俞募配穴针灸治疗慢性疲劳综合征临床疗效及对细胞因子的影响

Clinical Efficacy of Back-Shu and Front-Mu Point Acupuncture on Chronic Fatigue Syndrome and Its Effect on Serum Level of Cytokines

目的观察俞募配穴针灸治疗慢性疲劳综合征(CFS)的临床疗效及对血清白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)等细胞因子的影响,探讨其作用机制。方法将77例CFS患者随机分为治疗组39例和对照组38例,另设正常组20例。治疗组采用俞募配穴针灸治疗,对照组采用Streitberger’s安慰针具治疗,连续治疗4周。比较2组临床疗效。2组治疗前后血清IL-2、TNF-α水平用放免法测定,血清IFN-γ水平用ELISA法测定,并采用同一方法在治疗前同时测定正常组血清IL-2、TNF-α、IFN-γ水平。结果 2组疗效比较,治疗组总有效率71.8%(28/39),对照组总有效率15.8%(6/38),治疗组优于对照组(P<0.01)。2组患者治疗前与正常组比较血清IL-2、IFN-γ、TNF-α水平均显著降低(P<0.05或P<0.01);治疗后治疗组血清IL-2、IFN-γ、TNF-α水平均显著升高(P<0.05或P<0.01),而对照组稍有升高,但均无统计学意义;2组治疗后比较,血清IL-2、IFN-γ、TNF-α水平差异均有统计学意义(P<0.05或P<0.01)。结论俞募配穴针灸对CFS患者有较好的疗效,升高患者血清IL-2、IFN-γ、TNF-α等细胞因子的水平,提高免疫力,可能是本法治疗CFS取效的主要机制之一。

Objective To evaluate the clinical efficacy of Back-Shu and Front-Mu point prescription on chronic fatigue syndrome （CFS） and its effect on the serum level of IL-2, IFN-γ and TNF-α, and explore its mechanism. Methods A total of 77 patients were divided into the test group （n=39） and the control group （n=38）. A normal control group designated included 20 normal volunteers. Patients in the test group and control group were subject to Back-Shu and Front-Mu point prescription and acupuncture with Streitberger’s placebo needles, respectively, continuously for 4 weeks. Serum IL-2 and TNF-α level of the patients before and after treatment were determined using RIA, and serum IFN-γ level was evaluated using ELISA. The serum levels of the three cytokines in the normal control group were also evaluated. Results The total effective rate in the test group （71.8%, 28/39） was superior to that in the control group （15.8%, 6/38, P〈0.01）. The serum IL-2, IFN-γ and TNF-α levels before treatment in the test and control group were significantly lower than those in the normal control group （P〈0.05 or 〈0.01）. The post-treatment serum IL-2, IFN-γ and TNF-α levels significantly increased in the test group （P〈0.05 or 〈0.01）, and slightly increased in the control group with no significance. After treatment, there was a significant difference on the serum levels of these three cytokines between the two groups （P〈0.05 or 〈0.01）. Conclusion Back-Shu and Front-Mu point prescription has a good clinical efficacy on CFS, and can elevate the serum IL-2, IFN-γ and TNF-α levels, improve the immunity in these patients, which may be one of the major mechanisms contributing to the effectiveness of the therapy for patients with CFS.