刺络拔罐配合自血穴位注射对慢性荨麻疹患者血清IL-4、IFN-γ水平及安全性的影响研究

Bloodletting Puncture and Cupping Combined with Acupoint Injection of Autologous Blood in the Treatment of Chronic Urticaria: Safety Study and Effect on Serum Levels of IL-4 and IFN-γ

目的:探讨刺络拔罐配合自血穴位注射对慢性荨麻疹患者血清白细胞介素-4(IL-4)、干扰素γ(IFN-γ)水平的影响,并分析其安全性。方法:选择92例慢性荨麻疹患者,随机分为对照组与实验组,每组各46例。对照组给予刺络拔罐治疗,实验组在对照组的基础上采用自血穴位注射治疗,每周3次,2周为1个疗程,连续治疗4个疗程。检测患者治疗前后血清中IL-4、IFN-γ的含量,对生活质量、中医证候、荨麻疹活动性进行评分,并评价疗效,观察不良反应发生情况以及复发情况。结果:治疗后两组患者血清IL-4含量减少,IFN-γ含量升高,其中实验组IL-4含量低于对照组,IFN-γ含量高于对照组,差异有统计学意义(P <0. 05);两组患者中医证候评分与荨麻疹活动性评分均降低,其中实验组中医证候评分与荨麻疹活动性评分低于对照组,差异有统计学意义(P <0. 05);两组患者生活质量评分随着时间延长均显著降低,其中实验组在各时间段评分均低于同期对照组,差异有统计学意义(P <0. 05);对照组有效率为78. 26%,低于实验组的93. 48%,差异具有统计学意义(P <0. 05);对照组复发率为26. 09%,高于实验组的8. 70%,差异有统计学意义(P <0. 05)。结论:刺络拔罐配合自血穴位注射治疗慢性荨麻疹患者,能明显改善患者临床症状,提高疗效,可能与调节IL-4、IFN-γ含量有关,并且安全性高,复发率低,值得推广应用。

Objective： To explore the effect of bloodletting puncture and cupping combined with acupoint injection of autologous blood on serum levels of IL-4 and IFN-γ in patients with chronic urticaria,and to assess its safety. Methods： 92 cases of chronic urticaria were randomly divided into the control group（ n = 46） and the observation group（ n = 46）. The control group was treated by bloodletting puncture and cupping; on which basis,the observation group was also treated with acupoint injection of autologous blood. The treatment was 3 times per week for four courses,and 2 weeks was taken as one course. The serum levels of IL-4 and IFN-γwere detected before and after the treatment. The quality of life,TCM syndromes and urticaria activity were scored,and the curative effect was evaluated. The incidence of adverse reactions and recurrence were observed. Results： After the treatment,the serum content of IL-4 was decreased,and the content of IFN-γ was increased in the two groups; the improvement was more significant in the observation group than that in the control group（ P〈0. 05）. The scores of TCM syndromes and urticaria activity were both decreased in the two groups,and the decreases were more obvious in the observation group compared to those in the control group（ P〈0. 05）. The scores of life quality were significantly reduced in the two groups with time,and the scores of the observation group were lower than those of the control group at the same time point（ P〈0. 05）. The effective rate of the control group was 78. 26%,which was significantly lower than 93. 48% of the observation group（ P〈0. 05）. The recurrence rate of the control group was 26. 09%,which was significantly higher than 8. 70%of the observation group（ P〈0. 05）. Conclusion： The therapy of bloodletting puncture and cupping combined with acupoint injection of autologous blood can significantly improve the clinical symptoms and increase the curative effect of the patients with chronic urticaria,which may be related to the regulation of IL-4 and IFN-γ.The therapy has high safety with low recurrence rate,therefore it is worthy of popularization and application.