Objective To evaluate the curative effects, the expenses and time of hospitalization, the condition of recurrence and the adverse reactions of different protocols of glucocorticoids on treating multiple sclerosis (MS). Methods Ninty-seven MS patients at acute stage were randomly divided into melhylprednisolone (MPS) intrathecal injection group (30 cases) , MPS pulse therapy group (36 cases) and dexamethasone ( DXM ) therapy group (31 cases). The decrease of Kurtzke expanded disability status scale(EDSS) at different time after treatmentand, the expenses and time of hospitalization, the proportion of drugs in hospitalization expenses, the condition of recurrence and the adverse reactions among all the groups were compared with each other. Results The decrease of EDSS in MPS intrathecal injection group scince 5 d after treatment and in MPS pulse therapy group scince 10 d after treatment were significantly higher than that in DXM therapy group (all P<0. 05). The decrease of EDSS in MPS intrathecal injection group at 5 d after treatment was significantly higher than that in MPS pulse therapy group (P < 0.05). Among the three groups, the total expense of hospitalization and the proportion of drugs in hospitalization expenses were the least in MPS intrathecal injection group, and the daily mean expense of hospitalization was little, ihe hospitalization time was short (all P<0.05). The daily mean expense of hospitalization was the most in MPS pulse therapy group, and the hospitalization time was the longest in DXM therapy group (all P<0.05). The recurrence rate was the highest and the recurrence time was the shortest in MPS pulse therapy group (all P < 0. 05). The difference of recurrence rate and time was no statistical significance between MPS intrathecal injection group and DXM therapy group. There was no severe adverse reaction in all the groups. Conclusions The curative effect of MPS intrathecal injection on treating MS is fast and significant in short-term with little hospitalization expense, low recurrence rate and long recurrence time. It has no severe adverse reaction, and is suitable to be generalized in clinic.%目的 探讨糖皮质激素治疗多发性硬化(Ms)的不同方案的疗效、住院费用、住院时间、复发情况及不良反应等.方法 97例MS急性期患者随机分为鞘内注射甲泼尼龙(MPS)组(30例)、MPS冲击治疗组(36例)及地塞米松治疗组(31例),比较各组治疗后不同时间的Kurtzke扩展致残量表(EDSS)评分减少值、住院费用、费用中药品比例、住院时间、复发情况及不良反应等.结果 鞘内注射MPS组治疗后5d起,MPS冲击治疗组治疗后10d起EDSS评分减少值明显高于地塞米松治疗组(均P＜0.05).治疗后5d时鞘内注射MPS组EDSS评分减少值明显高于MPS冲击治疗组(P＜0.05).3组间鞘内注射MPS组总住院费用最少,费用中药品比例最低,日均住院费用较少,住院时间较短(均P＜0.05)；MPS冲击治疗组日均住院费用最高,地塞米松治疗组住院时间最长(均P＜0.05).MPS冲击治疗组复发率最高,复发时间最短(均P＜0.05)；地塞米松治疗组和鞘内注射MPS组复发率及复发时间比较差异无统计学意义.各组均无严重不良反应发生.结论 鞘内注射MPS治疗MS起效较快,近期疗效显著,住院费用较低,复发率较低,复发时间较长,无严重不良反应,宜在临床推广应用.
展开▼
