穴位埋线法治疗顽固性葡萄膜炎的临床研究

Clinical study of catgut embedding on refractory uveitis

目的探讨常规中西医结合疗法联合使用穴位埋线技术在治疗顽固性葡萄膜炎过程中对机体免疫功能的影响。方法将60例顽固性葡萄膜炎患者随机分为3组,即激素组(A组)、激素+中药组(B组)、激素+中药+穴位埋线组(C组),每组20例。观察治疗前后各组患者CD4^+、CD8^+淋巴细胞以及免疫球蛋白IgG、IgM、IgA的变化,同时对治疗后不同时间的临床疗效进行追踪。结果 CD4+细胞:A、B组CD4^+百分比无统计学意义的变化(P>0.05),C组CD4^+百分比较治疗前升高(P=0.040),并高于A组(P>0.05)、B组(P<0.05)。CD8^+细胞:三组CD8^+百分比均较治疗前下降,C组数值降低最明显(P<0.001),其次为B组(P=0.040),A组前后差异无统计学意义(P=0.300)。免疫球蛋白:三组IgG数值均较治疗前降低(P<0.05),C组IgG血清浓度低于A组及B组(P<0.05)。C组IgM水平有统计学意义的降低(P=0.040),A、B组IgM、IgA血清浓度均未见明显变化(P>0.05)。临床疗效:A组治疗后6周、12周、18周的总有效率分别为50%、60%、70%,B组为50%、75%、85%,C组为50%、80%、100%。结论在常规激素及中药治疗基础上使用穴位埋线,有助于改善顽固性葡萄膜炎患者的免疫状态,是治疗顽固性葡萄膜炎的一种有效方法。

OBJECTIVE To discussed effects of integrative therapy with catgut embedding on immune function of refractory uveitis cases. METHODS Sixty patients with refractory uveitis were randomly divided into three groups, namely, the hormone group（A）, hormone combined with Chinese medicine group（group B）, hormone medicine, Chinese medicine plus catgut embedding group（group C）, each group included 20 cases. The variation of CD4~＋, CD8~＋ lymphocytes and immunoglobulins IgG, IgM, IgA of patients was observed before and after treatment,besides, the clinical efficacy at different time point after treatment was tracked. RESULTS CD4~＋cells： The change of CD4~＋ percentage of group A and B was not statistically significant（P〈0.05）, the percentage of group C increased significantly after treatment（P=0.040）, and it was higher than the counterpart of group A（P〈0.05） and group B（P〈0.05）. CD8~＋cells： CD8~＋ percentage of three groups all dropped after treatment the decrease of group C was most obvious（P〈0.001）, it followed by group B（P=0.040）, and the reduction of group A was not statistically significant（P=0.300）. Immunoglobulins： The Ig G concentration of three groups all dropped after treatment（P〈0.05）, and the digit of group C was lower than it of group A and group B（P〈0.05）. Group C experienced a significant reduction of IgM level（P=0.040）. Similar scale of decrease of IgM, IgA did not happen in group A and B IgM（P〈0.05）. Clinical efficacy： At the 6^（th） weeks, the 12^（th） weeks, the 18 thweeks, responsive rate of group A was 50%, 60%, 70%, it of group B was 50%, 75%, 85%, and the rate of group C was50%, 80%, 100%. CONCLUSIONS Using Catgut embedding in addition to conventional hormone therapy combined with Chinese medicine helped to improve the immune status of patients with refractory uveitis, it was an effective method for this disease.