健中益肾汤联合针刺治疗脾肾两虚型重症监护病区获得性肌无力的临床观察  

Clinical observation on treating the spleen-kidney deficiency type intensive care unit acquired myasthenia with the Jianzhong Yishen decoction plus acupuncture

作　　者：张端端 李小兰 肖麟蔚 ZHANG Duanduan

机构地区：[1]福建省龙岩市中医院,福建龙岩364000

出　　处：《中医临床研究》2024年第28期59-65,共7页Clinical Journal Of Chinese Medicine

基　　金：龙岩市科学技术局2021年度市科技创新联合资金卫生项目(2021LYF17063):健中益肾汤治疗脾肾两虚型ICU获得性肌无力的临床观察。

摘　　要：目的:观察健中益肾汤联合针刺治疗脾肾两虚型重症监护病区获得性肌无力(Intensive Care Unit Acquired Myasthenia,ICUAW)的临床效果。方法:选取2020年1月-2022年1月龙岩市中医院收治的ICUAW患者90例,采用随机数字表法分为A组、B组、C组。A组采用西医常规治疗,B组在A组常规治疗的基础上联合应用健中益肾汤治疗,C组在西医常规治疗的基础上采用健中益肾汤联合针刺治疗。观察三组患者治疗前后中医证候积分、英国医学研究理事会量表(Medical Research Council,MRC)评分、改良Barthel指数量表(Modified Barthel Index,MBI)评分、机械通气时长、重症监护病区(ICU)住院天数,以及肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin 6,IL-6)水平。结果:三组患者治疗前中医证候积分、MRC评分、MBI评分及TNF-α、IL-6水平的差异无统计学意义(P>0.05)。治疗后,三组患者的中医证候积分、MRC评分、MBI评分、机械通气时长、ICU住院天数及TNF-α、IL-6水平与治疗前比较均改善(P<0.05),且C组的改善较A组、B组显著(P<0.05)。C组机械通气时长、ICU住院天数明显少于A组、B组(P<0.05)。结论:健中益肾汤联合针刺治疗脾肾两虚型ICUAW效果显著,可显著改善患者的临床症状,促进患者预后,其机制可能与减轻炎症反应有关。Objective:To observe the clinical effect of the Jianzhong Yishen decoction(健中益肾汤)plus acupuncture on the spleen-kidney deficiency type intensive care unit acquired myasthenia(ICUAW).Methods:A total of 90 ICUAW patients in Longyan Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected and divided into group A,group B and group C by random number table method,with 30 patients in each group.Group A was treated by conventional Western medicine treatment,while group B was given the Jianzhong Yishen decoction on the basis of conventional Western medicine treatment.Group C was treated with the Jianzhong Yishen decoction plus acupuncture on the basis of conventional Western medicine treatment.Results:There were no significant differences in TCM syndrome score,MRC score,MBI score,and TNF-αand IL-6 levels among the three groups before treatment(P>0.05).After treatment,the TCM syndrome score,MRC score,MBI score,mechanical ventilation time,ICU stay days,TNF-αlevel and IL-6 level in the three groups were ameliorated compared with those before treatment(P<0.05),and the amelioration in group C was significantly higher than that in group A and group B(P<0.05).The mechanical ventilation time and ICU stay days in group C were significantly less than those in group A and group B(P<0.05).Conclusion:The Jianzhong Yishen decoction plus acupuncture shows a significant effect on the spleen-kidney deficiency type ICUAW,can significantly ameliorate clinical symptoms and promote the prognosis of patients,and its mechanism may be related to the reduction of inflammatory response.

关 键 词：健中益肾汤 脾肾两虚型 针刺 重症监护病区获得性肌无力 临床观察 

分 类 号：R25[医药卫生—中医内科学]