补中益气汤化裁配合四步针刺法治疗Ⅱb型重症肌无力的临床观察

Clinical observation of myasthenia gravis Ⅱb treated with the modified buzhong yiqi tang and four-step acupuncture technique

目的观察补中益气汤化裁配合四步针刺法治疗Ⅱb型重症肌无力的临床疗效。方法Ⅱb型重症肌无力患者23例,在西药(溴吡斯的明和/或泼尼松)常规治疗基础上,给予补中益气汤化裁煎剂口服,1剂/d,分3次服;四步针刺法(咽后壁点刺法、舌面点刺法、舌底刺法、咽穴针法),1次/d;共治疗3个疗程。参照洼田氏饮水试验行吞咽功能分级评定,分别记录治疗前、治疗3个疗程后的分级,对咀嚼、吞咽肌无力的严重程度进行比较,并评定疗效。结果 23例患者中9例(39%)治愈,11例(47.8%)好转,3例(13%)未愈,总有效率达到86.9%。结论补中益气汤化裁配合四步针刺法治疗Ⅱb型重症肌无力,可明显改善患者的吞咽障碍等临床症状,临床疗效肯定。

Objective To observe the clinical efficacy on myasthenia gravis（MG） Ⅱb treated with the modified buzhong yiq tang and four-step acupuncture technique. Methods A total of 23 patients of MG Ⅱb were collected according to the inclusive criteria. On the base of the routine treatment with western medicine（pyridostigmine bromide and/or prednisone）,the oral administration with the modified buzhong yiqi tang was used,one dose a day,three times a day. Additionally,the four-step acupuncture technique was used（pricking on the posterior pharynx,pricking on the tongue surface,pricking on the bottom of the tongue and pricking at Yanxue）,once a day. Totally,3 courses of treatment were required.The Kubota drinking test was taken as reference to grade the swallowing function. Separately,before and after 3 courses of treatment,the grade of swallowing function was recorded,the severity of the weakness of the muscles involved in swallowing and the muscles of mastication was compared and the efficacy was evaluated. Results Of 23 cases,9 cases were cured（39%）,11 cases improved（47. 8%） and 3 cases failed（13%）. The total effective rate was 86. 9%. Conclusion The combined treatment with the modified buzhong yiqi tang and four-step acupuncture technique remarkably relieves the clinical symptoms of swallowing impairment in MG Ⅱb and achieves the definite clinical effects.