To study the effect of Buyang Huanwu Decoction（补阳还五汤）combined with acupuncture on immune function and muscle strength recovery in patients with acquired myasthenia in Intensive Care Unit（ICU）.

From January to October 2023，72 patients with ICU-acquired myasthenia in the hospital were selected. The random number table method was divided into two groups，36 cases in each group. Both groups received routine rehabilitation intervention. At the same time，the control group was treated with acupuncture and moxibustion，and the observation group was treated with Buyang Huanwu Decoction combined with acupuncture. The recovery time，muscle strength，daily activity ability，immune function index and adverse reactions were compared between the two groups.

The mechanical ventilation time，ICU hospitalization time and total hospitalization time in the observation group were shorter than those in the control group［（5.97±2.10）d，（16.32±3.77）d，（32.67±3.18）d vs（7.45±1.84）d，（18.90±4.06）d，（35.29±4.06）d］（P<0.05）. There was no significant difference in muscle strength，daily activity ability or immune function between the two groups before treatment（P>0.05）. At 2 and 4 weeks after treatment，the muscle strength rating scale（MRC）scores of the observation group were lower than those of the control group［（76.85±6.92）points，（86.90±5.83）points vs（72.03±5.11）points，（82.76±6.47）points］（P<0.05）. The Barthel index（MBI）score of the observation group was lower than that of the control group［（74.34±5.68）points，（90.25±5.36）points vs（68.21±6.10）points，（86.03±6.33）points］（P<0.05）. The levels of interleukin（IL）-6，IL-8，tumor necrosis factorα（TNF-α）and insulin-like growth factor 1（IGF-1）in the observation group were better than those in the control group［（22.51±2.64）pg/mL，（43.74±5.60）pg/mL，（29.49±2.85）pg/mL，（117.50±10.49）ng/mL vs（26.08±3.05）pg/mL，（47.09±6.11）pg/mL，（33.01±2.48）pg/mL，（105.63±11.20）ng/mL］（P<0.05）. The incidence of adverse reactions was 8.33% in the observation group and 13.89% in the control group（P>0.05）.

Buyang Huanwu Decoction combined with acupuncture is effective in the treatment of ICU acquired myasthenia. It can enhance muscle strength，improve daily living ability，regulate immune balance，and promote faster recovery of patients. It is a safe and reliable treatment plan.