关键词: 多发性硬化病, 四妙丸, 辅助T细胞17, 调节T细胞

Abstract: Objective　To observe the effect of Simiao pills combined with conventional western medicine for patients with multiple sclerosis. Methods　Eighty-six patients with multiple sclerosis treated at Xi'an Traditional Chinese Medicine Brain Disease Hospital from April 2022 to June 2024 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 43 cases in each group. There were 16 males and 27 females in the control group; they were (37.65±9.13) years old; their body mass index was (23.72±2.78) kg/m²; their disease course was (4.28±1.07) years; the attack frequency was 2.53±0.63; 18 cases had lesions in the cerebral hemisphere, 9 in the cerebellum, 13 in the brainstem, and 3 in the spinal cord. There were 14 males and 29 females in the observation group; they were (38.86±9.51) years old; their body mass index was (23.47±2.45) kg/m²; their disease course was (4.16±1.04) years; the attack frequency was 2.65±0.67; 17 cases had lesions in the cerebral hemisphere, 10 in the cerebellum, 12 in the brainstem, and 4 in the spinal cord. The control group took conventional western medicine, and the observation group Simiao pills and conventional western medicine, for 4 weeks. The clinical treatment efficacies, incidence rates of adverse reactions, and neurological function, traditional Chinese medicine symptom scores, levels of immune function indicators [helper T cell 17 (Th17), regulatory T cell (Treg), and Th17/Treg], and levels of inflammatory indicators [interleukin (IL) -17, IL-23, and tumor necrosis factor-α (TNF-α)] before and after the treatment were compared between the two groups by t test, χ² test, rank sum test, calibration χ² test, and Fisher's precision probability test. Results　After the treatment, the score of the Expanded Disability Status Scale, traditional Chinese medicine syndrome score, and the levels of Th17, Th17/Treg, IL-17, IL-23, TNF-α, and Treg in the observation group were better than those in the control group [3.79±0.76 vs. 4.51±0.92, 9.45±1.59 vs. 11.27±1.88, (1.58±0.39)% vs. (1.82±0.46)%, 0.79±0.21 vs. 1.05±0.26, (51.36±12.84) ng/L vs. (62.23±15.55) ng/L, (436.71±109.67) ng/L vs. (512.58±128.65) ng/L, (17.78±4.49) ng/L vs. (23.26±5.85) ng/L, and (2.01±0.51)% vs. (1.73±0.43)%; t=3.891, 4.766, 2.566, 5.018, 3.476, 2.894, 4.794, and 2.701; all P<0.05]. The total effective rate of the observation group was higher than that of the control group [95.24% (40/42) vs. 78.05% (32/41); χ²=4.822; P=0.028]. There was no statistical difference in the incidence rate of adverse reactions between the observation group and the control group [14.29% (6/42) vs. 7.32% (3/41); calibration χ²=0.771; P=0.380]. Conclusion　Simiao pills combined with conventional western medicine in the treatment of patients with multiple sclerosis is effective, and can effectively improve their neurological function and clinical symptoms, regulate Th17/Treg cell balance, and alleviate inflammatory reactions.

Key words: Multiple sclerosis,  , Simiao , pills,  , Helper T cells 17,  , Regulating T cells