Objective To evaluate the extent of axonal injury in multiple sclerosis (MS) patients using magnetic resonance spectroscopy (MRS) quantitatively, appraise the effect of Erhuangfang on reducing recurrence rate and protecting axonal injury. Methoeds Standard methylprednisolone impact therapy was adopted in acute phase of 39 MS patients while taking Erhuangfang, and continue taking Erhuangfang in remission phase. The patients were followed up per six months for one year. Year recurrence rate, the level of N-acetylaspertate (NAA), creatine (CR), NAA/CR between the lesions and contralateral normal white matter before and after treatment for one year were compared. Results The NAA/CR level of lesion side was correlated to disease duration, the correlation coefficient was 0.429, P＝0.006. The longer duration, the lower NAA/CR level. Year recurrence rate of pretreatment was 0.75±0.53, and posttreatment was 0.21±0.13, the difference was statistically significant (P＝0.003). The EDSS of pretreatment was 4.4±2.1, and posttreatment was 4.5±2.2, the difference was not statistically significant (P＞0.05). The NAA/CR level of lesion side of pretreatment was 2.05±0.68, posttreatment was 1.70±0.76, the difference was not statistically significant (P＞0.05). Conclusion With the course prolonging, axonal injury is increasingly severe. Long-term use of Erhuangfang (one year) is effective in reducing recurrence, delaying the process of axonal injury.%目的 运用磁共振波谱分析定量评价多发性硬化(MS)轴索损伤程度,评价二黄方对复发率的影响及对轴索损伤的保护作用.方法 39例MS急性期患者行标准化甲强龙冲击疗法的同时服用二黄方,缓解期继续服用二黄方,并随证加减,半年随访1次,随访1年.比较治疗前后年复发率、病灶和对侧正常外观白质N-乙酰天门冬氨酸(NAA)、肌酸(CR)、NAA/CR水平的差异.结果 病灶侧NAA/CR水平与疾病病程长短相关,相关系数为0.429,P＝0.006,病程越长,NAA/CR水平越低;年复发率治疗前为(0.75±0.53)次/年,治疗后为(0.21±0.13)次/年,差异有统计学意义(P＝0.003);扩展残疾状态量表(EDSS)评分治疗前为(4.4±2.1)分,治疗后为(4.5±2.2)分,差异无统计学意义(P＞0.05);病灶侧NAA/CR水平治疗前为2.05±0.68,治疗后为1.70±0.76,差异无统计学意义(P＞0.05).结论 随着病程的延长,轴索损伤逐渐严重,长期服用二黄方(1年)能有效减少复发,延缓轴索损伤进程.
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