小续命汤联合免疫球蛋白对急性格林巴利综合征患者生活活动能力、神经功能缺损程度及CSF蛋白含量的影响
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摘要
目的观察小续命汤联合免疫球蛋白对急性格林巴利综合征患者生活活动能力、神经功能缺损程度及脑脊液(CSF)蛋白含量的影响并探讨其机制。方法将104例急性格林巴利综合征患者随机分为两组各52例,对照组应用免疫球蛋白治疗,研究组予小续命汤联合免疫球蛋白治疗,两组均持续治疗2周。比较两组治疗后临床疗效,统计两组治疗前、治疗后3 d、治疗后1周和治疗后2周生活活动能力、神经功能缺损程度及CSF蛋白含量变化情况,记录两组不良反应。结果研究组总有效率为94.23%,显著高于对照组的73.08%(P<0.05)。治疗后3 d、治疗后7 d和治疗后2周,两组生活活动能力评分均较治疗前呈现显著升高趋势(P<0.05),且研究组治疗后各个时间点生活活动能力评分均显著高于对照组(P<0.05);两组斯堪的纳维亚神经功能缺损量表(SSS)评分、CSF蛋白含量均较治疗前呈现显著降低趋势(P<0.05),且研究组治疗后各个时间点SSS评分、CSF蛋白含量均显著低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论小续命汤联合免疫球蛋白治疗急性格林巴利综合征,能明显增强患者生活活动能力,降低神经功能缺损程度,改善CSF蛋白含量。
Objective: To observe the effect of Xiaoxuming Decoction combined with immunoglobulin on the ability of activities and living,the degree of nerve function deficit and content of cerebrospinal fluid(CSF) protein in patients with acute Guillian-Barre syndrome. Methods: 104 patients with acute Guillian-Barre syndrome were randomly divided into two groups. 52 cases in the control group were treated with immunoglobulin,and 52 cases in the study group were treated with Xiaoxuming Decoctioncombined with immunoglobulin;the two groups were treated with continuous treatment for 2 weeks. The clinical efficacy of the two groups after treatment was compared;the changes of the ability of activities and living,the degree of nerve function defect and the content of CSF protein in two groups before treatment,3 days after treatment,1 weeks after treatment and 2 weeks after treatment were observed;the adverse reactions of the two groups were recorded. Results: After treatment,the total effective rate of clinical treatment in the study group was significantly higher than that in the control group(P < 0.05). 3 days after treatment,7 days after treatment and 2 weeks after treatment,the ability of activities and living scores of the two groups were significantly higher than those before the treatment(P < 0.05);the scores at every time point of the study group was significantly higher than that of the control group(P < 0.05);the scores of Scandinavia nerve function defect scale(SSS) and the content of CSF protein in the two groups were significantly lower than those before the treatment(P < 0.05);the SSS scores and the contents of CSF protein at all time points in the study group were significantly lower than those in the control group(P < 0.05). During the treatment,there was no significant difference in the incidence rate of adverse reactions between the two groups(P > 0.05). Conclusion: Xiaoxuming Decoction combined with immunoglobulin on acute Guillian-Barre syndrome can significantly enhance the ability of activities and living of the patients,reduce the degree of nerve function deficit and improve the content of CSF protein.
Objective: To observe the effect of Xiaoxuming Decoction combined with immunoglobulin on the ability of activities and living,the degree of nerve function deficit and content of cerebrospinal fluid(CSF) protein in patients with acute Guillian-Barre syndrome. Methods: 104 patients with acute Guillian-Barre syndrome were randomly divided into two groups. 52 cases in the control group were treated with immunoglobulin,and 52 cases in the study group were treated with Xiaoxuming Decoctioncombined with immunoglobulin;the two groups were treated with continuous treatment for 2 weeks. The clinical efficacy of the two groups after treatment was compared;the changes of the ability of activities and living,the degree of nerve function defect and the content of CSF protein in two groups before treatment,3 days after treatment,1 weeks after treatment and 2 weeks after treatment were observed;the adverse reactions of the two groups were recorded. Results: After treatment,the total effective rate of clinical treatment in the study group was significantly higher than that in the control group(P < 0.05). 3 days after treatment,7 days after treatment and 2 weeks after treatment,the ability of activities and living scores of the two groups were significantly higher than those before the treatment(P < 0.05);the scores at every time point of the study group was significantly higher than that of the control group(P < 0.05);the scores of Scandinavia nerve function defect scale(SSS) and the content of CSF protein in the two groups were significantly lower than those before the treatment(P < 0.05);the SSS scores and the contents of CSF protein at all time points in the study group were significantly lower than those in the control group(P < 0.05). During the treatment,there was no significant difference in the incidence rate of adverse reactions between the two groups(P > 0.05). Conclusion: Xiaoxuming Decoction combined with immunoglobulin on acute Guillian-Barre syndrome can significantly enhance the ability of activities and living of the patients,reduce the degree of nerve function deficit and improve the content of CSF protein.
引文
[1]尹尚鹤林,石坚,张朝跃.格林巴利综合征的相关研究进展[J].医学临床研究,2016,33(2):396-399.
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[12]樊金莲.鞘内注射地塞米松联合静滴大剂量人免疫球蛋白治疗急性格林—巴利综合征的临床研究[J].热带医学杂志,2015,15(4):521-523.
[13]Maddur MS,Rabin M,Hegde P,et al.Intravenous immunoglobulin exerts reciprocal regulation of Th1/Th17 cells and regulatory T cells in Guillain-Barrésyndrome patients[J].Immunol Res,2014,60(2-3):320-329.
[14]殷越,刘玉岩,阿嘎茹.以脏腑辨证治疗痿证的临床经验整理[J].中医药信息,2016,33(2):117-120.
[15]郑爱华,李飞燕,黄义平,等.电针加中药内服结合康复训练治疗格林巴利综合征疗效观察及对功能恢复的影响[J].四川中医,2017,35(3):174-176.
[16]侯晓洁,代二庆.小续命汤治疗格林—巴利综合征临床探讨[J].天津中医药,2017,34(8):548-549.
[17]刘双利,姜程曦,赵岩,等.防风化学成分及其药理作用研究进展[J].中草药,2017,48(10):2146-2152.
[18]杨昕宇,肖长芳,张凯熠,等.麻黄临床应用与药理作用研究进展[J].中华中医药学刊,2015,33(12):2874-2877.
[19]董国菊.赤芍总苷药理作用的研究进展[J].环球中医药,2017,10(9):1057-1060.
[20]许源,宿树兰,王团结,等.桂枝的化学成分与药理活性研究进展[J].中药材,2013,36(4):674-678.
[2]姜颖,赵欢.甲泼尼龙联合丙种球蛋白治疗急性格林巴利综合征的临床效果[J].实用临床医药杂志,2017,21(9):179-180.
[3]石英杰.中医治疗格林—巴利综合征研究进展[J].四川中医,2017,35(6):218-220.
[4]贾建平.神经病学[M].北京:人民卫生出版社,2008:346-348.
[5]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:371-373.
[6]李小峰,陈敏.改良Barthel指数评定量表的设计与应用[J].护理研究,2015,29(13):1657-1658.
[7]全国第4届脑血管并学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[8]侯熙德.格林—巴利综合征的回顾与现状[J].临床神经病学杂志,1994,7(5):307-314.
[9]Grimm A,Décard BF,Schramm A,et al.Ultrasound and electrophysiologic findings in patients with Guillain-Barre syndrome at disease onset and over a period of six months[J].Clin Neurophysiol,2015,127(2):1657-1663.
[10]陈玉,李递通.格林-巴利综合征患者急性期病情严重程度及相关因素分析[J].临床医学,2011,31(8):21-22.
[11]Gunatilake SSC,Gamlath R,Wimalaratna H.An unusual case of recurrent Guillain-Barrésyndrome with normal cerebrospinal fluid protein levels:a case report[J].Bmc Neurol,2016,16(1):161.
[12]樊金莲.鞘内注射地塞米松联合静滴大剂量人免疫球蛋白治疗急性格林—巴利综合征的临床研究[J].热带医学杂志,2015,15(4):521-523.
[13]Maddur MS,Rabin M,Hegde P,et al.Intravenous immunoglobulin exerts reciprocal regulation of Th1/Th17 cells and regulatory T cells in Guillain-Barrésyndrome patients[J].Immunol Res,2014,60(2-3):320-329.
[14]殷越,刘玉岩,阿嘎茹.以脏腑辨证治疗痿证的临床经验整理[J].中医药信息,2016,33(2):117-120.
[15]郑爱华,李飞燕,黄义平,等.电针加中药内服结合康复训练治疗格林巴利综合征疗效观察及对功能恢复的影响[J].四川中医,2017,35(3):174-176.
[16]侯晓洁,代二庆.小续命汤治疗格林—巴利综合征临床探讨[J].天津中医药,2017,34(8):548-549.
[17]刘双利,姜程曦,赵岩,等.防风化学成分及其药理作用研究进展[J].中草药,2017,48(10):2146-2152.
[18]杨昕宇,肖长芳,张凯熠,等.麻黄临床应用与药理作用研究进展[J].中华中医药学刊,2015,33(12):2874-2877.
[19]董国菊.赤芍总苷药理作用的研究进展[J].环球中医药,2017,10(9):1057-1060.
[20]许源,宿树兰,王团结,等.桂枝的化学成分与药理活性研究进展[J].中药材,2013,36(4):674-678.