目的:探讨经过西医规范治疗1个月以上、疗效仍不理想的皮肌炎患者配合中药治疗的临床疗效。方法:对经过西医规范治疗1个月以上但疗效仍不理想的40例皮肌炎患者加用中药治疗,疗程为6个月。观察患者治疗前后乏力、呼吸、吞咽、皮疹、肌肉关节疼痛等临床症状及肌酸磷酸激酶、乳酸脱氢酶、血沉、免疫球蛋白G、抗核抗体等实验室指标变化及激素用量情况并判断其临床疗效。结果:临床症状:患者乏力、下蹲起立困难、吞咽困难、呼吸困难、肌肉关节疼痛症状完全缓解,缓解率为100.0%,皮肤红斑消退率为75.8%,皮肌炎钙化现象亦有明显改善。实验室指标:肌酸磷酸激酶、乳酸脱氢酶、免疫球蛋白G、血沉等指标异常者经治疗后基本恢复正常。糖皮质激素用量:甲泼尼龙组减少74%以上,泼尼松组减少75%以上。综合疗效:临床治愈33例(82.5%),好转7例(17.5%),总有效率为100.0%。不良反应:黄芪用量超过60g以上时,部分患者出现轻微腹胀、纳差等症状。结论:对经过西医规范治疗1个月以上但疗效仍不理想的40例皮肌炎患者加用中药治疗可显著提高疗效,且副作用小,是非常有效的治疗方法。 Objective: To investigate the clinical efficacy of traditional Chinese medicine treatment for patients with dermatomyositis who have undergone western medicine standard treatment for more than 1 month and the effect is still not satisfactory. Methods: Forty cases of dermatomyositis who had been treated by western medicine for more than 1 month but whose effect was still unsatisfactory were treated with traditional Chinese medicine. The course of treatment was 6 months. Observed before and after treatment in patients with fatigue, respiratory, swallowing, rash, muscle and joint pain and other clinical symptoms and creatine phosphokinase, lactate dehydrogenase, erythrocyte sedimentation rate, immunoglobulin G, anti-nuclear antibody and other laboratory indicators and hormone dosage and determine the situation Its clinical efficacy. Results: The clinical symptoms were as follows: weakness, difficulty squatting, dysphagia, dyspnea and complete remission of pain in muscle and joint. The remission rate was 100.0%, the erythema of the skin was 75.8%, and the dermatomyositis calcification was significantly improved. Laboratory indicators: Creatine phosphokinase, lactate dehydrogenase, immunoglobulin G, erythrocyte sedimentation rate and other indicators were normal after treatment returned to normal. Glucocorticoid dosage: methylprednisolone group reduced by more than 74%, prednisone group reduced by 75% or more. Comprehensive curative effect: clinical cure in 33 cases (82.5%), improved in 7 cases (17.5%), the total effective rate was 100.0%. Adverse reactions: Astragalus dosage of more than 60g or more, some patients showed mild abdominal distension, anorexia and other symptoms. Conclusion: 40 cases of dermatomyositis treated by western medicine standard treatment more than 1 month but the effect is still not ideal, can significantly improve the curative effect with less side effects and is a very effective treatment.