针灸结合免疫抑制剂治疗对副肿瘤综合征患者相关抗体及肌电图指标的影响

赵航 刘晓阳

摘要 目的：探究針灸结合免疫抑制剂治疗对副肿瘤综合征患者相关抗体及肌电图指标的影响。方法：选取2015年3月至2017年4月本溪钢铁公司总医院收治的副肿瘤综合征患者100例，随机分为对照组和观察组，每组50例。对照组患者给予免疫抑制剂规范化治疗，观察组患者在对照组的基础上联合中医针灸辨证治疗，2组均连续治疗4周。统计2组患者临床疗效;检测并比较治疗前后2组血清相关抗体水平及肌电图指标变化。结果：治疗后观察组总有效率为86.00%，较对照组的56.00%显著升高（P<0.01）;与治疗前比较，治疗后2组血清抗Hu-抗体、抗-Yo抗体、抗-Ri抗体水平均显著降低（P<0.01），且观察组均显著低于对照组（P<0.01）;与治疗前比较，治疗后2组患者正中神经及尺神经运动/感觉传导速度均显著加快（P<0.05或P<0.01），且观察组显著快于对照组（P<0.01）;运动/感觉波幅显著增大（P<0.01），且观察组显著大于对照组（P<0.01）。结论：针灸结合免疫抑制剂治疗副肿瘤综合征可显著调节患者自身免疫紊乱，并有效改善患者肌电图，恢复其正常神经功能，临床疗效显著且优于免疫抑制剂单用。

关键词 副肿瘤综合征;免疫抑制剂;针灸;抗体;肌电图

Effects of Acupuncture Combined with Immunosuppressor on the Related Antibodies

and Electromyogram Index in the Treatment of Paraneoplastic Syndrome Patients

Zhao Hang1， Liu Xiaoyang2

（1 General Hospital of Benxi Steel Company， Benxi 117000， China;

2 The Third People′s Hospital of Dalian， Dalian 116091， China）

Abstract Objective：To explore the effects of acupuncture combined with immunosuppressor on the related antibodies and electromyogram index in the treatment of paraneoplastic syndrome patients. Methods：A total of 100 cases of paraneoplastic syndrome patients in our hospital from March 2015 to April 2017 were selected and randomly divided into control group and research group， with 50 cases in each group. Control group patients were treated with immunosuppressor for standardized treatment and research group patients were treated with TCM acupuncture differential treatment on the basis of control group. Patients in the 2 groups were treated for 4 weeks continuously. The clinical effects of 2 groups were statisticsed; the levels of serum related antibodies and the changes of electromyogram indexes of 2 groups before and after treatment were detected and compared. Results：The total effective rate of research group after treatment was 86.00%， which was higher than 56.00% of control group significantly （P<0.01）; compared with before treatment， the serum anti-Hu antibody， anti-Yo antibody， anti-Ri antibody levels of 2 groups after treatment decreased significantly （P<0.01）， and the levels of research group were lower than those of control group （P<0.01）; compared with before treatment， the movement/sensory conduction velocity of median nerve and ulnar nerve of 2 groups before and after treatment quickened significantly （P<0.05 or P<0.01）， and the velocity of research group was more quick than that in control group （P<0.01）; the movement/sensory amplitude increased significantly （P<0.01）， and amplitude in study group was greater than that in control group （P<0.01）. Conclusion：Acupuncture combined with immunosuppressor can adjust the autoimmune disorders of paraneoplastic syndrome patients， which can improve the electromyogram of patients， recover normal nerve function， enhance the clinical efficacy effectively， and is better than use immunosuppressor alone.

Key Words Paraneoplastic syndrome; Immunosuppressor; Acupuncture; Antibody; Electromyogram

中图分类号：R273文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.046

神经系统副肿瘤综合征是一种比较罕见的临床征候群，广泛累及周围神经系统及中枢神经系统，是普遍存在于恶性肿瘤患者中的一种神经系统性疾病，患者临床表现复杂多样[1-2]。目前副肿瘤综合征的发病机制尚不明确，由于患者表现出多种抗体异常高表达，目前医学界普遍认为其是一种自身免疫病，发病机制与患者自身免疫异常密切相关[3]。目前对副肿瘤综合征的治疗主要是切除原发肿瘤，并辅以免疫调节或免疫抑制剂，但疗效并不理想。中医学理论认为副肿瘤综合征是由肝肾亏损、髓枯筋萎所致，周敏等[4]研究报道，针灸辨证治疗可滋补肝肾、荣筋生髓，已逐步应用于副肿瘤综合征的临床治疗。本研究旨在探究针灸结合免疫抑制剂治疗副肿瘤综合征的临床疗效，分析其对患者血清相关抗体及肌电图指标的改善效果，现将结果报道如下。……