of disease,prevention of recurrence of symptoms,can better achieve the purpose of disease prevention.2、The expression of spleen deficiency group rat model of skeletal muscle mitochondrial SDH activity,PGC-1α mRNA and protein significantly decreased compared with the normal group,after Si jun zi decoction treatment increased significantly,the skeletal muscle mitochondrial function of spleen deficiency group rat model injury,reduced respiratory chain enzymes and respiratory chain electron transfer.Lead to the decline of mitochondrial oxidative phosphorylation,reduced ATP generation,leading to the body’s biosynthesis,energy metabolism had obstacled.After strengthening spleen and invigorating Qi traditional Chinese medicine intervention can improve mitochondrial oxidative phosphorylation,promoted the synthesis and metabolism of energy. |
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