上海针灸杂志2024，Vol.43Issue(7)：750-756,7.DOI:10.13460/j.issn.1005-0957.2024.07.0750
督灸配合中药治疗重症肌无力的疗效观察
Therapeutic observation of Governor Vessel moxibustion plus Chinese medication for myasthenia gravis
摘要
Abstract
Objective To observe the clinical efficacy of Governor Vessel moxibustion plus Yi Sui Jian Ji granules in treating myasthenia gravis(MG).Method Ninety-four MG patients were randomized into a treatment group and a control group,with 47 cases in each group.The treatment group was treated with Governor Vessel moxibustion plus Yi Sui Jian Ji granules,and the control group was treated with oral administration of Methylprednisolone tablets.After the treatment,changes in the Medical Research Council(MRC)muscle strength scale score,myasthenia gravis muscular endurance scale(MGMES)score,muscle content,and laboratory indexes[T follicular helper cells(Tfh),T follicular regulatory cells(Tfr),Tfr/Tfh,tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-17(IL-17),irisin,peroxisome proliferator-activated receptor-γ coactivator 1-α(PGC-1α),fibronectin type Ⅲdomain-containing protein 5(FNDC5),phosphoinositide 3-kinase(PI3K),protein kinase B(AKT),and mammalian target of rapamycin(mTOR)]were observed.The two groups were also compared in terms of clinical efficacy,adverse reaction rate,and relapse rate at the 6-month follow-up.Result The total effective rate was 95.7% in the treatment group,significantly higher than 81.4% in the control group(P＜0.05).After the treatment,the MRC muscle strength scale score and muscle content increased notably,and the MGMES score dropped markedly in both groups(P＜0.05).After the intervention,the treatment group showed significant increases in the levels of Tfr,Tfr/Tfh,and irisin and significant decreases in the levels of Tfh,TNF-α,IL-2,IL-17,PGC-1α,FNDC5,PI3K,AKT,and mTOR(P＜0.05).In the control group,the levels of Tfr and Tfr/Tfh increased notably,and the levels of Tfh,TNF-α,IL-2,and IL-17 dropped significantly after the treatment(P＜0.05).There were significant differences in the MRC muscle strength scale score,MGMES score,muscle content,and laboratory test results between the treatment and control groups after the treatment(P＜0.05).In the treatment group,the adverse reaction rate during the intervention was 2.2%,and the relapse rate at the 6-month follow-up was 6.8%,significantly lower than 32.6% and 42.9% in the control group,respectively(P＜0.05).Conclusion Governor Vessel moxibustion plus Yi Sui Jian Ji granules can increase muscle strength in MG patients,balance Tfh and Tfr,inhibit the secretion of serum proinflammatory factors,and improve serum levels of muscle-regulatory factors and PI3K/AKT/mTOR pathway,showing high safety rating.关键词
灸法/铺灸/督灸/重症肌无力/肌力/炎性因子Key words
Moxibustion/Long-snake moxibustion/Governor Vessel moxibustion/Myasthenia gravis/Muscle strength/Inflammatory factors分类
医药卫生引用本文复制引用
王玲,杨俊红..督灸配合中药治疗重症肌无力的疗效观察[J].上海针灸杂志,2024,43(7):750-756,7.基金项目
河南省科技公关项目(232102311196) （232102311196）
