愈障散神阙穴灸疗对肾阳虚型慢性再生障碍性贫血患者外周血IL-17 mRNA影响的临床研究

Effect of “Yuzhang Powder”moxibustion on umbilicus on IL-17mRNA in peripheral blood for the treatment of chronic aplastic anemia of kidney-yang deficiency pattern

目的观察愈障散神阙穴灸疗治疗肾阳虚型慢性再生障碍性贫血的临床疗效及其对患者IL-17 mRNA的影响。方法将70例慢性再生障碍性贫血患者随机分为治疗组与对照组,每组35例。对照组采用西医常规治疗,治疗组在对照组治疗措施基础上加用愈障散神阙穴灸疗。两组疗程均为6个月,观察临床疗效以及血象指标(Hb、WBC、PLT)、血清IL-17水平、外周血T淋巴细胞中IL-17 mRNA表达变化情况。结果 1疗程结束时,最终完成试验者63例,治疗组32例,对照组31例。2治疗组、对照组总有效率分别为87.50%、61.29%;组间临床疗效,差异有统计学意义(P<0.05)。3治疗前后组内比较,两组Hb、WBC、PLT差异有统计学意义(P<0.05);组间治疗后比较,Hb、WBC差异有统计学意义(P<0.05)。4治疗前后组内比较,两组血清IL-17及外周血T淋巴细胞中IL-17 mRNA相对值差异有统计学意义(P<0.05);组间治疗后比较,血清IL-17及外周血T淋巴细胞中IL-17 mRNA相对值差异有统计学意义(P<0.05)。5两组均未见明显不良反应。结论愈障散神阙穴灸疗治疗肾阳虚型慢性再生障碍性贫血,可显著改善血象;其机制可能与降低血清IL-17及外周血T淋巴细胞IL-17mRNA表达有关。

Objective To observe the clinical efficacy of ＂Yuzhang Powder＂ moxibustion on umbilicus for the treatment of chronic aplastic anemia of＇ kidney-yang deficiency pattern. Methods Seventy cases with chronic aplastic anemia of kidney-yang deficiency pattern were randomized into treatment group and control group, with 35 cases in each group. Control group was treated with conventional therapy, and treatment group was treated with ＂Yuzhang Powder＂ moxibustion on umbilicus additionally, with the course of 6 months. The clinical efficacy, indicators of Hb, WBC, PLT and levels of IL-17 and IL-17 mRNA were observed. Results （1）At the end of the treatment, 63 cases completed the trial. Thirty-two patients in the treatment group and 31 cases in the control group. （2） The overall effective rate was 87.50% in the treatment group and 61.29% in the control group, with a difference between the two groups （ P 〈 0.05 ）. （3） In both groups, there were significant differences in the levels of Hb, WBC and PLT between before and after treatment （ P 〈 0.05 ） ; after treatment, there were significant differences in the levels of Hb and WBC between the two groups, and the treatment group was superior to the control group （P 〈 0.05）. （4） In both groups, there were significant differences in the IL-17 level of the serum and relative value of IL-17 mRNA in thymus-dependent lymphocytes of peripheral blood between befoe and after treatment （P 〈 0.05 ） ; after treatment, there were significant differences in the IL-17 level of the sernra and relative value of IL-17 mRNA in peripheral blood between the two groups, and the treatment group was superior to the control group （P 〈 0.05 ）. （5） No adverse reaction was found in both groups. Conclusion ＂Yuzhang Powder＂ moxibustion on umbilicus is effective to patients with chronic aplasfic anemia of the kidney-yang deficiency pattern. Its mechanism may be assication with the decrease of IL-17 level and the expression of IL-17 mRNA in the peripheral blood T-lymphocytes.