| Objectives:To observe the clinical efficacy of Qiangji Jianli Recipe combined with western medicine in treating MG of Spleen-stomach Qi deficiency type and the effects of Qiangji Jianli Recipe on Th17 cell specific transcription protein ROR y T,cytokines IL-17 and Treg cell specific transcription protein Foxp3,cytokines TGF-? proteins' expression levels in experimental myasthenia gravis model rats,for the purpose of providing strong clinical evidence to treat myasthenia gravis with TCM differentiation via symptoms and signs,and exploring the mechanism of Qiangji Jianli Recipe in treating myasthenia gravis.Methods:Experimental research:From 70 female Lewis rats,7 rats were chosen as the normal group,the left 63 rats were given injection of the emulsifier of rat-derived 97-116 peptide(R97-116)of the acetylcholine receptora(AchR a)-subunit to establish the MG model.Ultimately,30 rats were successfully induced into MG model.The 30 MG rats were randomly divided into model group(N=7),high-dose Qiangji Jianli Recipe group(N=8),middle-dose Qiangji Jianli Recipe group(N=7),and low-dose Qiangji Jianli Recipe group(N=8).The high-,middle-and low-dose Qiangji Jianli Recipe groups were given intragastric administration of Qiangji Jianli Recipe(at the dosage of 23.4,15.6,7.8 g·kg-1·d-1,respectively),and the normal group and model group were given intragastric administrat-ion of the same volume of normal saline,the treatment lasting for 4 weeks.During the medication period,the body mass and Lennon scores for muscle strength in each group were observed and recorded twice a week.After treatment,the protein expression levels of retinoic receptor-related orphan receptor y t(ROR y t),forkhead box p3(Foxp3),interleukin 17A(IL-17A)and transforming growth factor ?(TGF-?)in rat spleen.Clinical research:Sixty patients with myasthenia gravis who met the inclusion criteria and Osserman classification was type ?,type ?a and type ?b were divided into Qiangji Jianli Recipe combined with western medicine group(N=30)and western medicine group(N=30).The Qiangji Jianli Recipe combined with western medicine group was treated with Qiangji Jianli Recipe on the basis of western medicine,while the western medicine group was treated with western medicine only,with two treatments.The difference of QMG score,TCM syndrome score and Busch quality of life score before and after treatment were compared and analyzed.Results:The experimental results show that when Compared with the normal group,the expression of ROR ? T(except the high dose group)?IL-17A proteins in model group and Qiangji Jianli Recipe groups were significantly increased,and the expression of Foxp3(except the high dose group)?TGF-0 proteins were significantly decreased(P<0.05),while the expression of ROR?T and FoxP3 protein in high dose group was close to that in normal group(P>0.05).Compared with model group,the expression levels of ROR?T and IL-17A in spleen of rats in Qiangji Jianli Recipe groups decreased significantly(P<0.01),while the expression levels of Foxp3(except low dose group)and TGF-? increased significantly(P<0.05).The results of clinical study indicated that when compared with before treatment,QMG score,TCM syndrome score and Busch score of each Osserman clinical classification in the The Qiangji Jianli Recipe combined with western medicine group and the western medicine group decreased significantly(P<0.01);compared with the western medicine group,QMG score in the experimental group decreased more significantly,but there was no significant difference between the two groups before and after treatment(P>0.05).In terms of TCM syndrome score and Busch score of quality of life,the Qiangji Jianli Recipe combined with western medicine group decreased even more obviously,the difference of scores between the two groups before and after treatment except Osserman type I had significant statistical significance(P<0.01);there were no obvious side effects in the two groups during the treatment.Conclusions:Qiangji Jianli Recipe combined with western medicine on the treatment of myasthenia gravis patients with spleen and stomach qi deficiency is significantly better than the western medicine group on the efficacy and improvement of life quality,and it' s safety and effective,without obvious side effects.Besides,Qiangji Jianli Recipe has therapeutic eff-ect on the MG rats through modulating the balance of Th17/Treg lympho-cytes by affecting the protein expression of transcription factors and related cytokines of Th17 and Treg cells. |
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