针刺联合隔热姜灸治疗风寒型荨麻疹的临床疗效及其作用机制研究

Clinical Effect and Immune Mechanism of Acupuncture Combined with Ginger-Padded Moxibustion Treating Urticaria of Cold Pattern

目的:观察针刺联合隔热姜灸治疗风寒型荨麻疹的临床疗效及其免疫机制。方法:将58例风寒型荨麻疹患者随机分为观察组和对照组,每组各29例。对照组采用常用口服药物氯雷他定进行治疗,观察组采用针刺联合隔热姜灸治疗,双侧取穴:曲池、风池、合谷、膻中、天枢、太冲、血海和足三里进行针刺,再施以隔热姜灸治疗。分别于周一、周三、周五进行治疗,4周为一疗程。采用荨麻疹活动性评分来评估病情的严重程度,包括患者的瘙痒程度、荨麻疹团块的数量、大小以及皮肤划痕症状等,进而观察两组患者的临床疗效;采用皮肤病生活质量指数评价两组患者的生活情况;采用ELISA法检测风寒型荨麻疹患者血清中总Ig E、趋化因子CCL26、CCL27水平表达情况。结果:观察组总有效率高于对照组,具有统计学意义(P<0.05);与对照组比较,观察组血清中总Ig E、趋化因子CCL26、CCL27的表达水平显著降低,具有统计学差异(P<0.05),且与风寒型荨麻疹的严重程度呈现正相关。结论:针刺治疗风寒型荨麻疹疗程短、疗效显著,其作用机制可能与调整Th1/Th2细胞因子的平衡有关,对于风寒型荨麻疹的早期诊断和临床治疗具有重要意义。

Objective： To observe the clinical effect and the immune mechanism of acupuncture combined with ginger-padded moxibution in treatment of urticaria of cold pattern. Methods： 58 urticaria patients of cold pattern were randomly divided into the observation group（ n = 29） and the control group（ n = 29）. The control group was treated with Loratadine; the observation group was treated with acupuncture combined with ginger-padded moxibuston,bilateral acupoints chosen were Quchi（ LI11）,Fengchi（ GB20）,Hegu（ LI4）,Danzhong（ CV17）,Tianshu（ ST25）,Taichong（ Liv3）,Xuehai（ SP10）,and Zusanli（ ST36）. The treatment was on Monday,Wednesday and Friday,and four weeks were taken as one treatment course. The clinical efficacy was compared by evaluating urticaria severity,including itching degree,the amount and size of the clumps,and skin scratches. Index of life quality was used to assess the patient＇s life condition. Serum levels of total Ig E,CCL26 and CCL27 were detected by ELISA method. Results： The total effective rate of the observation group was significantly higher than that of the control group（ P〈0. 05）. The serum levels of total Ig E,CCL26 and CCL27 were significantly reduced in the observation group than those in the control group（ P〈0. 05）,and it is positively correlated with the severity of urticaria of cold pattern. Conclusion： Acupuncture combined with ginger-padded moxibution is effective for urticaria of cold pattern with short course of treatment,which mechanism may be related to the balance of Th1/Th2. It has clinical importance to the early diagnosis and treatment for urticaria of cold pattern.