针刺“足三里”对太阳病(风寒表证)患者周节律及免疫炎性因子表达水平的影响

目的观察针刺足三里对太阳病(风寒表证)患者周节律及免疫炎性因子表达水平的影响并探讨其作用机制。方法68例太阳病(风寒表证)患者,随机分为针刺组与对照组各34例。对照组予复方盐酸伪麻黄碱缓释胶囊,每日1粒。针刺组在对照组基础上针刺足三里每日1次,行针30 min,疗程3 d。观察比较检测治疗前后白细胞(WBC)、淋巴细胞(LYM)、中性粒细胞-淋巴细胞比率(NLR)、超敏C反应蛋白(hs-CRP)、白介素-10(IL-10)的水平,进行中医证候评分。结果针刺组总有效率100.00%,显著高于对照组的88.24%(P<0.05)。针刺组病程短于对照组(P<0.01)。两组治疗3 d后中医证候总积分均较治疗前下降(均P<0.01),且针刺组证候评分下降更明显(P<0.05)。治疗3 d后,两组WBC计数均较治疗前下降(均P<0.05),但两组间比较差别不大(P>0.05)。两组LYM计数均较治疗前上升(均P<0.01),且针刺组增加幅度高于对照组(P<0.01);两组NLR均较治疗前均下降(均P<0.01),且针刺组NLR降低幅度优于对照组(P<0.01);针刺组hsCRP及IL-10与治疗前比较降低(P<0.01),对照组与治疗前比较差别不大(P>0.05)。结论太阳病风寒表证常规疗法的病程接近周节律现象,早期针刺足三里能增加淋巴细胞计数,下调NLR、hs-CRP、IL-10炎性免疫因子水平,从而缩短病程,防止传变,其机制与提升机体免疫能力、减轻炎症反应、调整促炎-抗炎双向平衡相关。

Effects of Acupuncture at Zusanl(iST36)on the Weekly Rhythm and the Expression Levels of Inflammatory Cytokines in Patients with Taiyang Disease(Wind-cold Exterior Pattern)

Objective:To observe the effect of acupuncture at Zusanli(ST36)on the weekly rhythm and the expression level of inflammatory cytokines in patients with Taiyang disease(wind-cold exterior pattern).Methods:68 patients were randomly divided into the acupuncture group(conventional treatment+acupuncture ST36)and the control group(conventional treatment),34 cases in each group.The acupuncture group were given needling at Zusanli for 30 minutes once a day,3 days in total.WBC,LYM,NLR,hs-CRP and IL-10 were detected before and after treatment.TCM syndromes were scored and the total course of disease were recorded.Results:After treatment,the total effective rate of acupuncture group and the control group was 100.00%and 88.24%respectively.The course of disease in the acupuncture group was lower than that in the control group,and the comparison between them was statistically significant(P<0.01);the difference between the two groups was statistically significant(P<0.05).After treatment,the TCM syndrome scores of both decreased significantly compared with those before treatment(P<0.01),and the decline degree of the acupuncture group was statistically significant,compared with the control group(P<0.05).After treatment,WBC in both groups were decreased significantly compared with those before treatment(P<0.05),but there was no significant difference between two groups(P>0.05).After treatment,the lymphocyte in the acupuncture group were increased significantly(P<0.01),and the expression levels of NLR,hs-CRP and IL-10 were decreased significantly(P<0.01),which was statistically significant compared with the control group(P<0.01).Conclusion:The course of Taiyang disease(wind-cold exterior pattern)in the routine group is close to the weekly rhythm.Early acupuncture can increase LYM,decrease the levels of NLR,hsCRP and IL-10,so as to shorten the course of the disease and prevent the change.The mechanism may be related to promoting immunity,reducing inflammation,adjusting the pro-inflammatory and anti-inflammatory balance.