目的 探討黃芪注射液聯(lián)合甲潑尼龍治療多發(fā)性硬化癥的臨床療效。方法 選取2014年6月-2015年8月在綿陽(yáng)市第三人民醫(yī)院神經(jīng)內(nèi)科住院治療的多發(fā)性硬化癥患者78例,隨機(jī)分為對(duì)照組和治療組,每組各39例。對(duì)照組靜脈滴注注射用甲潑尼龍琥珀酸鈉,1.0 g/次加入生理鹽水500 mL,1次/d,連續(xù)用藥5 d后改為口服醋酸潑尼松片,60 mg/次,1次/d,1周后逐漸減量,每5天減10 mg,直至完全停用。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注黃芪注射液,30 mL加入5%葡萄糖溶液250 mL,1次/d。兩組患者均連續(xù)治療6周。觀察兩組的臨床療效,同時(shí)比較治療前后兩組Kurtzke擴(kuò)展致殘量表(EDSS)評(píng)分、外周血單核細(xì)胞(PBMC)平均刺激指數(shù)(SI)、IL-23、IL-17的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為74.36%、92.31%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者EDSS評(píng)分、SI值、IL-23、IL-17均較治療前明顯降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 黃芪注射液聯(lián)合甲潑尼龍治療多發(fā)性硬化癥具有較好的臨床療效,可降低血清中IL-23、IL-17水平,并能抑制PBMC增殖活化,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Huangqi Injection combined with methylprednisolone in treatment of multiple sclerosis.Methods Patients (78 cases) with multiple sclerosis in Department of Neurology of the Third Hospital of Mianyang from June 2014 to August 2015 were randomly divided into control (n= 39 ) and treatment (n= 39 ) groups. The patients in the control group were ivadministered with Methylprednisolone Sodium Succinate for injection, 1.0 g added into normal saline 500 mL, once daily. And they were poadministered with Prednisone Acetate Tablets after 5 d, 60 mg/time, once daily. The dosage of Prednisone Acetate Tablets was gradually reduced after one week, minus 10 mg every five days until completely stopped. The patients in the treatment group were ivadministered with Huangqi Injection on the basis of the control group, 30 mL added into 5% glucose solution 250 mL, once daily. The patients in two groups were treated for six weeks. After treatment, the efficacy was evaluated, and the changes of EDSS scores, SI of PBMC, IL-23, and IL-17 in two groups before and after treatment were compared.Results After treatment, the efficacies in the control and treatment groups were 74.36% and 92.31%, respectively, and there were differences between two groups (P < 0.05). After treatment, EDSS scores, SI, IL-23, and IL-17 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05).Conclusion Huangqi Injection combined with methylprednisolone has clinical curative effect in treatment of multiple sclerosis, and can decrease the serum level of IL-23, IL-17, also can inhibit the proliferation and activation of PBMC, which has a certain clinical application value.