泼尼松联合桂龙通络胶囊治疗慢性炎性脱髓鞘性多发神经病的临床疗效

Therapeutic effect of prednisone and Guilongtongluo capsules on chronic inflammatory demyelinating polyneuropathy

目的观察泼尼松联合桂龙通络胶囊治疗慢性炎性脱髓鞘性多发神经病患者的临床疗效。方法选取2012年1月—2015年2月大连大学附属新华医院神经内科诊治慢性炎性脱髓鞘性多发神经病患者76例,按照随机数字表法分为对照组(给予泼尼松片15 mg/d)与观察组(给予泼尼松片15 mg/d+桂龙通络胶囊6粒/次,3次/d)各38例。观察2组临床疗效,治疗前、后上肢近端及远端、下肢近端及远端肌力情况;采用肌电图仪/诱发电位仪检测2组患者治疗前、后尺神经、腓总神经的运动神经传导速度(MCV)、末端潜伏期(ML)及感觉神经传导速度(SCV)情况;评价治疗前、后运动功能及感觉功能,采用Barthel指数评价患者日常生活能力(ADL)变化,记录治疗期间不良反应。结果观察组总有效率显著高于对照组(92.11%vs.68.42%,x^2=6.79,P=0.03)。治疗后2组患者上肢近端及远端、下肢近端及远端肌力明显高于治疗前(t时=9.76、6.99、7.85、4.69,P<0.01;t_观=8.36、7.82、8.02、5.82,P<0.01),且观察组高于对照组(t=11.02、10.22、6.68、11.14,P<0.01)。2组患者尺神经及腓总神经MCV、SCV高于治疗前,尺神经及腓总神经ML明显低于治疗前,而观察组MCV、SCV高于对照组,ML低于对照组(t=6.17、7.77、7.98、6.51、4.96、7.18,P<0.01)。2组患者运动功能及感觉功能分级低于治疗前,而观察组治疗后各项指标分级低于对照组(t=9.36、6.72,P<0.01)。2组患者治疗后ADL评分明显高于治疗前(t=4.36,5.24,P<0.05),观察组治疗后ADL评分明显高于对照组(t=9.66,P<0.01);2组治疗期间无明显不良反应发生。结论采用泼尼松联合桂龙通络胶囊治疗慢性炎性脱髓鞘性多发神经病疗效显著,安全性好。

Objective To explore the clinical effect of prednisone combined with Guilongtongluo capsules in the treatment of chronic inflammatory demyelinaliug polyneuropathy.Methods A total of 76 cases from January 2012 to February2015 in Dalian University Affiliated Xinhua Hospital which were diagnosed and received the treatment of chronic inflammatory demyelinating polyneuropathy patients were randomly divided into control group（given prednisone tablets 15 mg/d） and observation group（given prednisone tablets 15 mg/d ＋ Guilongtongluo capsules 6 pills / time,3 times /d） with 38 cases in each group.The clinical efficacy of the 2 groups before and after treatment of upper limb distal and proximal,distal and proximal lower limb muscle strength were observed;the EMG / evoked potential were examined in 2 groups of patients before and after treatment of ulnar nerve,common peroneal nerve motor nerve conduction velocity（MCV）,distal latency（ML） and sensory nerve conduction velocity（SCV） were evaluated before and after treatment,the motor function and sensory function,the evaluation of the ability of daily file of patients with Barthel index（ADL） changes and adverse reactions during treatment were compared.Results The total efficiency of the observation group was significantly higher than the control group（92.11%vs.68.42%,χ^2=6.79,P =0.03）.Alter treatment,2 groups of patients with upper limb distal and proximal,distal and proximal lower limb muscle strength was significantly higher than before treatment（Control group;t=9.76,t=6.99,t=7.85,t=4.69,P〈0.01,observation group：t=8.36,t=7.82,t = 8.02,t=5.82,P〈0.01）.and the observation group was higher than that of the control group（t =11.02,t=10.22,t=6.68,t=11.14,P〈0.01）.2 groups of patients with ulnar nerve and common peroneal nerve MCV,SCV higher than that before treatment,ulnar nerve and peroneal nerve ML was significantly lower than that before treatment,and the observation group MCV,SCV higher than the control group,ML was lower than the control group（t = 6.17,t =7.77,t =7.98,t =6.51,t =4.96,t =7.18,P〈0.01）.The scores of motor function and sensory function of the 2 groups were lower than those before treatment,while the scores of the observation group after treatment were lower than those of the control group（t =9.36,t= 6.72,P〈0.01）.2 groups of patients after treatment ADL score was significantly higher than before treatment（t =4.36,t =5.24,P〈0.05）,the observation group after treatment ADL score was significantly higher than that of the control group（t =9.66,P〈0.01）;2 groups had no significant adverse reactions during treatment.Conclusion Prednisone combined with Guilongtongluo capsules in the treatment of chronic inflammatory demyelinating polyneuropathy has a significant effect and safety.