格林-巴利综合征中西医治疗研究进展

Research Progress in Treatment of Guillain-Barre Syndrome with Chinese and Western Medicine

急性炎症性脱髓鞘性多发性神经病简称格林-巴利综合征(GBS),是一种自身免疫性疾病,主要表现为多数脊神经、周围神经及脑神经损害。其发病率较高,多见于男性,发病机制较为复杂,但具体病因尚不明确。其中,祖国传统医学以口服中药、针灸、推拿为主要治疗方法,其能明显改善患者遗留的肢体功能障碍,减轻GBS对日常生活和工作的影响。而西医治疗以血浆置换和静脉注射免疫球蛋白为主,血浆置换疗法可以缩短疗程和减轻疾病的程度,但易发生输血浆后肝炎,有被安全性较好的血浆吸附疗法所替代的趋势。静脉注射免疫球蛋白疗法应在出现呼吸肌麻痹前尽早实施,但需排除免疫球蛋白过敏或先天性IgA缺乏患者。未来,应进一步寻找高效低毒的治疗手段以提高GBS的治疗效果。

Acute inflammatory demyelinating polyneuropathy is also known as Guillain-Barre syndrome(GBS)is an autoimmune disease,mainly manifested as damage to most spinal nerves,peripheral nerves and cerebral nerves.Its incidence is relatively high,more common in men,the pathogenesis is complex,but the specific etiology is not yet clear.The traditional medicine of the motherland takes oral Chinese medicine,acupuncture and massage as the main treatment methods,which can significantly improve the patient′s remaining limb dysfunction and eliminate the impact of GBS on daily life and work.Western medicine treatment is mainly based on plasma exchange and intravenous immunoglobulin.Plasma exchange therapy can reduce the treatment course and reduce the degree of disease,however,post-transfusion plasma hepatitis is prone to occur,so there is a tendency for it to be replaced by plasma adsorption therapy with a better safety.Intravenous immunoglobulin therapy should be administered as early as possible before respiratory muscle paralysis occurs,but patients with immunoglobulin allergy or congenital IgA deficiency need to be excluded.In the future,we should look for more effective treatment methods with low toxicity to improve the therapeutic effect of GBS.