The Exploration Of Hyperbaric Oxygen Therapy To Progressive Muscular Dystrophy

Background:Progressive muscular dystrophy are a heterogeneous group of inherited muscledegenerative disorders that share similar clinical features which are mainly slowprogressive increase in muscle weakness and atrophy of symmetry, usually no sensorydisturbances and dystrophic changes on muscle biopsy. So far, there is currently noresolutive therapy that is based on supportive therapy (eg: immune suppressants,myoblast transplantation, gene therapy, growth hormone and insulin-like growthfactor).Explore the adjuvant treatment of muscular dystrophy imminent.Literature, hyperbaric oxygen therapy can increase the oxygen content and bloodoxygen, increased tissue oxygen storage capacity, improve the organization ofcapillary oxygen diffusing capacity, reducing the number of L-type calcium channels,inhibition of calcium influx. Hyperbaric oxygen prevents the altered distribution offiber types and decreased oxidative enzyme activity of fibers in the skeletal musclesof rats with type2diabetes and subsequently inhibits the glucose elevation. Aftertreatment with hyperbaric oxygen dramatically improve myocardial cell ultrastructureabnormalities in Diabetic cardiomyopathy.The hyperbaric oxygen as an aid in thetreatment of progressive muscular dystrophy, observe the changes of clinicalsymptoms and laboratory examination before and after the treatment.Objective:Preliminary analysis of the efficacy of hyperbaric oxygen therapy for musculardystrophy, the hyperbaric oxygen as an aid in the treatment of progressive musculardystrophy, to prolong their survival and improve the quality of life.Materials and Methods:Animal experiments：40female Wistar rats peripheral nerve injury models weremade through clamping sciatic nerve. They were randomly divided into three groups:saline group(A), drug group(B), drug and hyperbaric oxygen group(C),After20days, the following items as sciatic nerve function index(SFI),slope experiment andtricipital muscle wet weight were detected. And through the pathology examination ofnerve fibers and muscle fiber related data for statistical analysis.Clinical trials: According to the diagnostic criteria, choose the out-patient andin-patient cases who were diagnosed as Progressive muscular dystrophy indepartments of Neurology in the first hospital of jilin university, Collection theclinical datas of25cases from Jun.2006to Dec.2013period. Eight of hyperbaricoxygen and medicine comprehensive treatment(C’),8routine drug treatment (B’),9cases give up treatment(A’). To the patient’s general information, clinicalmanifestation, kinase inspection results of collecting and sorting, using follow-upoutpatient, hospital, telephone, mail, follow-up of patients with clinical symptomsbefore and after treatment in the case of a change and test results.Result：Animal experiments：In sciatic nerve function index(SFI),slope experiment andtricipital muscle wet weight: in rats of test group C after20days more apparentlyincreased as compared with those of rats in group A(p<0.01), at the same time that ofgroup B was better than those of group A (p<0.05).With muscle fiber cross-sectionalarea measured, after treatment group B,C were greater than group A, at the same timethat of group C was better than those of group A,B (p<0.01).Assessing undermicroscope, the axon and myelin of the regenerative sciatic nerve in rats of the lastfour groups are much denser and thicker than those in group A, group C changes moreevident than in group B. In addition myelinated fibers through the area, diameter andcircumference counting statistics, the group B was better than the group A (P <0.05);the group C was better than the group A,B.(P <0.01).Clinical trials: After treatment, patients were conscious improvement over theprevious lower extremity strength, and7m walking time and squat times are shortened.In the year of follow-up, Clinical symptoms of two patients who accept hyperbaricoxygen therapy every1to2months are no obvious progress. While others give upthis treatment the patient’s condition gradually progress, there are four patients havelost ability to walk. The dates of the creatine kinase, lactate dehydrogenase and ɑ-hydroxybutyric acid dehydrogenase wera statistical analysis. The group B’,C’ werabetter than the group A’(P <0.01); the group C’ was better than the group B’.(P Conclusion:Hyperbaric oxygen can promote the repair of damaged nerves and muscles.Observed in clinical trials, after hyperbaric oxygen therapy can improve the patient’sclinical symptoms, enhance physical strength, significantly lower in patients with thechange of serum myocardial enzyme, and has the potential to slow diseaseprogression.