| Objective: Polymyositis (PM) and Dermatomyositis (DM) that are harmful to people's health are immunity diseases. And PM implicates the whole skelecton muscle , which involves skin is called DM .In clinics the siagnoses for this disease contain the typical tetter, the end muscle incapacity, the increase of serum enzyme, electromyogram shift, the change of immunity mark and pathology shift. PM/DM in the flaccidity of TCM, the researches of which the past medicine investigators constantly reinforced and consummated that formed the whole diagnosis and treatment system relatively. The TCM which depent on clinic system was short of external standard. In 58 patients with PM/DM ,we use the way that combined TCM with west -ern medicine to summarize the distributing rules of the invest-igation and analyse among the stage , label, laboratory exami-ne and TCM symptomatology. The impersonal data and labor-atory can be helpful to clinic treatment , which make the categ-orical identification in terms of TCM more imporsonal and more intnitionnistic. Methods: In 58 patients with PM/DM, we classified the period of manipulative disease and the emergency state of the disease , and labelled the severe degree of the disease, choosing the 58 patients who did not use the hormone at the first diagnoses for 5 monthes , testing the seroiogic zymogram. ( CK, CK-MB, AST, CDH, HBDH). After the state of the illness straightened, counterchecking the seroiogic zymogram. Then choosing 35 patients who didn't use the hormone test the immunoglobulin (IgG,IgA, IgM) and complement (C3,C4), the electromyogra-phy of 44 patients , the skin and muscle biopsy of 26. Before all the examinations, categorical identification in terms of TCM adapted the standard of <> compiled by Zhuwenfeng. The analysis of all the materials used the spss11.5 stat software, with the statistics difference of P < 0.05. Results: 1 the result of stage and label 1.1 the stage: 35 active patients , 23 stable patients, the disease incidence of the later was more than the former obviously in Deficiency of QI and Deficiency of Yin . 1.2 the stage : the acute and the subscute of 35 patients, the chronic of 23 patients, the former was more than the later in Deficiency of Yin. 1.3 The label: the low –grade of 38 patients , the heavier of 20 patients , the later was more than the former in Deficiency of Yin. 2 the test of serologic zymogram a group of 58 patients tested the serologic zymogram, whose serologic zymogram of 35 active patients increased and 29patients decreased , espescially the change of CK, and 21of 23 stable patient were wellbalanced. According to categorical identification in terms of TCM, compared to the Normal Control Group (NCG), the serologic zymogram in Deficiency of QI, Deficiency of Yin, the Phlegm syngrome , the heat syndrome and the blood stasis increased, especially the increase of CK. Deficiency group was lower than Excess syndrome group. 3 the test of immunoglobulin and complement in 35 patients, according to categorical identification in terms of TCM, we could find that Deficiency of QI, Dificiency of YI, the phlegm syndrome ,the heat syndrome ,the blood stasis, IgG and IgA were lighter than the NCG, and the level of C3 decreased. and IgM were the same as C4. 4 the test of electromyography 44 patients were made off the three groups of nonspontaeity electragraph, less-spontaneity electrograph and much , based on the state and the number of patients spontaneity electrograph, the incidence of three groups have no relatition. 5 the test of the pathology In the muscle test of 26 patients , based on musculature and the defferent states of skin pathology, the patients with PM/DM were made off two groups of the light and the heavy with TCM identification, which had the presence rate in Deficiency of QI, Dificiency of Yin, the phlegm syndrome ,the heat syndrome the blood stasis. But the presence rate of the heavy Deficiency of Yin was more than the light. 6　TCM identification according to the four examines of looking , smelling ,asking and feeling in TCM identification 58 patients contained : Deficiency of QI 36, Dificiency of Yin 29, the phlegm syndro-me 42 ,the heat syndrome 51,the blood stasis 57. Conclusions: From the experient, the phlegm syndrome ,the heat syndrome the blood stasis were the main diseases in the process of PM/DM. The incidence of the stable patients with Deficiency of QI and Dificiency of Yin were more than the active patients. With time prolonged , the disease incidence of Deficiency of QI and Dificiency of Yin tend to increase. The incidence of the acute and subacute patients were more than the non-acute patients shows that Deficiency of QI were closely related to the emergency of the disease. The heavy patients with Deficiency of Yin in PM/DM were more than the light. It is possible that TCM Deficiency of Yin was closely related to the damaged degree of patient muscle pathology. The heavier patients pathology dama-ges were worse , whose Deficiency of Yin were more clearer. Microcosmic test guideline shows , compared with the NCG, the level of CK, CK-MB, AST, LDH, HBDH, IgG, and IgA increa-sed, especially the change of CK. So, CK could be a guideline while inspecting the disease activity , which could be as a consulted guideline of categorical idenfication in clinic. Deficiency of QI IgG was lower than other TCM simple groups , for the body fluid immunity system function of the patients with Deficiency of QI were worse than... |
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