自拟中药方熏蒸治疗慢性荨麻疹疗效及对血清细胞因子的影响

The Curative Effect of Traditional Chinese Medicine Fumigation in Treating Chronic Urticaria and the Influence on Serum Cytokines

目的:观察自拟中药方熏蒸治疗慢性荨麻疹的疗效及其对患者血清细胞因子水平的影响。方法:将120例符合慢性荨麻疹诊断的患者随机分为联合治疗组及西药治疗组。联合治疗组给予自拟中药方熏蒸联合咪唑斯汀缓释片口服治疗,西药治疗组则单纯给予咪唑斯汀缓释片口服治疗。于治疗前及治疗后第28天对患者症状进行评价,并随访3个月观察荨麻疹复发情况;同时采用ELISA法检测治疗前、后患者血清中细胞因子IL-4、IFN-γ水平,并将其结果与40例健康志愿者进行比较对照。结果:联合治疗组总有效率为86.8%,复发率3.3%;西药治疗组总有效率66.7%,复发率31.3%。治疗前患者血清中IL-4水平较健康对照者升高而IFN-γ水平降低,疗程结束后患者血清中IL-4水平明显下降而IFN-γ水平升高,与治疗前相比,差异有统计学意义(P<0.05);与西药治疗组相比,联合治疗组患者血清中细胞因子水平变化更为显著(P<0.05)。结论:自拟中药熏蒸方法联合咪唑斯汀缓释片治疗慢性荨麻疹疗效具有协同增效作用,其增效机制可能与该方中部分中药调节患者血清中IL-4、IFN-γ等细胞因子的水平,纠正荨麻疹患者机体的免疫失衡状态有关。

Objective ： To observe the curative effect of Traditional Chinese Medicine fumigation in treating chronic urticaria and the influence on serum cytokines of patients. Method： 120 cases diagnosed with chronic urticaria were randomly divided into treatment group and control group. Treatment group was given Traditional Chinese Medicine fumigation combined with imidazole sting zyban oral therapy, while control group was treated with imidazole sting zyban oral therapy. The patients＇ symptoms were evaluated before the treatment and on the 28th day of it. After the treatment, the patients were followed up for 3 months to observe their recurrence. At the same time, the levels of serum cytokines, IL-4 and IFN-γ, were tested by ELISA method before and after the treatment, and the results were compared with those of 40 healthy volunteers. Result： The total effective rate of treatment group was 86.8%, and the recurrence rate was 3.3%. The total effective rate of control group was 66.7%, and the recurrence rate was 31.3%. Before the treatment, serum IL-4 level of the patients was higher than those of the healthy volunteers, while serum IFN-γ level of the patients was lower. After the treatment, the patients＇ IL-4 level dropped notably and IFN-γ level raised, which, compared with those before treatment, showed significant difference （P〈0.05）. Compared with control group, the change of the serum cytokines levels in the treatment group was much more significant（ P〈0. 05 ）.Conclusion： Traditional Chinese Medicine fumigation and imidazole sting zyban can increase each other curative effect in treating chronic urticaria. The mechanism is probably that some Chinese herbs in the decoction can adjust patients＇ serum cytokines, such as IL-4 and IFN-γ,which is related to the patients＇ immunity.