摘要
Objective:To observe the clinical efficacy of acupuncture in treatment of chronic urticaria and the change in the content of serum immunoglobulin E(IgE),and to discuss the effect of acupuncture on the imbalance of T helper(Th)1/Th2 cell function via observing the changes in the contents of interferon-y(IFN-y)and interleukin-4(IL-4).Methods:Ninety patients meeting the inclusion criteria of chronic urticaria were randomized into an acupuncture-medication group,an acupuncture group and a Western medication group by the random number table method.The acupuncture-medication group was intervened by acupuncture,cupping,collateral-pricking bloodletting and oral administration of cetirizine hydrochloride tablets;the acupuncture group was treated with acupuncture,cupping and collateral-pricking bloodletting;the Western medication group only received oral administration of cetirizine hydrochloride tablets.Before treatment and after 6-week treatment,the changes in the symptom scores and the contents of serum IgE,IFN-γ and IL-4 in the three groups were observed.Results:There were no significant differences in the total effective rate among the three groups(all P>0.05),but the cured and markedly effective rate was significantly higher in the acupuncture-medication group than that in the Western medication group(P<0.05).After treatment,the total symptom score decreased in the three groups(P<0.05),and the improvement of total symptom score in the acupuncture-medication group was more significant than that in the Western medication group(P<0.05).The component symptom scores all decreased after treatment in the three groups(all P<0.05);the improvements of the scores of itch intensity,and skin lesion size and number were more significant in the acupuncture-medication group than in the Western medication group(all P<0.05);the improvement of the skin lesion size score was more significant in the acupuncture group than in the Western medication group(P<0.01).The contents of IgE and IL-4 dropped(all P<0.05)and the content of IFN-y increased(P<0.05)after treatment in the three groups;the post-treatment changes in the serum contents of IgE and IFN-y were more significant in the acupuncture-medication group than in the Western medication group(both P<0.05).The incidence rate of adverse reactions was significantly lower in the acupuncture-medication group and acupuncture group than in the Western medication group(both P<0.05),and the relapse rate was significantly lower in the acupuncture-medication group than in the Western medication group(P<0.05).Conclusion:Combined acupuncture and medication can enhance the cured and markedly effective rate in treating chronic urticaria.Acupuncture is equivalent to cetirizine hydrochloride tablets comparing the clinical efficacy in treatment of chronic urticaria.Acupuncture plus medication and acupuncture alone both can effectively mitigate the clinical symptoms,with low incidence of adverse reactions.The relapse rate is low when using acupuncture together with medication.Acupuncture plus medication can work better in regulating the contents of IgE and IFN-y and improving the imbalance of Th1/Th2 cell function.
目的:观察针刺治疗慢性荨麻疹的临床疗效及血清免疫球蛋白E(IgE)、干扰素γ(IFN-γ)及白细胞介素4(IL-4)的含量变化,探讨针刺对辅助T(Th)1/Th2细胞功能失衡的影响.方法:将符合慢性荨麻疹纳入标准的90例患者经随机数字表法随机分为针药组、针刺组和西药组.针药组采用针刺、拔罐、刺络放血加口服盐酸西替利嗪片治疗,针刺组采用针刺、拔罐和刺络放血治疗,西药组仅口服盐酸西替利嗪片.观察治疗前和治疗6周后三组症状评分的变化及血清IgE、IFN-γ及IL-4的含量变化.结果:治疗后三组总有效率差异无统计学意义(均P>0.05),针药组愈显率明显优于西药组(P<0.05).治疗后,三组症状总分均较治疗前降低(均P<0.05),针药组治疗后症状总分改善优于西药组(P<0.05);三组各单项症状评分均较治疗前降低(均P<0.05),针药组瘙痒程度、风团大小、风团数目评分的改善优于西药组(均P<0.05),针刺组风团大小评分的改善优于西药组(P<0.01).治疗后,三组患者体内IgE和IL-4的含量均较治疗前降低(均P<0.05),IFN-γ的含量均较治疗前升高(均P<0.05);针药组治疗前后血清IgE与IFN-γ含量的差值均大于西药组(均P<0.05).针药组和针刺组不良反应的发生率均显著低于西药组(均P<0.05),针药组复发率显著低于西药组(P<0.05).结论:针药结合治疗慢性荨麻疹可提高临床愈显率,针刺治疗慢性荨麻疹临床疗效与盐酸西替利嗪片相当,且针药结合与针刺治疗可有效改善临床症状.针药结合和针刺治疗的不良反应发生率低,针药结合治疗的复发率低.针药结合的作用机制可能是更好地调节IgE和IFN-γ含量,改善Th1/Th2细胞功能失衡.
作者
Zhang Xin
Ji Jun
Hong Jue
张欣;纪军;洪珏(译)(Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China;不详)
