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健脾益气颗粒对采用中药配方制备的儿童眼肌型重症肌无力的影响

Effect of Jianpiyiqi granule on ocular myasthenia gravis in children prepared with a formula from Traditional Chinese Medicine.

作者信息

Qi Guoyan, Liu Peng, Gu Shanshan, Yang Hongxia, Dong Huimin, Xue Yinping

机构信息

Center of Treatment of Myasthenia Gravis, First Hospital of Shijiazhuang, Shijiazhuang 050011, China.

出版信息

J Tradit Chin Med. 2017 Aug;37(4):546-553.

PMID:32188214
Abstract

OBJECTIVE

To investigate the effect of Jianpiyiqi granule, prepared according to a Traditional Chinese Medicine (TCM) formula, on the ocular type of myasthenia gravis (MG) caused by a defect in synaptic transmission at the neuromuscular junction.

METHODS

A total of 155 children with ocular MG were recruited from January 2008 to January 2015. All individuals received ineffective glucocorticoid treatment prior to admission, and were given Jianpiyiqi granules (two doses per day) for 12 months. Plasma levels of acetylcholine receptor autoantibodies (AChR-Ab), cytokines, immune parameters and clinical score were analyzed.

RESULTS

After intervention with Jianpiyiqi granule for 12 months, the levels of cytokines [including interleukin (IL)-6, IL-12, IL-17], immune parameters [including immunoglobulin G (IgG), IgM, free triiodothyronine, free thyroxine] and AChR-Ab were significantly decreased (P = 0.042, P = 0.049, P = 0.011, P = 0.02, P = 0.04, P = 0.03, P = 0.01; F = 21.60, P = 0.000). In contrast, IL-4 levels were significantly increased (P = 0.049). The absolute clinical score after treatment declined significantly compared with before treatment (F = 33.24, P = 0.000). The effective cure rate and the total effective rate gradually increased to a maximum of 149 (96.2%) and 151 (97.4%) in MG patients after 12 months of treatment, respectively.

CONCLUSION

The Jianpiyiqi granule treatment lowered AChR-Ab levels and improved cytokine and other immune parameter levels, which suggests that the granule could be an ancillary treatment for ocular MG in children caused by a defect in synaptic transmission at the neuromuscular junction.

摘要

目的

研究按照中医配方制备的健脾益气颗粒对因神经肌肉接头处突触传递缺陷所致眼肌型重症肌无力(MG)的影响。

方法

2008年1月至2015年1月共招募了155例眼肌型MG患儿。所有个体在入院前接受无效的糖皮质激素治疗,并给予健脾益气颗粒(每日2剂),持续12个月。分析血浆乙酰胆碱受体自身抗体(AChR-Ab)水平、细胞因子、免疫参数和临床评分。

结果

健脾益气颗粒干预12个月后,细胞因子[包括白细胞介素(IL)-6、IL-12、IL-17]、免疫参数[包括免疫球蛋白G(IgG)、IgM、游离三碘甲状腺原氨酸、游离甲状腺素]和AChR-Ab水平均显著降低(P = 0.042、P = 0.049、P = 0.011、P = 0.02、P = 0.04、P = 0.03、P = 0.01;F = 21.60,P = 0.000)。相比之下,IL-4水平显著升高(P = 0.049)。治疗后的绝对临床评分与治疗前相比显著下降(F = 33.24,P = 0.000)。治疗12个月后,MG患者的有效治愈率和总有效率分别逐渐升至最高,达149例(96.2%)和151例(97.4%)。

结论

健脾益气颗粒治疗降低了AChR-Ab水平,改善了细胞因子和其他免疫参数水平,这表明该颗粒可能是神经肌肉接头处突触传递缺陷所致儿童眼肌型MG的辅助治疗药物。

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