Clinical And Experimental Studies Of Polymyositis And Dermatomyositis Being Treated By JiaWeiSiMiaouSan

Purpose:The thesis is divided into three parts: the reviewing analysis, the clinical curativeanalysis and the animal experimental study. It concludes the analysis and thesummary of clinical characteristic of Polymyositis (PM) and Dermatomyositis (DM),and the therapeutic use of medicine in observing the clinical cure of theJiaWeiSiMiaouSan on experimental dampness-heat animal model of PM.Furthermore, we can expound the treatment of JiaWeiSiMiaouSan on PM/DM incombining all the above treatments with the experimental results. It is also exploringa safe and new method of therapy in offering the use of clinical application for itsreliability.Methods:1. It consists of eighty reviewing analytical cases, thirty-five cases of DM andforty-five cases of PM. According to PM/DM patients' clinical information, wenote down the first visit symptom, solicit the body, tongue, pulse-taking,prescription, serum of muscle enzyme, the electric picture of skin, live-muscleexamine, the first time traditional Chinese medicine (TCM) prescription byprofessor, and the mainly used medicine during in hospital.2. Clinical analysis: of 40 PM/DM patients, they are divided into two groups, thetreating group and the contrasting group, twenty patients for each group.Observing the symptom of two groups before and after being treated byJiaWeiSiMiaouSan, they are muscular strength, muscle tenderness, the serumenzyme, hormone consumption, side effects and curative effects.3. The experiment adopts the immunity inject method in combining dampness-heatanimal PM model of cavy. The thesis uses pathology, electric mirror, theelectric picture of skin and the serum skin enzyme table to measure etc. Thesemethods are to observe the treated difference of TCM (JiaWeiSiMiaouSan) andprednisone.Result: 1. The reviews show that the patients who suffer from this disease accounts for51.25% around the ages of forty to sixty years old, and the ratio of men towomen are 1: 1.7. The serum of muscle enzyme increases, specially sensitivein LDH. Pathological positive rates of the muscle are more obvious than theelectric picture of skin. The disease, itself to TCM, is the mixture of excessivefunction and hypo function in which the spleen asthenia occurs to be the primaryfactor and the dampness-heat appears to be the secondary. There are two mainfactors of DM, the dampness-heat and the deficiency of qi and ying, involvingthree zang-viscera: lung, spleen and kidney. PM is mainly with accumulationof dampness and heat, involving three zang-viscera: liver, spleen and kidney. Inthe therapy of Chinese Traditional Medicine (TCM), lung (large intestine),spleen (stomach) and kidney (bladder) systems rank to be the top three fortreating the disease. This means that the core of treating this kind of disease islung, spleen and kidney systems. This is identical with the point-view ofprofessor Liu You Zhang in treating the disease, and also similar with the scholarreports of recent years.2. The clinical study shows that the treating group and the contrasting group bothcan improve the patient's muscular strength, muscle tenderness, serum enzymeetc. Effectively, the clinical symptom of TCM treated group improves muchmore obvious than the contrasting group. The hormone consumption of theTCM treated group is obviously lower than the contrasting group with fewer sideeffects. JiaWeiSiMiaouSan can obviously improve patients' symptom andstabilize the disease. It can also oppose the side effects of the hormone, thishelps patients to reduce and dismiss from the hormone smoothly, and can alsooffer a new way of treatment for treating the disease.3. The experiment shows that the serum of the cavies, the fourth week after thecavies being ill, appears promptly rising progressively in serum's CK, LDH andAST. The pathological change is shown as mainly the segment muscle fiberdistributed and necrosis, necrotizing area, the quality among the skin big musclefiber changes, and also a large number of inflammation cells soak into liver, lungand muscle. After the eighth week, being treated for one week, treating groupsC-G had various changes in electrical physiological function, lightens the muscledamages, especially in group C, F group and G group. There are no significantdifferences among three groups. Each treating group has its CK, LDH and ASTunder control in various degrees. G group shows the best control in serumenzyme; secondly is group C. The skeleton of skin change subdue withinflammation in C group with the best cell repair apparently. The inflammationis limited. The improvement degree of the pneumonia situation of G group is better than group F. The pneumonia presents as limited with fewer soakedinflammation cells. Group C shows the best result in treating hepatitis and fattyliver.Conclusion:1. Accordingly, if women, at the age of forty to sixty, happen to have rash withmuscle aches and muscle weakness, PM/DM should first be considered. Thebasic type of PM/DM is spleen asthenia and accumulation dampness and heat.Treatment involves multi-viscera, treating lung, spleen and kidney as primary,and other viscera should be considered as well. Professor Liu You Zhang,according to years of experience in treating the disease, JiaWeiSiMiaouSan withTCM of south of the Five Ridges in treating the dampness-heat type of PM/DMhas repeatedly won a good result. It is worth to study in depth.2. The therapy, JiaWeiSiMiaouSan with hormone, is the combination of TCM andwestern medicine. It shows the security and the stability in treating spleen asthenia-dampness-heat kind of PM/DM. It can reduce the hormone, the immune inhibitorconsumption, the poisonous side effect and complication. Therefore, the therapycan be applied for the long run in'treating the disease. Moreover, the therapy, TCMcombines with hormone, will be the main trend of treating PM/DM in the therapyfield of combining TCM and western medicine.3. The high dosage group of JiaWeiSiMiaouSan shows the inhibition to cells'immune response. It can control the soaked inflammation cells, and alsoregulate the immune system. JiaWeiSiMiaouSan not only can improve themuscle pathological change, but also have the function of preventing and curingthe disease.