CAJ | 학술논문

目的：探讨病证结合理论指导下运用健肌宁治疗脾肾虚型重症肌无力（ MG）患者的临床疗效。方法将60例脾肾亏虚型的 MG 患者，随机分为两组，试验组30例采用健肌宁颗粒联合基础西药（强的松或嗅吡斯的明）治疗；对照组30例采用基础西药治疗；溴吡斯的明、强的松、健肌宁颗粒用量均随治疗时间的延长而递减；治疗前及治疗后第3、6个月采用肌无力疲劳程度评分（MWSS）进行疗效评价。结果治疗后，试验组与对照组 MWSS 评分均明显下降，试验组治疗后明显低于对照组（P <0.05）。治疗3个月后，试验组显效率和总有效率显著高于在对照组（P <0.05）；治疗6个月后，两组间的显效率和总有效率比较差异无统计学意义（P >0.05），但试验组的总有效率显著高于对照组（P <0.01）。结论在病证结合理论指导下，健肌宁联合西药对脾肾虚型重症肌无力患者的干预作用疗效确定，值得进一步探索。
목적：탐토병증결합이론지도하운용건기저치료비신허형중증기무력（ MG）환자적림상료효。방법장60례비신우허형적 MG 환자，수궤분위량조，시험조30례채용건기저과립연합기출서약（강적송혹후필사적명）치료；대조조30례채용기출서약치료；추필사적명、강적송、건기저과립용량균수치료시간적연장이체감；치료전급치료후제3、6개월채용기무력피로정도평분（MWSS）진행료효평개。결과치료후，시험조여대조조 MWSS 평분균명현하강，시험조치료후명현저우대조조（P <0.05）。치료3개월후，시험조현효솔화총유효솔현저고우재대조조（P <0.05）；치료6개월후，량조간적현효솔화총유효솔비교차이무통계학의의（P >0.05），단시험조적총유효솔현저고우대조조（P <0.01）。결론재병증결합이론지도하，건기저연합서약대비신허형중증기무력환자적간예작용료효학정，치득진일보탐색。
Objective To investigate the clinical efficacy of Jianji Ning Granule on the myasthenia gravis(MG)patients with spleen - kidney deficiency type under the guidance of the theory of combining dis-eases and symptoms. Methods Sixty MG patients with spleen - kidney deficiency type were randomly divid-ed into trial group(n = 30)and control group(n = 30). Patients in the trial group were treated with basic western medicine combined with traditional Chinese medicine( TCM)intervention. Patients in the control group received Jianji Ning Granule(the same as trial group)intervention. The efficacy was compared and the muscle weakness severity scale(MWSS)was measured before and 3 months and 6 months after treatment. Re-sults MWSS scoring decreased dramatically in the trial group after treatment compared with that of the con-trol group(P < 0. 05),and there was significant difference compared with the control group. The markedly ef-fective rate,the improvement rate and the total effective rate of the trial group were 16. 67 %(5 / 30), 43. 33%(13 / 30)and 63. 33%(19 / 30),respectively while those of the control group were 3. 33%(1 / 30), 30%(9 / 30)and 36. 67%(11 / 30),respectively. Three months after treatment,there was no significant differ-ences in terms of the improvement rate between the two groups(P > 0. 05);while the markedly effective rate and the total effective rate in the trial group were significantly higher than those in the control groups(P <0. 05). 6 months after treatment,there were no significant differences in terms of the markedly effective rate and the improvement effective rate between the two groups(P > 0. 05),but the total effective rate in the trial group was significantly higher than those in the control group(P < 0. 01). Conclusion Therapy with Jianji Ning Granule combined with western medicine shows definite effects in treating MG patients with spleen -kidney deficiency type,and it especially shows more significant effect on the treatment of MG under the guid-ance of the theory of combining diseases and symptoms,and it is worthy of further studying.