温肾健脑经验方治疗多系统萎缩的临床疗效观察

Observation of clinical effect of Wenshen Jiannao Formula in multiple system atrophy

目的:本研究旨在观察多系统萎缩(MSA)温肾健脑经验方治疗前后的临床疗效。方法:收集治疗前及温肾健脑经验方加减治疗后12个月MSA患者统一多系统萎缩评估量表(UMSARS)评分,整体失能等级,病情进展程度(评分/病程);非运动症状如尿失禁评分、夜尿次数、导尿次数,直立性血压数值;患者主诉改善症状及改善率。观察时点包括15d及1、3、6、12个月,并在中药治疗后24、36、48个月随访。结果:共105例MSA患者,中药治疗在15d^(-1)个月后开始显效,治疗12个月时疾病严重程度无明显进展,24、36、45个月时仍未见明显增长趋势,主要体现在非运动症状的改善。36例MSA患者(数据缺失)尿失禁及夜尿症状初期改善明显,后期效果欠佳,直立性低血压或晕厥疗效显著(治疗后6个月收缩压差,P=0.026;舒张压差,P=0.050)。结论:温肾健脑经验方加减治疗可以较有效延缓MSA患者疾病进展(至少52.5%),以非运动症状改善为主,其中,直立性低血压效果最佳。

Objective: To observe the effects of Wenshen Jiannao Formula in multiple system atrophy(MSA). Methods: MSA patients were assessed by unified multiple system atrophy rating scale(UMSARS) before treatment and 12 months after treatment of the traditional remedies. The progression(score of UMSARS/course), and patient-report improved symptoms were also evaluated. They were observed at 1/2, 1, 3, 6, 12 months after the treatment, additionally 24, 36, 45 months as follow-up observations. Results: The progression of MSA was not increased until 1/2 to 1 month, and there was no significant improvement in the 12 th months after traditional remedies treatment, so did 24 months, 36 months, and 45 months follow-up observations, mainly on the improvement of non-motor symptoms. Especially orthostatic hypotension were alleviated significantly(blood pressure value of 36 patients before treatment compared with that after 6 months, P=0.026, P=0.050). Conclusion: Traditional remedies mostly slowed down the progression of MSA(at least 52.5%), mainly on non-motor symptoms, and the orthostatic hypotension are specifically alleviated significantly.