| 1. Research ObjectivesMyasthenia gravis is a nerve muscle joints excited the immune system disease transmission obstacles. In recent years, has been increasing incidence of myasthenia gravis, caused the people to the attention of this disease. Ocular myasthenia gravis, (OMG), as one type of myasthenia gravis, has highest incidence.It is the earliest and the most light type, often be regarded as a first choice to confrim the effective of clinical treatment.Research results show that patients wi th myasthenia grais (50% found begin from OMG), if not revealed to intervention and treatment, more than 80% will tranform to a more serious systemic type, even life-threatening. In recent years, about the treatment of myasthenia gravis has been growing. Inhibitor of acetylchol ines terase, the western most often use medcine use from the beginning has already been probably 70 years of history. Pritchard first used Pyridostigmine Bromide as one treatment of myasthenia gravis [1], and now if patients just limited to OMG, we first use Inhibitor of acetylchol ines terase to treat him, if the disease can not be controled, then consider use cort icosteroids or the other methods. Given the limitations of traditional Chinese medicine, Because of western medicine therapy treatment, TCM started to be accepted by people slowly. But at present interpretation of the cause about of myasthenia gravis are not identical views held by, treatment is also different. This article is to follow tutor of doctor of vice director of Baoyu Xu use professor Ershou Shang's Fu Jing Ningl to add and subtract, liuwei dihuang pill for marbling grading treatment of patients with OMG, observe the changes before and after the treatment level of immunity to verify its square curative effect. Intended for application this square treatment myasthenia gravis provide more clinical evidence.2. Clinical research2.1 Research objectPatients from January 2010 to March 2011 Chinese medical academy out-patient clinic service xiyuan hospital neural NO.145 OMG patients Into the case matches in 1997 for national neuroimmune's five diagnosis standard. Inclusion criteria:1) the outpatient service sustained long-term clinic of MG patients, gender, age 2) comply with OMG revealed diagnostic criteria of patients. Exclusion criteria:1)patients not comply with the type of OMG 2) patients into the group was taking or continuous use acetylcholine inhibitors or corticosteroids and other drugs 3) serious mental illness can't match with the clinical investigators 4) with serious diseases, such as severe heart, kidney and blood vital organs 5) also attend other researchers.2.2Research methodsAccording to the literature and clinical research, will divided the OMG patients'revealed medicine clinical symptoms and signs of TCM medicine syndrome questionnaires respectively. Met inclusion exclusion standard patients, fill in the questionnaire, and medicine syndrome were performed before and after the treatment by antibodies and acetylchol ine T lymphocyte subsets examination. Use a database of SPSS17.0 statistical software, statistical analysis, analysis to two months for an observation treatment, patients before and after the treatment of immune level change.Treatment:Select patients with type myasthenia gravis revealed the group,the tutor of doctor of vice director of BaoYu XU use professor ErShou Shang's Fu ji ning 1 experience prescription to calming liver wind and fill kidney essence. Specific medication as follows:tianma,du zhong,quan chong,di long,huai niu xi,sheng di,shan yu rou and so on。And those with the disorder and add subtract. Patient of Deficiency syndrome add huang qi, dang shen etc; Patient of Phlegmy wet disorder add shi chang pu, chen pi etc.; patient of blood deficiency syndrome add dang gui,suan zao ren etc; patient of blood stasis syndrome add tao ren, hong hua, etc. Day 1 agent, twice uniform, according to the illness, such as traditional Chinese medicine charmed adjustment daily 1 agent, taking three days after seven agent stopped continued to take, etc.2.3Research result2.3.1 GeneralSex ratio:include 23 male patients,22 female patients, men and women scale: 1.045:1, male proportion slightly higher than women' Age Ratio:all patients,11 years old to 50years of age for disease morbidity of the highest stage (26), followed by 51 to 70 years of age (11),71 years old and more than 71 years old(6),10 years following ages minimum (2) incidence.2.3.2 Symptoms of traditional Chinese and western medicine Western medicine symptoms:these patients common symptom is drooping eyelids and external ophthalmoplegia casued diplopia and limit eyes' movements. Before treatment the average scores of drooping eyelids and external ophthalmoplegia are 3.356 and 3.311,after the scores of them are 3.600 and 3.422 respectively, both rose, so single from western medicine clinical symptoms, the symptoms before and after the treatment of patients were improved.TCM symptoms:this topic research inclued 10 TCM symptoms. Appear in more than 50 percent of the rate of symptoms has 2, respectively eyes dry (62.22%) and blurred vision (55,56%), appear in 20% rate there are 2, Lumbar debility (35.56%), insomnia (25.93%), the others all below 20 percent.From these,we can piont out the symptoms agree with that described in TCM.2.3.3 Immune indexHumoral immune:Patients acetylcholine resistance by antibodies after the former film and film P value of data 0.04and 0.004, respectively, all that <0.05, before and after treatment were statistically has obvious correlation significance. The average data of acetylcholine membrane before treatment is 0.9840±0.6157af ter treatment is 0.8373±0.5701, resistance to acetylcholine the film by antibodies respectively 1.0913±0.6772and 0.8947±0.3981.From specific data can be seen, resist acetylchol ine before by the former film antibody in data contrast,30 patients,21patients decline after the effective index 70%; Resistance to acetylcholine and film by antibodies in data contrast,30 patients,18 patients decline after the effective index 60%. we according to test data indicating that this can improve marbling grading qi-deficiency type myasthenia gravis humoral immune index for the treatment of myasthenia gravis revealed has certain effect.Cellular immune:This research mainly from T lymphocyte subsets and auxiliary T lymphocyte subsets two groups of indicators to compare the data of patients before and after treatment.Before treatment CD4/CD8 confidence interval is 1.6252±2.0215, after treatment is 1.6252±2.0215,P>0.05, before and after the treatment of Thl confidence interval are respectively:18.4963±17.6890,21.5741±19.4681, P>0.05, Th2 are respectively 1.9963±1.6194,1.9037±0.9790, P>0.05. Through statistics we found, three indexes in the statistical results are P> 0,05, are not statistically significant after treatment. But we through the concrete numerical can also see that Th2 CD4/CD8 and two indexes after treatment in different degree, indicating that this decline in improving cellular immune recepto level can play a certain role.Through the clinical research, we can see the tutor of doctor of vice director of Baoyu Xu use Er shou Shang's experience decoction in treating the experience of myasthenia gravis revealed type of medicine, either from the symptoms improve or immune level index declines, all have certain effect, indicating that this for the treatment of this type qi-deficiency myasthenia gravis is effective. And we can see the problem, clinical theoretical basis, the inadequate case the shortage, compliance with degrees, all is causing issues such as statistical results of inadequate, so this recepto is waiting to be further experiments. |
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