| Objective:To explore the efficacy and safety of tacrolimus combined with pentateride tablets and acviting spleen chinese medicine in treatment of refractory Myasthenia gravis with spleen and stomach deficiencyMethod:To select 40 cases of the spleen and stomach deficiency group from in the First Affiliated hostital of TCM from Apr.2018 to Sep.2018,the experimental group were divided into three groups,group A treaded with prednisolone acetate Pyridostigmine Bromide+Chinses Herb,group B treaded with A group with tacrolimus;group C treated with B group together Wu Zhi soft capsule,These patients were followed up for 6 months,then observe the following indicator changes:tacrolimus blood concentration,alanine transaminase,blood glucose,aspartate transaminase,adverse reaction,QMG score,economic benefits ect.Result:40 patients were completed therapy.Aftet the 6th month,both group B and C,compaired to the first week,the blood concentration of F506 was examined higher,(P<0.05),which increased significantly after January,After 3 months and 6 months of treatment,there was no significant difference in blood concentration of between B and C group(p>0.05),There was no increase in the concentration of FK506 in March and June.In the QMG score,in group A,the drooping eyelids?the flatting armsand?the swallowing deficiency was statistically significant(p<0.05),this symptoms improved,and the rest of the compound vision,leg elevation,and lung capacity were rated before and after the treatment.(p>0.05).In group B,after treatment,the drooping eyelids,the construction difficulty,swallowing deficiency,flatting arms,elevated legs,and lung activity.were statistically significant.P<0.05,The QMG score was dropped,and the above myasthenia Gravis symptoms were are improved.However,both hands grip,double vision,p>0.05,no statistical significance,the above symptoms did not improve significantly.In terms of adverse reactions,2 cases had elevated blood sugar,3 cases had pulmonary infection and one case had headache and nausea.The symptoms improved or disappeared after treatment.There was no significant difference in Scr?AST?ALT?GLU and other biochemical indicators between group B and group C after 1 month and 6 months(P>0.05).There was no significant change before and after treatment.In terms of economic benefits,after six months of treatment,the cost of group B was 8647.00 yuan,the therapeutic effect was 92.8%,and the cost-effectiveness was 93.18;the cost of C in the experimental group was 6439.00 yuan,the therapeutic effect was 92.3%,and the cost-effectiveness was 69.76.The cost-effectiveness of the two groups was p<0.05.The cost-effectiveness of C in the experimental group was less than that of B in the experimental group,and there was statistical difference.Analyzing from the level of economics-effectiveness,the same blood was achieved.The dosage of tacrolimus can be reduced by adding Wu Zhi soft tablets to the therapeutic window of drug concentration,thus reducing the medical cost of MG patients.Conclution:Wu Zhi soft capsule can increase the blood concentration of tacrolimus,but it has a time window.The combined treatment of traditional Chinese and Western medicine has a good clinical effect on myasthenia gravis,with fewer adverse reactions,and can reduce the economic burden of patients with myasthenia gravis.To provide certain idea for treating myasthenia gravis throug"liver and spleen related"?... |
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