The changes of respiratory muscle strength by traditional Chinese medicine combined with cholinesterase inhibitors in myasthenia gravis patients / 中国综合临床

ABSTRACT

Objective To observe the changes of respiratory musc]e strength by traditional Chinese medicine combined with cholinesterase inhibitors in myasthenia gravis (MG) patients.Methods Thirty-four cholinesterase inhibitor-resistant patients,of them 14 were MG patients with stage Ⅰ ,and 20 were stage Ⅱ ,were treated with bromide dimethylcarbamate ( 360-480 mg/d ).Traditional Chinese potion were administered in those without effectiveness,and the dosages of bromide dimethylcarbamate decreased with Traditional Chinese potion lasting for 4-6 months.Vital capacity ( VC ),maximal voluntary ventilation ( MVV ),maximal inspiratory pressure ( PIM ),maximal expiratory pressure ( PEM ),respiratory centre driving pressure ( P0.1 ),residual volume ( RV )were measured before and after treatment.Results The amelioration of VC,MVV,PIM,PEM,P0.1 ,RV,respiratory muscle strength and other indicators of 34 MG patients were not obviously after treatment with cholinesterase inhibitor alone ( P ＞ 0.05 ).After treatment with traditional Chinese medicine combined with cholinesterase inhibitors,VC,MVV,PIM,PEM ( before treatment76.66% ± 18.59%,68.03 % ± 10.45 %,43.25 % ± 18.16%,21.75 % ±14.44% ) increased significantly in all 34 MG patients( after treatment86.91% ± 14.87% ,75.11% ± 11.17%,52.66% ±20.32% ,28.56% ± 10.06% ) ( P ＜ 0.05).RV decreased from 164.94% ± 67.97% to 143.16% ±79.21% (P ＜0.01 ),and respiratory muscle strength,endurance and other indicators significantly improved (P ＜0.01).PIM(65.80% ±28.03% to 52.66% ±20.32%),and PEM (37.03% ±20.57% to 28.56% ±10.06%)improved more significantly in group stage than in group stage (P ＜0.01 ).Respiratory muscle endurance in stage Ⅰpatients ( 108.71% ± 17.56% ) improved significantly than stage Ⅱ patients (96.01% ± 14.12% ,P ＜ 0.01 ).Conclusions Traditional Chinese medicine combined with cholinesterase inhibitors could effectively improve the lung function and respiratory muscle strength in patients with resistance of the cholinesterase inhibitors.The improvement of lung function,respiratory muscle strength were more obviously in stage Ⅰ patients than in stage Ⅱ patients.Respiratory muscle strength and endurance were improved greater in stage Ⅱ than in stage Ⅰ patients.