火针联合拔罐对静止期寻常型银屑病患者氧化应激、脂肪细胞因子和生活质量的影响

目的观察火针联合拔罐治疗静止期寻常型银屑病患者疗效及对氧化应激、脂肪细胞因子和生活质量的影响。方法将2016年10月—2018年10月秦皇岛市中医院诊治的128例静止期寻常型银屑病患者随机分为对照组和观察组,每组各64例。对照组给予西医对症治疗,观察组在对照组治疗基础上给予火针联合拔罐治疗,2组均治疗8周。比较2组临床疗效,观察2组治疗前后中医症候评分、瘙痒程度视觉模拟(VAS)评分、银屑病皮损面积和严重程度指数(PASI)评分、氧化应激和脂肪细胞因子表达水平的变化,评价2组治疗前后生活质量情况。结果观察组中医证候疗效、临床疾病治疗疗效均显著高于对照组(P均<0.05);2组治疗后皮损颜色、皮损肥厚侵润、瘙痒、肌肤甲错评分和总分及VAS评分、PASI评分均较治疗前显著降低(P均<0.05),观察组治疗后以上评分均显著低于对照组(P均<0.05)。2组治疗后血清超氧化物歧化酶(SOD)、脂联素水平均较治疗前显著升高(P均<0.05),丙二醛(MAD)和内脂素水平均较治疗前显著降低(P均<0.05),观察组治疗后以上指标改善情况均显著优于对照组(P均<0.05)。2组治疗后皮肤病生活质量指数(DLQI)评分中主观症状、心理感受、日常活动、休闲娱乐、工作和学习、社会交际、性生活评分和DLQI总分均较治疗前显著降低(P均<0.05),观察组治疗后以上评分均显著低于对照组(P均<0.05)。2组治疗过程中均未发生严重不良反应。结论火针联合拔罐可显著缓解静止期寻常型银屑病患者临床症状,逆转皮损病变进程,改善患者生活质量,且安全,机制可能与抑制机体氧化应激、调节脂肪细胞因子表达有关。

Effects of fire needling combined with cupping on oxidative stress,fat cytokines and quality of life in patients with psoriasis vulgaris at quiescent stage

Objective It is to observe the curative effect of fire acupuncture combined with cupping in patients with psoriasis vulgaris at quiescent stage and its effect on oxidative stress,adipocytokines and quality of life.Methods 128 patients with psoriasis vulgaris at quiescent stage were randomly divided into control group and observation group,with 64 cases in each group.The control group was given symptomatic treatment with western medicine,and the observation group was given fire needle combined with cupping treatment on the basis of the treatment of the control group.Both groups were treated for 2 months.The clinical efficacy of the two groups were compared,and the changes in TCM symptom scores,visual iteration(VAS)scores,psoriatic lesion area and severity index(PASI)scores,the expression levels of oxidative stress and adipocytokine before and after treatment were observed in the two groups,and the quality of life before and after treatment in the two groups were evaluated.Results The efficacy of TCM syndromes and clinical disease treatment in the observation group were significantly better than those in the control group(P<0.05).The scores of color of skin lesions,hypertrophy of skin lesions,itching,pachylosis and total scores,VAS scores,PASI scores were significantly lower than those before treatment in the two groups(P<0.05),and the above scores in the observation group were significantly lower than those in the control group after treatment(P<0.05).After treatment,the levels of serum superoxide dismutase(SOD)and adiponectin were significantly higher and the levels of malondialdehyde(MAD)and lactone were significantly lower than those before treatment in the two groups(P<0.05),the improvement of the above indicators in the observation group was significantly better than that in the control group(P<0.05).The scores of subjective symptoms,psychological feelings,daily activities,leisure activities,work and study,social communication,sexual life,and total scores in DLQI scores after treatment were significantly lower than those before treatment in the two groups(P<0.05).,the above scores in the observation group were significantly lower than those in the control group after treatment(P<0.05).No serious adverse reactions occurred during the treatment of the two groups.Conclusion Fire acupuncture combined with cupping can significantly alleviate the clinical symptoms,reverse the course of skin lesions,improve the quality of life,and is safe in the patients with psoriasis vulgaris at quiescent stage.The mechanism may be related to inhibiting oxidative stress and regulating the expression of adipocytokines.