针药并用治疗重症肌无力的临床研究及优势肌群探索

Clinical study of acupuncture combined with medication in treating myasthenia gravis and the exploration ofpredominant muscle groups

目的 观察针药并用治疗重症肌无力(myasthenia gravis, MG)的临床疗效并探索其优势肌群。方法 将40例MG患者分为观察组和对照组,每组20例。对照组采用基础西药配合中药治疗,观察组在对照组基础上加用针刺治疗。观察两组治疗前后定量重症肌无力(quantitative myasthenia gravis, QMG)量表总分及不同肌群(眼面肌、咽喉肌、上肢颈背肌、呼吸肌、下肢肌)评分的变化情况。结果 两组治疗后QMG量表总分及眼面肌、咽喉肌、上肢颈背肌评分均较同组治疗前显著下降(P<0.01,P<0.05),观察组治疗后QMG量表下肢肌评分较同组治疗前显著下降(P<0.05)。观察组治疗前后QMG量表总分差值及眼面肌评分差值与对照组比较,差异均具有统计学意义(P<0.05)。结论 针药并用与单纯药物治疗均能改善MG患者病情严重程度,且针药并用效果更好。在各肌群比较上,针药并用能更好地改善眼面肌力量。

Objective To observe the clinical efficacy of combining acupuncture and medication in treating myasthenia gravis(MG)and explore the predominant muscle groups.Method Forty MG patients were divided into an observation group and a control group,each consisting of 30 cases.The control group was treated with basic Western medication plus Chinese medicine,and the observation group additionally received acupuncture treatment.The total score of the quantitative myasthenia gravis(QMG)scale and the scores of different muscle groups(ocular-facial,pharyngeal,upper-limb neck and back,respiratory,and lower limb muscles)were observed.Result The QMG total score and the scores of the ocular-facial,pharyngeal,and upper-limb neck and back muscles decreased significantly in both groups after the treatment(P<0.01,P<0.05);the QMG score of the lower limb muscles dropped markedly in the observation group after the treatment(P<0.05).There was a significant difference in the post-treatment change in the QMG total score and the score of ocular-facial muscles between the two groups(P<0.05).Conclusion Either medication used alone or combined with acupuncture can improve the severity of MG,but the combined use can produce better results.Regarding the muscle groups,acupuncture combined with medication can improve better the strength of ocular-facial muscles.