Domzał T, Zalewska B
Klinika Neurologiczna CSK WAM ul. Szaserów, Warszawa.
Neurol Neurochir Pol. 1992 Sep-Oct;26(5):621-5.
Corticosteroids have a firm place in the treatment of ms, but as yet no generally accepted regimen of this therapy exists. It is not known either, how to achieve the greatest effectiveness of these drugs and avoid side effects. Many clinicians advocate high intravenous doses of methylprednisolone in a short time of 5-7 days. This method is more effective and leads to less adverse effects. The studied patients received prednisone (Encorton Polfa) in short course of 3 days every month. The dose of Encorton in each course depended on the clinical condition but never exceeded 200 mg. The regimen was used in 18 patients who were followed up at least one year. Evident improvement or stabilization was obtained in 11 cases. No adverse effects were noted. These results are comparable to those achieved with methylprednisolone. It may be supposed that every regimen of corticoid treatment in ms is usefull if it causes no adverse effects. The treatment by method of long-term pulse therapy with corticoids is applicable in outpatients.
皮质类固醇在多发性硬化症的治疗中占有稳固地位,但目前尚无普遍接受的该疗法方案。也不清楚如何实现这些药物的最大疗效并避免副作用。许多临床医生主张在5至7天的短时间内静脉注射高剂量甲基泼尼松龙。这种方法更有效且副作用更少。研究中的患者每月接受为期3天的短期泼尼松(恩考松,波拉制药)治疗。每个疗程中恩考松的剂量取决于临床状况,但从未超过200毫克。该方案用于18例患者,对其进行了至少一年的随访。11例患者病情明显改善或稳定。未观察到不良反应。这些结果与使用甲基泼尼松龙所取得的结果相当。可以推测,如果皮质类固醇治疗方案不产生不良反应,那么在多发性硬化症中任何皮质类固醇治疗方案都是有用的。长期脉冲式皮质类固醇治疗方法适用于门诊患者。