Xu Xian-Peng, Jiang Yan-Bing, Guan Li-Hua, Ji Qing-Jie, Jin Ying
Department of Acupuncture and Moxibustion, Quzhou Hospital of TCM, Quzhou 324000, Zhejiang Province, China.
Zhongguo Zhen Jiu. 2022 Jul 12;42(7):755-9. doi: 10.13703/j.0255-2930.20210908-k0003.
To compare the clinical efficacy between acupuncture combined with western medication and simple western medication for ocular myasthenia gravis (OMG), and to explore its possible mechanism.
A total of 60 patients of ocular myasthenia gravis were randomized into an acupuncture combined with western medication group (30 cases, 1 case dropped off) and a western medication group (30 cases, 2 cases dropped off). Oral pyridostigmine bromide tablet and prednisone acetate tablet were given in the western medication group. On the basis of the treatment in the western medication group, acupuncture (acupuncture for unblocking the governor vessel and regulating ) was applied at Baihui (GV 20), Fengfu (GV 16), Hegu (LI 4), Zusanli (ST 36), etc. in the acupuncture combined with western medication group, once a day, 6 days a week. The treatment was given 8 weeks in both groups. Before and after treatment, the OMG clinical absolute score was observed, electrophysiological indexes of orbicularis oculi (value of mean jitter, percentage of jitter >55 μs and percentage of blocks) were measured by single-fiber electromyography (SFEMG), serum levels of acetylcholine receptor antibody (AChR-Ab), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) were detected by ELISA method.
After treatment, the OMG clinical absolute scores, values of mean jitter, percentages of jitter >55 μs, percentages of blocks and serum levels of AChR-Ab, IFN-γ and IL-4 were decreased compared before treatment in both groups (<0.05), and those in the acupuncture combined with western medication group were lower than the western medication group (<0.05).
Acupuncture combined with western medication can effectively improve ptosis, palpebra superior fatigability, eye movement disorder and neuromuscular junction dysfunction in patients with ocular myasthenia gravis, the therapeutic effect is superior to simple western medication. Its mechanism may be related to down-regulating serum levels of AChR-Ab, IFN-γ and IL-4 and promoting the recovery of orbicularis oculi function.
比较针刺联合西药与单纯西药治疗眼肌型重症肌无力（OMG）的临床疗效，并探讨其可能机制。
将60例眼肌型重症肌无力患者随机分为针刺联合西药组（30例，脱落1例）和西药组（30例，脱落2例）。西药组口服溴吡斯的明片和醋酸泼尼松片。针刺联合西药组在西药组治疗的基础上，针刺百会（GV20）、风府（GV16）、合谷（LI4）、足三里（ST36）等穴位（针刺督脉以通调），每日1次，每周6天。两组均治疗8周。治疗前后观察OMG临床绝对评分，采用单纤维肌电图（SFEMG）检测眼轮匝肌电生理指标（平均抖动值、抖动>55μs百分比和阻滞百分比），采用酶联免疫吸附测定（ELISA）法检测血清乙酰胆碱受体抗体（AChR-Ab）、干扰素-γ（IFN-γ）和白细胞介素-4（IL-4）水平。
治疗后，两组患者的OMG临床绝对评分、平均抖动值、抖动>55μs百分比、阻滞百分比以及血清AChR-Ab、IFN-γ和IL-4水平均较治疗前降低（<0.05），且针刺联合西药组低于西药组（<0.05）。
针刺联合西药能有效改善眼肌型重症肌无力患者的上睑下垂、上睑疲劳、眼球运动障碍及神经肌肉接头功能障碍，疗效优于单纯西药。其机制可能与下调血清AChR-Ab、IFN-γ和IL-4水平及促进眼轮匝肌功能恢复有关。
