【作者】 张迪；

【导师】 岳增辉；

【作者基本信息】 湖南中医药大学 ， 针灸推拿学， 2012， 硕士

【摘要】 目的：研究针药结合治疗重症肌无力IIA型脾肾虚损证的疗效,并探讨针药结合治疗重症肌无力的作用机理。方法：将34例重症肌无力IIA型脾肾虚损证病人随机分为观察组(针刺+药物组)18例和对照组(药物组)16例。两组药物治疗均采用溴吡斯的明及补中益气汤口服,观察组在药物治疗的基础上进行针刺治疗,4周为1个疗程,共治疗3个疗程。采用临床绝对计分法进行治疗前后的疗效评定,并运用酶联免疫吸附分析法(ELISA法)检测治疗前后血清IFN-γIL-4的含量。结果：(1)临床绝对计分：观察组、对照组治疗后临床绝对评分均降低,与治疗前对比有非常显著性意义(p<0.01)；治疗后观察组临床绝对评分显著降低,与对照组差异有显著性意义(p<0.05),显示观察组的疗效优于对照组；(2)血清IFN-γ、IL-4的含量：观察组、对照组治疗后血清IFN-γ、IL-4的含量均降低,且均具有非常显著性意义(P<0.01)；两组治疗后组间比较,IFN-γ、IL-4的含量均具有非常显著性意义(P<0.01),观察组IFN-γ、IL-4含量显著降低,针药结合治疗重症肌无力可能与降低血清中的IFN-γ、IL-4的含量有关；(3)观察组的总有效率为94.44%,其中痊愈0例,基本痊愈3例,显效12例,好转2例,无效1例；对照组的总有效率为81.25%,其中痊愈0例,基本痊愈0例,显效5例,好转8例,无效3例。经秩和检验,观察组的总有效率优于对照组,两组差异有显著性意义(p<0.05)。结论：针药结合较单纯药物治疗对重症肌无力IIA型脾肾虚损证具有较好的疗效,其作用机理可能与调节血清IFN-γ、IL-4含量有关。更多还原

【Abstract】 Objective:To study the combination of acupuncture and medicine method’s influence on Myasthenia gravis (Syndrome of the deficiency of kidneys and spleen) by Randomized controlled experimental design.Methods:32cases were randomly divided into a combination of acupuncture and medicine group (observation group)(n=18) and a medicine group (control group)(n=14), both of the two groups used Pyridostigmine Bromide and Middle-Tonifying Qi-Replenishing Decoction, and on the basis of medicine, the observation group conducted the combination of acupuncture and medicine. Before and after the treatment we evaluated the curative effect by absolute score and relative score, and detected the content of IFN-γ, IL-4in serum by Enzyme-linked immunosorbent assay.Results:(1) Evaluation of clinical symptoms:After treatment, the recovery of RCS in the observation group was better than in the control group, and there was a difference between them(p﹤0.05);(2) The content of IFN-γ,IL-4in serum:After the treatment, the content of IFN-y,IL-4in serum were all lower in the two groups, and all of them had significant differences (P﹤0.01). After the treatment, the content of IFN-γ,IL-4in serum between the two groups had significant differences (P﹤0.01), it just showed that the observation group’s curative effect was better than the control group;(3) According to the results of evaluation of rehabilitation, the total effective rate was94.44%in the observation group and81.25%in the control group, and there was a difference between them(P﹤0.05);Conclusion:The combination of acupuncture and medicine method has a good effect on the treatment of Myasthenia gravis, the function mechanism may be relative to ajusting the content of IFN-γ,IL-4in serum.更多还原