| Objective: To explore the clinical efficacy of compound Huangqi Decoction in the treatment of AChR antibody positive and Titin antibody double positive MG patients.Materials and METHODS: From September 2020 to September 2021,47 patients with myasthenia gravis who had been confirmed as myasthenia gravis and had completed serum detection of pathogenic antibody were collected from the clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.According to the detection results of serum pathogenic antibody,the patients were divided into Ach R-Ab positive group(monoclonal antibody group)and Ach R-Ab combined with Titin-Ab double positive group(double antibody group).Monoclonal antibody group: 27 cases,including 11 males and 16 females,onset age 18-70 years,course of disease 5-33 months,MGFA clinical classification of type I 11 cases,IIa 7 cases,IIb 9 cases;In the double antibody group,there were 20 cases,including 9 males and 11 females.The age of onset was 26 ～ 75 years,and the course of disease was 6 ～ 36 months.MGFA was clinically classified as type I in 7 cases,type IIa in 4cases,and type IIb in 9 cases.All patients had taken compound Huangqi Decoction for treatment,and the treatment course lasted for more than 6 months(in the treatment process,the dosage < could be appropriately combined with brompyrixmine according to the patients’ own symptoms;480mg/d.).Patients’ medical records,QMG score,MG-ADL score,AChR-Ab titer change and effective rate before treatment and 6 months after treatment were collected and analyzed.SPSS22.0 software was used for statistical analysis.Results:1.Thymic condition: There were 2 patients with monoclonal antibody combination and thymoma(7.41%),and 7 patients with dual antibody combination and thymoma(35.0%),and the difference between the two groups was statistically significant(P<0.05),double antibody combination and thymoma rate were higher.2.Comparison of QMG scores between the two groups before and after treatment:monoclonal antibody group(4.22±1.22)was higher than that of dual antibody group(3.05±1.19),and there was a statistical difference between the two groups(P<0.01),and the difference was significant.3.MG-ADL score: After treatment,monoclonal antibody group(3.15±1.43)was lower than dual antibody group(4.85±1.60),and the difference between the two groups was statistically significant(P<0.01);Intra-group comparison showed that monoclonal antibody group(3.15±1.43)was lower than before treatment(5.74±1.61),and dual antibody group(4.85±1.60)was lower than before treatment(6.70±1.98),and the differences were statistically significant(P all <0.01).4.AChR-Ab titer: There was no statistical difference in AChR-Ab titer between the two groups before and after treatment(P>0.05);Intra-group comparison,monoclonal antibody group(8.26±3.37)was lower than before treatment(11.18±3.89),the difference was statistically significant(P<0.01);The double antibody group(10.43±4.17)was lower than that before treatment(11.46±4.29),and the difference was not statistically significant(P>0.05).5.Effective rate: The total effective rate of the monoclonal antibody group was 77.78%;The total effective rate of the double antibody group was 40%.The effective rate was statistically different between the two groups(P<0.01),the effective rate of monoclonal antibody group was much higher than that of double-clonal antibody group.Conclusion:1.The proportion of patients with Titin-Ab positive MG combined with thymoma was higher.2.Compound Huangqi Decoction can effectively improve MG symptoms,and the clinical symptoms of patients with single antibody positive MG are more significantly improved than those with double antibody positive MG.3.Compound Huangqi Decoction can effectively reduce AChR-Ab titer,and single antibody positive MG patients are better than double antibody positive MG patients. |
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