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目的探讨糖皮质激素(GC)辅以针灸治疗对重症肌无力(MG)患者的免疫调节疗效及机制。方法将68例患者采用抽签法随机分为2组,每组34例。治疗组GC辅以针灸治疗;对照组单用GC治疗,疗程2个月,观察两组患者治疗前后症状改善情况及外周血免疫球蛋白及补体的水平。结果经治疗2个月后,治疗组临床总有效率为85%(29/34);对照组临床总有效率为82%(28/34),两组间差异无统计学意义(P>0.05);治疗前两组MG患者血清IgG1、IgG3均高于健康组,C3低于健康组,差异均有统计学意义(P<0.05),IgM、IgA和C4、IgG2、IgG4与健康组比较差异均无统计学意义(P>0.05);经2个月治疗,治疗组与对照组IgG1、C3较治疗前差异有统计学意义(P<0.01);治疗组与对照组比较,IgG1差异有统计学意义(P<0.05),IgG3和C3差异无统计学意义(P>0.05)。结论 GC可能通过对体液免疫等功能的影响而发挥治疗作用,针灸治疗可能对MG患者的免疫功能有调节作用。
Objective To investigate the immunomodulatory effect and mechanism of glucocorticoid (GC) supplemented with acupuncture on patients with myasthenia gravis (MG). Methods Sixty-eight patients were randomized into two groups by random sampling, 34 cases in each group. The treatment group was supplemented with acupuncture and moxibustion. The control group was treated with GC only for 2 months. The improvement of symptoms and the level of peripheral blood immunoglobulin and complement before and after treatment were observed in both groups. Results After 2 months of treatment, the total clinical effective rate was 85% (29/34) in the treatment group and 82% (28/34) in the control group, with no significant difference between the two groups (P> 0.05 ); Before treatment, the serum IgG1 and IgG3 in patients with MG were higher than those in healthy group and C3 were lower than those in healthy group (P <0.05), but there was significant difference between IgM, IgA and C4, IgG2 and IgG4 (P> 0.05). After two months of treatment, the difference of IgG1 and C3 between the treatment group and the control group was statistically significant (P <0.01), and there was statistical difference between the treatment group and the control group Significance (P <0.05), IgG3 and C3 no significant difference (P> 0.05). Conclusion GC may play a therapeutic role through the influence of humoral immunity and other functions. Acupuncture treatment may have an effect on the immune function of MG patients.