Observation Of Therapeutic Effect Of Acupoint Injection On Patients With Myasthenia Gravis Crisis Undergoing Mechanical Ventilation

ObjectiveTo observe the clinical effect of acupoint injection of Astragalus injection combined with routine western medicine therapy on mechanical ventilation in patients with myasthenia gravis crisis,and to study the acupoint injection of Astragalus injection in the treatment of myasthenia gravis crisis from the aspects of oxygenation index,mechanical ventilation time,rapid shallow breathing index(RSBI),APACHE Ⅱ score,clinical absolute and relative score system for myasthenia gravis and total effective rate.Methods50 patients with myasthenia gravis crisis who hospitalized in the ICU of First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from August 2018 to March 2019 were divided into treatment group and control group with 25 cases in each group.The control group was treated with routine western medicine,while the treatment group was treated with routine western medicine combined with acupoint injection of Astragalus injection.The duration of mechanical ventilation was measured.The oxygenation index,RSBI,APACHE Ⅱ score,clinical absolute score,relative score and total effective rate were recorded before and after treatment.To observe the occurrence and treatment of adverse reactions in two groups during treatment.Results1.There was no significant difference between the two groups in general conditions,including gender,age,modified Osserman tpying,blood PH,oxygenation index,APACHE II score,clinical absolute scores(P>0.05).2.Respiratory function and total duration of hospitalization:The results showed that after treatment,the oxygenation index of the treatment group and control group was significantly higher than that of the same group before treatment(P<0.05).The oxygenation index of the treatment group was significantly higher than that of the control group after treatment(P<0.05).The duration of mechanical ventilation in the treatment group was significantly shorter than control group’ s mechanical ventilation time(P<0.05).The results showed that after treatment,there was significantly difference between the treatment group and the control group about RSBI(P<0.05),and RSBI of the treatment group improved more significantly than that of the control group after treatment(P<0.05).The total hospitalization time in the treatment group was lower than that in the control group(P<0.05).3.APACHEII score:After 8 days of treatment,APACHEII score of both groups was decreased(P<0.05).But after treatment,the difference of APACHEII score between the treatment group and the control group was not statistically significant(P>0.05).4.Clinical absolute and relative score system for myasthenia gravis:After treatment,the clinical absolute score of 8 muscle group in the treatment group was significantly lower than that before treatment(P<0.05),while the absolute scores of upper limb weakness,lower limb weakness,swallowing and chewing weakness in the control group had no significant difference compared with those before treatment(P>0.05).The clinical absolute scores of the remaining five groups had significant difference compared with those before treatment(P<0.05).After treatment,the clinical absolute scores of the two groups were compared,the absolute scores of upper limb fatigue,lower limb fatigue,swallowing and masticatory weakness in the treatment group were lower than those in the control group(P<0.05).There was no significant difference in the clinical absolute scores of other muscle groups between the two groups(P>0.05).5.Total effective rate:There was significant difference between the treatment group and the control group(P<0.05).6.Safety Assessment and Record of Adverse Reactions:No serious adverse reactions were observed in the two groups,and the difference between the treatment group and the control group was not statistically significant in safety indicators(P>0.05).ConclusionAcupoint injection of Astragalus injection in the treatment of myasthenia gravis crisis can improve the oxygenation index,RSBI,limb fatigue,fatigue and clinical symptoms.It is safe and valuable for the treatment of myasthenia gravis crisis.