本文選題：重癥肌無(wú)力 + 脾腎虧虛證�。� 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:評(píng)價(jià)復(fù)方黃杞顆粒治療脾腎虧虛型Ⅰ、Ⅱ型重癥肌無(wú)力的臨床療效。材料與方法:選取確診為脾腎兩虛型Ⅰ、Ⅱ型重癥肌無(wú)力的患者60例,均系2014年3月至2015年3月在遼寧中醫(yī)藥大學(xué)附屬醫(yī)院門(mén)診就診的患者。年齡在14-75歲之間,男性25例,女性35例。其中Ⅰ型重癥肌無(wú)力患者19例,IIA型MG患者23例,IIB型MG患者18例。病程3-48個(gè)月。采用隨機(jī)數(shù)字表法將所選患者按1:1分組,分為治療組30例和對(duì)照組30例。治療組給予復(fù)方黃杞顆粒+溴吡斯的明,對(duì)照組給予安慰劑+溴吡斯的明。療程36周,分別于4周、8周、12周、36周觀察兩組患者總的臨床絕對(duì)評(píng)分、中醫(yī)癥狀總分及中醫(yī)主癥評(píng)分變化情況,并且觀察兩組患者的中西醫(yī)臨床療效。對(duì)數(shù)據(jù)的統(tǒng)計(jì)分析應(yīng)用spss17.0軟件。計(jì)量資料用均數(shù)±標(biāo)準(zhǔn)差表示,首先對(duì)數(shù)據(jù)進(jìn)行正態(tài)分布檢驗(yàn),符合正態(tài)分布者進(jìn)行t檢驗(yàn),不符合正態(tài)分布者進(jìn)行秩和檢驗(yàn):計(jì)數(shù)資料進(jìn)行卡方檢驗(yàn);若P0.05,有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.臨床絕對(duì)評(píng)分總分:入組及治療4周(4w)時(shí)兩組間臨床絕對(duì)評(píng)分,經(jīng)t檢驗(yàn),組間P值0.05,無(wú)組間差異;治療8w、12w、36W時(shí),治療組臨床絕對(duì)評(píng)分低于對(duì)照組,組間P值0.05,組間有統(tǒng)計(jì)意義,差異顯著。兩組組內(nèi)在不同時(shí)間點(diǎn)比較,治療組從4周開(kāi)始、8周、12周、36周分別與0周比較p0.05,有統(tǒng)計(jì)學(xué)差異。對(duì)照組12周、36周與0周比較p0.05,有統(tǒng)計(jì)學(xué)差異。2.(1)兩組不同訪視時(shí)間中醫(yī)癥狀總分變化情況比較:兩組間不同訪視時(shí)間中醫(yī)癥狀總分在0周時(shí)、4周時(shí)兩組比較:p0.05,無(wú)顯著差異;治療8w、12w、36W時(shí),治療組中醫(yī)癥狀總分低于對(duì)照組,組間P值0.05,組間有統(tǒng)計(jì)意義,差異顯著。兩組組內(nèi)在不同時(shí)間點(diǎn)比較,治療組從4周開(kāi)始、8周、12周、36周分別與0周比較p0.05,有統(tǒng)計(jì)學(xué)差異。對(duì)照組12周、36周與0周比較p0.05,有統(tǒng)計(jì)學(xué)差異。(2)兩組不同訪視時(shí)中醫(yī)主癥評(píng)分變化情況比較:兩組在0周時(shí)、4周時(shí)兩組比較:p0.05,無(wú)顯著差異,8周、12周、36周隨訪期兩組比較p0.05,兩組有顯著差異。兩組組內(nèi)在不同時(shí)間點(diǎn)比較,治療組從4周開(kāi)始、8周、12周、36周與0周比較時(shí)p0.05,有統(tǒng)計(jì)學(xué)差異;對(duì)照組僅在12周、36周與0周比較時(shí)p0.05,有統(tǒng)計(jì)學(xué)意義。3(1)西醫(yī)臨床療效:痊愈:治療組0例(0%)、對(duì)照組為0例(0%);基本痊愈:治療組0例(0%)、對(duì)照組為0例(0%);顯效:治療組為11例(36.67%)、對(duì)照組為3例(10%);好轉(zhuǎn):治療組為15例(50%)、對(duì)照組為5例(16.67%);無(wú)效:治療組為4例(13.33%),對(duì)照組為22例(73.33%)。(2)中醫(yī)臨床療效:臨床控制:治療組1例(3.33%)、對(duì)照組為0例(0%);顯效:治療組為9例(30%)、對(duì)照組為2例(6.67%);有效:治療組為16例(53.34%)、對(duì)照組為4例(13.33%);無(wú)效:治療組為4例(13.33%),對(duì)照組為24例(80%)。結(jié)論:復(fù)方黃杞顆粒能夠明顯改善脾腎虧虛型Ⅰ、II型重癥肌無(wú)力患者的臨床癥狀,療效顯著。復(fù)方黃杞顆粒為防治重癥肌無(wú)力提供了新方法,具有更進(jìn)一步臨床推廣價(jià)值。
[Abstract]:Objective: To evaluate the clinical efficacy of compound Huang Qi granule in the treatment of spleen and kidney deficiency type I and type II myasthenia gravis. Materials and methods: 60 patients with two deficiency of spleen and kidney type I and type II myasthenia gravis were selected from March 2014 to March 2015 in the outpatient clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. The age was between 14-75 years and male 2. There were 5 cases and 35 women. Among them, 19 cases of myasthenia gravis, 23 cases of type IIA MG, 18 cases of type IIB MG. The course of disease was 3-48 months. The selected patients were divided into 30 cases in the treatment group and 30 cases in the control group by random digital table method. The treatment group was given the compound yellow Qi granule + bropipidus, and the control group was given placebo + bropiopyx therapy. After 36 weeks, the total clinical absolute score of the two groups was observed in the 4 weeks, 8 weeks, 12 weeks and 36 weeks respectively. The total scores of TCM symptoms and the main symptoms of traditional Chinese medicine were observed, and the clinical curative effect of Chinese and Western medicine in two groups of patients was observed. The statistical analysis of the data was applied to SPSS17.0 software. Cloth test, the normal distribution of t test, do not conform to the normal distribution of the rank sum test: count data for chi square test; if P0.05, there is statistical significance. Results: 1. clinical absolute score total score: the group and the treatment of 4 weeks (4W) between two groups of clinical absolute score, t test, the group P value 0.05, no difference between groups; the treatment of 8W, 12W, 36W, The clinical absolute score of the treatment group was lower than the control group, the P value between the groups was 0.05, the group had statistical significance, and the difference was significant. The two groups were compared with the 4 weeks, 8 weeks, 12 weeks, 36 weeks and 0 weeks respectively, compared with the 0 weeks. The control group was 12 weeks, 36 weeks and 0 weeks compared with the 0 weeks, and there were statistically different.2. (1) two group visits different visits. The total score of TCM symptoms was compared: the total score of traditional Chinese medicine symptoms in the two groups was 0 weeks, and the two groups were compared in 4 weeks. There was no significant difference between the two groups. When the treatment group was treated with 8W, 12W, 36W, the total score of TCM symptoms was lower than the control group, and the P value between the groups was 0.05. The difference was significant between the groups. The two groups were compared with the treatment group at different time points. The treatment group was compared with the treatment group. From the 4 weeks, 8 weeks, 12 weeks and 36 weeks compared with the 0 weeks, there were statistical differences. The control group was 12 weeks, 36 weeks and 0 weeks compared with the statistical difference. (2) the two groups of different visits of traditional Chinese medicine score changes when compared: two groups at 0 weeks, 4 weeks in the group comparison: P0.05, no significant difference, week, week, weekly follow-up period compared P0.05, 36 weeks, P0.05 week, weekly follow-up period comparison group P0.05, 36 weeks, peripheral follow-up period comparison group compared P0.05, dialectical week In the two groups, the two groups were compared at different time points. The treatment group started from 4 weeks, 8 weeks, 12 weeks, 36 weeks and 0 weeks, with statistical difference. The control group was only 12 weeks, 36 weeks and 0 weeks compared with P0.05, there were statistically significant.3 (1) clinical curative effect of Western medicine: cure group 0 (0%), and the control group for 0 cases (0%); basic recovery: treatment group cases (treatment group) 0%) the control group was 0 cases (0%), the treatment group was 11 cases (36.67%), the control group was 3 (10%), the treatment group was 15 cases (50%), the control group was 5 (16.67%); the treatment group was 4 cases (13.33%), the control group was clinically effective: clinical control: the treatment group, the control group, the treatment group as the cases, The control group was 2 (6.67%), effective: the treatment group was 16 cases (53.34%) and the control group was 4 (13.33%); the treatment group was 4 cases (13.33%) and the control group was 24 (80%). Conclusion: the compound Huang Qi granule can obviously improve the clinical symptoms of the spleen and kidney deficiency type I, II type myasthenia gravis, and the effect is significant. The new method is worthy of further clinical popularization.

【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R277.7

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