强力益气方治疗重症肌无力的疗效及声学评价
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摘要
目的研究强力益气方治疗重症肌无力(Myasthenia gravis,MG)的疗效及计算机声学评价。方法将80例脾气虚型重症肌无力(MG)患者,分为MG构音障碍组40例,MG非构音障碍组40例,每组又分为男女两小组,每小组20例。均采用强力益气方加减治疗,疗程6周。另设健康嗓音对照组男女各20例。治疗前后分别选用绝对评分量表、脾气虚型中医症候量表、计算机声学检测包括基频微扰(jitter)、振幅微扰(shimmer)、F0标准差和标准声门噪声能量(NNE),对疗效进行量化比较及疗效评定。结果构音障碍组总有效率85.00%,与治疗前比较,F0标准差、shimmer和NNE值均降低,差异有统计学意义(P<0.05,P<0.01)。非构音障碍组总有效率95.00%。声学检测无明显变化。结论强力益气方治疗MG构音障碍患者疗效确切。声学评定方法用于评价重症肌无力构音障碍的诊断和疗效评价具有临床意义。
Objective To study the efficacy of qiangli yiqi formula on myasthenia gravis(MG) and computer acoustic evaluation.Methods Eighty patients of MG of spleen qi deficiency type were divided into a dysarthria group(40 cases) and a non-dysarthria group(40 cases).Each group was subdivided into a male group and a female group,20 cases in each one.The modified qiangli yiqi formula was adopted and the duration of treatment was 6 weeks.Additionally,the healthy voice control subgroups were set up,for males and females separately,20 cases in each one.The absolute score scale,TCM spleen deficiency scale and computer acoustic detection including jitter,shimmer,F0 SD and NNE were selected for the quantitative comparison of efficacy and efficacy assessment before and after treatment separately.Results The total effective rate was85.00% in the dysarthria group.The differences in F0 SD,shimmer and NNE were significant as compared with those before treatment(P < 0.05,P < 0.01).The total effective rate was 95.00% in the non-dysarthria group.The difference in acoustic detection was not apparent.Conclusion Qiangli yiqi formula achieves the definite efficacy on dysarthria in MG patients.The acoustic evaluation method is significant clinically in the diagnosis and efficacy evaluation on MG dysarthria.
Objective To study the efficacy of qiangli yiqi formula on myasthenia gravis(MG) and computer acoustic evaluation.Methods Eighty patients of MG of spleen qi deficiency type were divided into a dysarthria group(40 cases) and a non-dysarthria group(40 cases).Each group was subdivided into a male group and a female group,20 cases in each one.The modified qiangli yiqi formula was adopted and the duration of treatment was 6 weeks.Additionally,the healthy voice control subgroups were set up,for males and females separately,20 cases in each one.The absolute score scale,TCM spleen deficiency scale and computer acoustic detection including jitter,shimmer,F0 SD and NNE were selected for the quantitative comparison of efficacy and efficacy assessment before and after treatment separately.Results The total effective rate was85.00% in the dysarthria group.The differences in F0 SD,shimmer and NNE were significant as compared with those before treatment(P < 0.05,P < 0.01).The total effective rate was 95.00% in the non-dysarthria group.The difference in acoustic detection was not apparent.Conclusion Qiangli yiqi formula achieves the definite efficacy on dysarthria in MG patients.The acoustic evaluation method is significant clinically in the diagnosis and efficacy evaluation on MG dysarthria.
引文
[1]王维治.神经病学[M].4版.北京:人民卫生出版社,2001:282-289.
[2]盛昭园,陈钢,董云,等,李庚和重症肌无力诊治经验[J].辽宁中医杂志,2013,40(6):1084-1085.
[3]盛昭园.李庚和教授治疗神经肌肉疾病学术思想探讨[J]中医药通报,2012,11(6):30-34.
[4]孙文海,刘华敏,梁大鹏,等.以发声困难为首发症状的重症肌无力患者的临床特点[J].中华耳鼻咽喉头颈外科杂志,2006,41(9):644-647.
[5]许贤豪.肌无力一临床与基础[M].北京:中国协和医科大学出版社,2003.
[6]Alfred J,Richard JB,Raina ME,et al.Myasthenia gravis:recommendations for clinical research standards Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of Amenca[J].Ann Thorac Surg,2000,70(1):327-334.
[7]林馨,柴秀娟.肺气虚患者发声功能的声学分析[J].中华中医药杂志(原中国医药学),2010,25(7):1133-1135.
[8]郑筱萸.中药新药临床研究指导原则[J].中国中医药科技出版社,2002,5(1):362.
[9]Kluin KJ,Bromberg MB,Feldman EL,et al.Dysphagia in eldedy men with myasthenia gravis[J].J Neurol Sci,1996,138:49-52.
[10]侯丽珍,徐文,韩德民,等.重症肌无力的咽喉部临床特点[J].中华耳鼻咽喉头颈外科杂志,2007,42(4):263-267.
[11]Toth L,Pap U,Dioszeghy P,et al.Phoniatric studies in myasthenia gravis patients[J].HNO,1999,47:981-985.
[12]孙文海,刘华敏,万秀民,等.重症肌无力患者发声功能的检测[J].临床耳鼻咽喉科杂志,2005,19(15):685-687.
[13]刘卫彬.以声带麻痹为突出表现的重症肌无力七例[J].中华医学杂志,2006,86(25):1778-1780.
[2]盛昭园,陈钢,董云,等,李庚和重症肌无力诊治经验[J].辽宁中医杂志,2013,40(6):1084-1085.
[3]盛昭园.李庚和教授治疗神经肌肉疾病学术思想探讨[J]中医药通报,2012,11(6):30-34.
[4]孙文海,刘华敏,梁大鹏,等.以发声困难为首发症状的重症肌无力患者的临床特点[J].中华耳鼻咽喉头颈外科杂志,2006,41(9):644-647.
[5]许贤豪.肌无力一临床与基础[M].北京:中国协和医科大学出版社,2003.
[6]Alfred J,Richard JB,Raina ME,et al.Myasthenia gravis:recommendations for clinical research standards Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of Amenca[J].Ann Thorac Surg,2000,70(1):327-334.
[7]林馨,柴秀娟.肺气虚患者发声功能的声学分析[J].中华中医药杂志(原中国医药学),2010,25(7):1133-1135.
[8]郑筱萸.中药新药临床研究指导原则[J].中国中医药科技出版社,2002,5(1):362.
[9]Kluin KJ,Bromberg MB,Feldman EL,et al.Dysphagia in eldedy men with myasthenia gravis[J].J Neurol Sci,1996,138:49-52.
[10]侯丽珍,徐文,韩德民,等.重症肌无力的咽喉部临床特点[J].中华耳鼻咽喉头颈外科杂志,2007,42(4):263-267.
[11]Toth L,Pap U,Dioszeghy P,et al.Phoniatric studies in myasthenia gravis patients[J].HNO,1999,47:981-985.
[12]孙文海,刘华敏,万秀民,等.重症肌无力患者发声功能的检测[J].临床耳鼻咽喉科杂志,2005,19(15):685-687.
[13]刘卫彬.以声带麻痹为突出表现的重症肌无力七例[J].中华医学杂志,2006,86(25):1778-1780.