补脾益肾方联合温针灸治疗重症肌无力疗效及对患者免疫功能的影响

Efficacy of Bupi Yishen recipe combined with needle warming moxibustion on myasthenia gravis and its effects on immune function

目的:探讨补脾益肾方联合温针灸治疗对重症肌无力(MG)疗效及对免疫功能的影响。方法:随机分配84例MG病例为西药组和针药组,每组各42例,西药组给予常规西药治疗,即泼尼松片中剂量冲击,小剂量隔日维持治疗,针药组基于以上用药基础给予补脾益肾方联合温针灸治疗,治疗3个月后,统计两组治疗前后的中医证候积分,评估两组中医证候疗效,对比治疗前后的颈部血管流速、T淋巴细胞亚群水平和血清可溶性白细胞介素6受体水平。结果:治疗后,两组中医证候积分显著降低,针药组的变化幅度大于西药组(P<0.05);针药组的中医证候总有效率低于西药组(P<0.05);治疗后,两组颈内动脉(ICA)、颈总动脉(CCA)、颈外动脉(ECA)显著提高(P<0.05),两组T淋巴细胞中CD3^+、CD4^+亚群所占比和CD8^+、CD4^+比值显著降低(P<0.05),两组血清slL-6R水平均显著降低(P<0.05),以上指标针药组变化幅度大于西药组(P<0.05)。结论:补脾益肾方联合温针灸治疗能缓解MG患者的中医证候症状,提高疗效,促进其颈部血管循环,纠正患者自身机体免疫功能紊乱。

Objective:To explore the efficacy of Bupi Yishen recipe combined with needle warming moxibustion on myasthenia gravis(MG)and its effects on immune function.Methods:84 cases of MG were randomly assigned to western medicine group and needle-medicine group,with 42 cases in each group.Western medicine group was given conventional western medicine treatment,middle dose shock of prednisone tablets and small dose maintenance therapy every other day,and needle-medicine group was given Bupi Yishen recipe combined with needle warming moxibustion on the basis of above medication.After 3 months of treatment,the TCM syndromes scores were counted in the two groups before and after treatment,and the efficacy of TCM syndromes was evaluated in the two groups.The neck blood vessel flow rate,T lymphocyte subsets levels and serum soluble interleukin 6 receptor level were compared before and after treatment.Results:After treatment,the scores of TCM syndromes in the two groups were significantly decreased,and the changes in needle-medicine group were significantly higher than those in western medicine group(P<0.05).The total effective rate of TCM syndromes in needle-medicine group was significantly lower than that in western medicine group(P<0.05).After treatment,the internal carotid artery(ICA),common carotid artery(CCA)and external carotid artery(ECA)were significantly increased in the two groups(P<0.05)while the proportions of CD3^+and CD4^+subsets in T lymphocytes and ratio of CD8^+/CD4^+were significantly decreased(P<0.05),and the serum slL-6R level in the two groups was significantly decreased(P<0.05),and the changes of the above indicators in needle-medicine group were significantly greater than those in western medicine group(P<0.05).Conclusion:Bupi Yishen recipe combined with needle warming moxibustion can alleviate the TCM syndromes in MG patients,improve the efficacy,promote the neck vascular circulation,and correct the immune dysfunction of patient.