滚针配合强力益气方对脾气虚型重症肌无力患者疗效及炎症因子水平的影响:随机对照研究

Effect of Needle Roller Combined with Qiangli Yiqi Prescription on Clinical Effect and Level of Inflammatory Cytokine in Myasthenia Gravis with Pi-qi Deficiency:A Randomised Controlled Trial

目的观察滚针配合强力益气方对脾气虚型重症肌无力(MG)患者的疗效作用及对白细胞介素-6(IL-6)、白细胞介素-8(IL-8)肿瘤坏死因子-α(TNF-α)等炎症因子水平的影响。方法采用随机对照试验,选择2018年7月—2020年6月上海市中西医结合医院收治的脾气虚型MG患者共计72例,随机分为治疗组和对照组,每组36例。对照组口服强力益气方治疗每日1剂,分2次口服,治疗组在对照组用药基础上配合滚针治疗,主穴:脾俞、肾俞、足三里、曲池,每周2次。两组均治疗21天。比较两组患者治疗总有效率、MG相对评分、中医证候积分及治疗前后患者血清IL-6、IL-8、TNF-α水平的变化情况。结果治疗组临床总有效率为94.40%(34/36),对照组为86.10%(31/36),治疗组临床总有效率明显高于对照组(Z=4.923,P<0.01)。与治疗前比较,两组患者MG相对评分与中医证候积分降低(P<0.01),血清炎症细胞因子IL-8含量降低(P<0.01),且治疗组低于对照组(P<0.01)。结论滚针配合强力益气方对脾气虚型MG患者能明显改善患者的临床症状,且可降低IL-8水平。

Objective To observe the curative effect of needle roller combined with Qiangli Yiqi Prescription(QLYQP)on myasthenia gravis(MG)patients with Pi-qi deficiency and on the levels of inflammatory factors such as interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α).Methods A randomised controlled trial was conducted,and 72 patients with Pi-qi deficiency myasthenia gravis admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to June 2020 were randomly assigned to treatment group and control group,with 36 patients in each group.The control group was treated with QLYQP orally,one dose daily taking in twice,and the treatment group received needle rolling treatment(twice per week)on the basis of medication in the control group,with main acupoints of Pishu(BL20),Shenshu(BL23),Zusanli(ST36),and Quchi(LI11).Both groups were treated for 21 days.The total effective rate,MG relative score,CM syndrome score,serum IL-6,IL-8,TNF-αlevels before and after treatment were compared between the 2 groups.Results The total clinical effective rate of the treatment group was 94.40%(34/36),and that of the control group was 86.10%(31/36).The total clinical effective rate of the treatment group was significantly higher than that of the control group(Z=4.923,P<0.01).Compared with before treatment,the MG relative score and CM syndrome score were decreased in both groups(P<0.01),those were lower in the treatment group than in the control group(P<0.01).After treatment,the level of serum inflammatory cytokine IL-8 in 2 groups was lower than that before treatment(P<0.01),and the level in treatment group was lower than in control group(P<0.01).Conclusion Needle roller combined with QLYQP can significantly improve the clinical symptoms of patients with MG of Pi qi deficiency type,and can reduce the level of IL-8.