Abstract:

Objective　To investigate the therapeutic efficacy of Yiqi Jiedu Compound in patients with myasthenia gravis (MG) and its effects on interleukin-6 (IL-6) and IL-17 levels. Methods　A prospective study was conducted with 100 children diagnosed with myasthenia gravis at Xi'an Children's Hospital from January 2021 to August 2024. Subjects were randomly assigned to a conventional group (50 cases) and a compound group (50 cases) using an envelope drawing method. In the conventional group, there were 28 males and 22 females, with an average age of (6.5±2.3) years and a disease duration of (1.2±0.8) years; clinical classification included 20 cases of type I, 18 cases of type IIa, and 12 cases of type IIb. In the compound group, there were 26 males and 24 females, with an average age of (6.8±2.5) years and a disease duration of (1.3±0.9) years; clinical classification included 19 cases of type I, 19 cases of type IIa, and 12 cases of type IIb. The conventional group received standard treatment. The compound group received Yiqi Jiedu compound in addition to the standard treatment, administered as one dose per day, with 300 ml of decoction taken in three warm doses. The treatment duration for both groups was 3 months. Clinical efficacy, quantitative myasthenia gravis score (QMG) before and after treatment, traditional Chinese medicine syndrome scores, immune indicators, and levels of retinoic acid receptor-related orphan receptor γt (RORγt) and forkhead box protein P3 (FoxP3) mRNA were compared between the two groups. Statistical analysis was performed using χ², t, and F tests. Results　After treatment, the overall effective rate in the compound group was higher than that in the conventional group [96.0% (48/50) vs. 82.0% (41/50)], with a statistically significant difference (χ²=5.005, P=0.025). At 1 and 3 months post-treatment, the QMG scores and traditional Chinese medicine syndrome scores in the compound group were lower than those in the conventional group [(9.94±0.96, 7.92±0.70) points vs. (12.32±1.27, 11.04±1.24) points; (7.90±0.74, 5.74±0.63) points vs. (11.52±0.91, 9.70±1.15) points] (all P<0.05). After 3 months of treatment, levels of helper T cell 17 (Th17), IL-6, and IL-17 in the compound group were lower than those in the conventional group [(1.64±0.18)% vs. (3.75±0.31)%; (5.36±0.52) ng/L vs. (9.15±0.91) ng/L; (7.78±0.71) ng/L vs. (11.12±0.95) ng/L], with all differences being statistically significant (t=41.621, 25.570, 19.912; all P<0.001). The RORγt mRNA levels in the compound group were lower than those in the conventional group, while the Foxp3 mRNA levels were higher in the compound group (all P<0.05). Conclusion　Yiqi Jiedu compound can improve the symptoms of weakness in children with myasthenia gravis, enhance clinical efficacy, and effectively regulate the immune function of these children by inhibiting the excessive expression of inflammatory factors.

Key words:

Myasthenia Gravis, Yiqi Jiedu , compound, Interleukin-6, Interleukin-17, Children

摘要：

目的　探究益气解毒复方治疗重症肌无力（MG）患儿的疗效及对白细胞介素-6（IL-6）、IL-17水平的影响。方法　选取2021年1月至2024年8月西安市儿童医院收治的100例重症肌无力患儿作为研究对象进行前瞻性研究，按信封抽签法分为常规组（50例）和方剂组（50例）。常规组男28例，女22例；年龄（6.5±2.3）岁；病程（1.2±0.8）年；临床分型：Ⅰ型20例、Ⅱa型18例、Ⅱb型12例。方剂组男26例，女24例；年龄（6.8±2.5）岁；病程（1.3±0.9）年；临床分型：Ⅰ型19例、Ⅱa型19例、Ⅱb型12例。常规组给予常规治疗。方剂组在常规组基础上给予益气解毒复方治疗，每日1剂，水煎服取汁300 ml，分3次温服。两组疗程均为3个月。比较两组治疗后临床疗效，治疗前后的重症肌无力定量评分量表（QMG）评分、中医证候积分、免疫指标及视黄酸受体相关核孤儿受体γt（RORγt）、叉头框蛋白质P3（FoxP3）mRNA水平。采用χ²、t、F检验进行统计分析。结果　治疗后，方剂组的治疗总有效率高于常规组［96.0%（48/50）比82.0%（41/50）］，差异有统计学意义（χ²=5.005，P=0.025）。治疗1、3个月后，方剂组的QMG评分和中医证候积分均低于常规组［（9.94±0.96、7.92±0.70）分比（12.32±1.27、11.04±1.24）分和（7.90±0.74、5.74±0.63）分比（11.52±0.91、9.70±1.15）分］（均P<0.05）。治疗3个月后，方剂组的辅助性T细胞17（Th17）、IL-6、IL-17水平均低于常规组［（1.64±0.18）%比（3.75±0.31）%、（5.36±0.52）ng/L比（9.15±0.91）ng/L、（7.78±0.71）ng/L比（11.12±0.95）ng/L］，差异均有统计学意义（t=41.621、25.570、19.912，均P<0.001）；方剂组的RORγt mRNA水平低于常规组，Foxp3 mRNA水平高于常规组（均P<0.05）。结论　益气解毒复方可改善重症肌无力患儿的肌无力症状，提高临床疗效，还能有效调节患儿的免疫功能，抑制炎症因子的过度表达。

关键词:

重症肌无力, 益气解毒复方, 白细胞介素-6, 白细胞介素-17, 儿童