复方黄杞汤加减治疗儿童眼肌型重症肌无力回顾性分析

Retrospective Study on the Treatment of Pediatric Ocular Myasthenia Gravis with Modified Compound Huangqi Decoction

目的观察复方黄杞汤加减治疗儿童眼肌型重症肌无力(OMG)患者临床疗效、减停西药与病情反复情况。方法选取2020年1月一2022年1月就诊于辽宁中医药大学附属医院重症肌无力门诊服用复方黄杞汤加减治疗的OMG患儿,共纳入25例符合标准的病例。13例口服中药联合溴吡斯的明片治疗,12例口服中药联合溴吡斯的明片与醋酸泼尼松治疗,收集患儿首诊、服用中药后西药减量至50%、完全停用西药(均为减停1种西药即可)3个时间点的临床绝对评分,评价患者总体临床疗效及西药减停情况,统计其病情反复情况。结果25例患儿首诊、西药减至50%、停西药每阶段临床绝对评分均较前一阶段下降一半;服药3个月时溴吡斯的明片与醋酸泼尼松片用量显著减少,均减至原剂量50%;25例可全部停服溴吡斯的明片,7例停服醋酸泼尼松片;25例患儿临床总有效率为96%,其中11例可达临床痊愈;治疗5年间有4例患儿病情反复,大多与自行停中药、间断服药或感冒有关。结论服用复方黄杞汤加减治疗OMG患儿能明显改善临床症状,可有效地减停基础西药,减少病情反复的发生,提高患儿生活质量。

Objective To observe the clinical efficacy of compound Huangqi Decoction(复方黄杞汤)in treating children with ocular myasthenia gravis(OMG)and to observe the reduction and withdrawal of western medicine and the recurrence of the dis-ease.Methods From January 2020 to January 2022,children with OMG who were treated with compound Huangqi decoction plus or minus in the clinic of Myasthenia gravis,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected.A total of 25 cases were included.Thirteen patients were treated with oral Chinese medicine combined with brompirimin tablets,and 12 patients were treated with prednisone acetate on this basis.The absolute clinical scores of the children were collected at three time points:the first diagnosis,the reduction of the dose of western medicine to half after taking traditional Chinese medicine,and the complete withdrawal of western medicine(all of which were only one western medicine reduction).Evaluate the overall clinical efficacy of patients and the situation of western medicine withdrawal,and count the recurrence of their conditions.Result In 25 chil-dren,the absolute clinical scores of the first diagnosis,the reduction of western medicine to half,and the withdrawal of western medicine in each stage decreased by one times compared with the previous stage.The dosage of bromopyridamole and prednisone acetate tablets was significantly reduced to half of the original dosage after 3 months of administration.25 cases could stop taking bropirimin tablets and 7 cases stopped taking prednisone acetate tablets,the total clinical effective rate of 25 cases was 96%,and 11 cases were clinically cured,during the 5 years of treatment,there were 4 children with recurrent illness,most of which were related to stopping traditional Chinese medicine,taking medicine intermttently,or catching a cold.Conclusion Compound Huangqi decoc-tion in the treatment of OMG children can significantly improve the clinical symptoms,effectively reduce the stop of basic western medicine,reduce the recurrence of the disease,and improve the quality of life of children.