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补中益气汤对青少年眼肌型重症肌无力患者抗乙酰胆碱受体抗体及临床状态的影响。

Effect of Buzhong Yiqi decoction on anti-acetylcholine receptor antibody and clinical status in juvenile ocular myasthenia gravis.

机构信息

Center of Treatment of Myasthenia Gravis, People's Hospital of Shijiazhuang Affiliated to Hebei Medical University, China.

Gastroenterology Department, People's Hospital of Shijiazhuang Affiliated to Hebei Medical University, China.

出版信息

Medicine (Baltimore). 2021 Nov 5;100(44):e27688. doi: 10.1097/MD.0000000000027688.

Abstract

Ocular myasthenia gravis (MG) is the mainly widespread type of MG among juveniles. Buzhong Yiqi decoction (BZ) is a well-known traditional Chinese medicine prescription for treating MG. It has rarely been discussed whether the concentration of anti-acetylcholine receptor (AChR) antibodies is related to the clinical status of juvenile ocular myasthenia gravis (JOMG) treated with BZ.The patients with JOMG who had more than once AChR-antibody (ab) test and treated with BZ were retrospectively identified from June 2013 to January 2020 in the first hospital in Shijiazhuang. The presence or absence of ocular symptoms was used to grade the effectiveness of treatment. Generalized estimating equations logistic regression analysis was used to evaluate the effect of AChR ab concentration on the clinical status of MG.A total of 549 AChR-ab tests were performed in 135 patients, and the corresponding clinical status was recorded. One hundred two patients received treatment with BZ only and 33 combined with immunosuppressive drugs. In the group receiving only BZ treatment, the anti-acetylcholine receptor ab concentration was positively correlated with the clinical score after treatment.The results suggest that BZ could affect the AChR-ab. Repeated AChR-ab assays can provide information about the clinical status. For JOMG patients who only receive Buzhong Yiqi Decoction treatment, this can support treatment decisions.

摘要

眼肌型重症肌无力(MG)是青少年中最广泛的 MG 类型。补中益气汤(BZ)是一种著名的治疗 MG 的中药方剂。对于接受 BZ 治疗的青少年眼肌型重症肌无力(JOMG)患者,其抗乙酰胆碱受体(AChR)抗体浓度是否与临床状况相关,这很少被讨论。本研究回顾性分析了 2013 年 6 月至 2020 年 1 月在石家庄市第一医院就诊的 JOMG 患者,这些患者均有多次 AChR-ab 检测且接受 BZ 治疗。采用广义估计方程逻辑回归分析评估 AChR ab 浓度对 MG 临床状况的影响。共对 135 例患者的 549 次 AChR-ab 检测进行了检测,并记录了相应的临床状况。102 例患者仅接受 BZ 治疗,33 例患者同时接受免疫抑制剂治疗。在仅接受 BZ 治疗的组中,治疗后抗乙酰胆碱受体 ab 浓度与临床评分呈正相关。结果表明,BZ 可能会影响 AChR-ab。重复进行 AChR-ab 检测可以提供有关临床状况的信息。对于仅接受补中益气汤治疗的 JOMG 患者,这可以支持治疗决策。

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