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目的回顾性分析甲状腺机能亢进伴重症肌无力(myasthenia gravis,MG)的各种不同治疗方案的疗效。方法对152例甲状腺机能亢进伴MG患者的各种治疗方案的疗效进行评估,比较患者有效率、基本痊愈率及不良反应。结果 (1)131I组的有效率比其它治疗组都显著性升高(P<0.05),而它的甲状腺机能减退发生率比甲状腺切除组低(P<0.05);(2)在I型MG的各种治疗方案中,D组(泼尼松+吡啶斯的明)、E组(泼尼松+吡啶斯的明+参芪扶正)总有效率都分别比A组(吡啶斯的明)、B组(泼尼松)及C组(泼尼松+参芪扶正)显著性提高(P<0.05);E组基本痊愈率最高(P<0.05)。在II型MG患者中,D、E组之间总有效率无显著性差异(P>0.05);E组基本痊愈率比D组高(P<0.05);(3)在I型MG的各种治疗方案中,A、C、E组不良反应发生率分别比B、D组显著性降低(P<0.05)。在II型MG患者中,E组不良反应发生率比D组显著性降低(P<0.05)。结论对于甲状腺机能亢进伴MG患者而言,口服131I是一种较好的治疗甲状腺机能亢进的方法,而皮质类固醇泼尼松联合抗胆碱酯酶药吡啶斯的明及中药参芪扶正的中西医结合疗法是治疗MG的一种较好的措施。
Objective To retrospectively analyze the curative effects of various treatment regimens of hyperthyroidism with myasthenia gravis (MG). Methods 152 cases of hyperthyroidism with MG patients with various treatment efficacy evaluation, evaluation of patient efficiency, the basic cure rate and adverse reactions. Results (1) The effective rate of 131I group was significantly higher than that of other treatment groups (P <0.05), and its incidence of hypothyroidism was lower than that of thyroid resection group (P <0.05). (2) , The total effective rates of group D (prednisone + pyridostigmine) and group E (prednisone + pyridostigmine + shenqi fuzheng) were significantly higher than those of group A (pyridostigmine) (P <0.05); Group B (prednisone) and group C (prednisone + Shenqi Fuzheng) increased significantly (P <0.05). There was no significant difference in total effective rate between group D and group E in patients with type II MG (P> 0.05). The rate of complete cure in group E was higher than that in group D (P <0.05). (3) Among the treatment regimens, the incidences of adverse reactions in groups A, C and E were significantly lower than those in groups B and D, respectively (P <0.05). In type II MG patients, the incidence of adverse reactions in group E was significantly lower than that in group D (P <0.05). Conclusion For hyperthyroidism with MG patients, oral 131I is a better method of treatment of hyperthyroidism, and corticosteroid prednisone combined with anti-cholinesterase pyridostigmine and Chinese medicine Shenqi Fuzhong Western medicine combination therapy is a better measure of MG treatment.