摘要
目的探讨针药联合治疗病毒感染后嗅觉障碍的临床效果及其潜在调控机制。方法将104例病毒感染后嗅觉障碍患者随机分成对照组和联合组,每组52例。其中,对照组给予常规鼻用激素糠酸莫米松鼻喷剂治疗,联合组在对照组基础上鼻内镜下针刺双侧内迎香穴和鼻丘穴。两组患者治疗前和治疗4周后行Sniffin Sticks嗅棒测试和T&T嗅觉计测试;采用副鼻窦CT扫描评估嗅裂通气情况;采集两组患者静脉血,采用Western blotting检测髓样分化因子88(MyD88)、Toll样受体4(TLR4)和核转录因子-κB(NF-κB)p65蛋白相对表达量,采用流式细胞术检测CD4^(+)CD25^(+)T细胞和CD4^(+)CD25^(high)T细胞百分率。结果两组治疗4周后和治疗前TDI评分差值比较,差异有统计学意义(P<0.05),联合组差值高于对照组。两组治疗4周后和治疗前T&T测试差值比较,差异有统计学意义(P<0.05),联合组差值高于对照组。两组治愈率和改善率比较,差异均有统计学意义(P<0.05),联合组高于对照组。两组患者静脉血MyD88、TLR4和NF-κB p65蛋白相对表达量治疗前与治疗4周后比较,差异有统计学意义(P<0.05),治疗4周后均低于治疗前;两组治疗4周后静脉血MyD88、TLR4和NF-κB p65蛋白相对表达量比较,差异有统计学意义(P<0.05),联合组低于对照组。两组患者静脉血CD4^(+)CD25^(+)T细胞百分率和CD4^(+)CD25^(high)T细胞百分率治疗前与治疗4周后比较,差异有统计学意义(P<0.05),治疗4周后均高于治疗前;两组患者治疗4周后静脉血CD4^(+)CD25^(+)T细胞百分率和CD4^(+)CD25^(high)T细胞百分率比较,差异有统计学意义(P<0.05),联合组高于对照组。结论针药联合可恢复病毒感染后嗅觉障碍患者的嗅觉功能并减轻炎症,且疗效优于单纯的药物治疗,其机制与抑制TLR4/MyD88/NF-κB信号通路有关。
Objective To explore the clinical effects and potential regulatory mechanism of combined acupuncture and medicine in the treatment of postviral olfactory dysfunction.Methods 104 PVOD patients were randomly divided into the Control group and the acupuncture-medicine combined group,with 52 patients in each group.Among them,the Control group was given conventional nasal hormone mometasone furoate nasal apray for treatment,and the acupuncture-medicine combined group was given intranasal acupuncture at bilateral Neiyingxiang and Biqiu points on the basis of conventional treatment.Sniffin Sticks test,T&T smell test,and paranasal sinus CT scan were performed before treatment and one month after treatment,also the venous blood of each group was collected.Western blotting was applied to detect the expressions of MyD88,TLR4,and NF-κB p65,and the flow cytometry was used to measure the percentages of CD4^(+)CD25^(+)T cells and CD4^(+)CD25^(high) T cells.Results Compared with the control group,the difference of TDI score and T&T smell test score,cure rate,improvement rate,CD4^(+)CD25^(+)T cells,and CD4^(+)CD25^(high) T cells percentages in the acupuncture-medicine combined group were increased(P<0.05).However,the T&T smell test score,MyD88,TLR4,and NF-κB p65 expressions were decreased(P<0.05);compared with the indexes before treatment,CD4^(+)CD25^(+)T cells and CD4^(+)CD25^(high) T cells percentages were increased after treatment(P<0.05),while MyD88,TLR4,and NF-κB p65 expressions were decreased(P<0.05).Conclusions The combination of acupuncture and medicine restored the olfactory function and reduced inflammation in viral-infectious olfactory dysfunction patients,and the curative effect was better than that of the simple drug group.Its mechanism is related to the inhibition of TLR4/MyD88/NF-κB pathway.
作者
丁晓明
郑丽红
孔菲
柏杉
Xiao-ming Ding;Li-hong Zheng;Fei Kong;Shan Bai(Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150040,China;Department of Gastroenterology,The Fourth Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China;Department of Endocrinology,The Fourth Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China;Department of Otolaryngology,The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150000,China)
出处
《中国现代医学杂志》
CAS
北大核心
2022年第17期1-7,共7页
China Journal of Modern Medicine
基金
黑龙江省中医药科研项目(No:ZHY2020-155)
黑龙江中医药大学科研基金项目(No:201731)。
