Hughes R A, Newsom-Davis J M, Perkin G D, Pierce J M
Lancet. 1978 Oct 7;2(8093):750-3. doi: 10.1016/s0140-6736(78)92644-2.
In a multicentre, randomised trial of prednisolone in acute polyneuropathy of undetermined aetiology (Guillain-Barré syndrome), 21 patients were treated with prednisolone (60 mg daily for one week, 40 mg daily for four days, and then 30 mg daily for three days) and 19 did not have steroid treatment. Patients were graded on a six-point scale by one of two neurologists who had no knowledge of the treatment schedule. Reassessment at one, three, and twelve months consistently showed greater improvement in the control than the prednisolone group but the only statistically significant result was in the improvement at three months among patients entered to the trial within a week of onset of illness. The 6 control patients had improved by 2.5 +/- 0.43 grades by three months from entry to the trial whereas the 10 prednisolone patients had only improved by 0.9 +/- 0.46 grades (P less than 0.05). There was 1 death related to the polyneuropathy in each group, and 1 suicide in a control patient during convalescence. 6 prednisolone patients were left with considerable disability compared with 1 control patient. There were 3 relapses in the prednisolone group, but none in the control group. The results indicate that steroid treatment is not beneficial and can be detrimental in acute neuropathy of undetermined aetiology.
在一项关于泼尼松龙治疗病因不明的急性多发性神经病（吉兰 - 巴雷综合征）的多中心随机试验中，21例患者接受泼尼松龙治疗（每日60毫克，共一周；每日40毫克，共四天；然后每日30毫克，共三天），19例患者未接受类固醇治疗。由两位对治疗方案不知情的神经科医生之一按照六点量表对患者进行分级。在1个月、3个月和12个月时的重新评估一致显示，未接受治疗组的改善情况优于泼尼松龙组，但唯一具有统计学意义的结果是在发病一周内进入试验的患者中，3个月时的改善情况。6例未接受治疗的患者从进入试验到3个月时改善了2.5±0.43级，而10例接受泼尼松龙治疗的患者仅改善了0.9±0.46级（P<0.05）。每组均有1例与多发性神经病相关的死亡，1例未接受治疗的患者在康复期间自杀。与1例未接受治疗的患者相比，6例接受泼尼松龙治疗的患者留有相当程度的残疾。泼尼松龙组有3例复发，而未接受治疗组无复发。结果表明，类固醇治疗在病因不明的急性神经病中并无益处，反而可能有害。
