艾灸对脓毒症患者免疫功能影响的临床研究

Effect of Moxibustion on the Immune Function of Patients with Sepsis

目的观察艾灸对脓毒症患者的治疗作用及对免疫功能的影响。方法将脓毒症患者60例随机分为艾灸组与对照组各30例。两组均予常规西医治疗,疗程10 d,艾灸组在常规西医治疗的基础上予以关元、气海、神阙、足三里、三阴交艾灸治疗。统计治疗过程中两组有创机械通气情况、ICU住院时间、28 d病死率,记录治疗前、治疗第5、10天的APACHEⅡ评分、CD3+、CD14+单核细胞HLA-DR、CD4+、CD8+的表达,计算CD4+/CD8+,以及白细胞数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)的水平。结果艾灸组患者机械通气时间、ICU住院时间均短于对照组(P<0.05),且治疗后艾灸组APACHEⅡ评分、WBC、CRP、PCT均低于同期对照组(P<0.05),但是两组28 d病死率无明显差异(P>0.05)。两组治疗后的CD3+、CD14+单核细胞HLA-DR、CD4+、CD8+、CD4+/CD8+较同组治疗前增加(P<0.05),且艾灸组CD3+、CD14+单核细胞HLA-DR、CD4+、CD8+、CD4+/CD8+均高于同期对照组(P<0.05)。结论艾灸可以通过调节免疫功能,从而控制感染,改善脓毒症患者的临床预后。

Objective:To observe the effect of moxibustion on sepsis and immune function.Methods:A total of 60 patients with sepsis were randomly divided into the moxibustion group(30 cases)and control group(30 cases).Both groups were treated with conventional western medicine for 10 days.The moxibustion group was treated with moxibustion in Guanyuan(CV4),Qihai(CV6),Shenque(CV8),Zusanli(ST36),Sanyinjiao(SP6)on the basis of conventional western medicine treatment.During the treatment,the invasive mechanical ventilation,the length of stay in ICU and the 28 d mortality rate of the two groups were counted.The APACHEⅡ score,and the levels,and the rates of CD3+,CD14+monocyte HLA-DR,CD4+,CD8+,CD4+/CD8+ were recorded before and on the 5 th and 10 th day of treatment.Results:The duration of mechanical ventilation and ICU stay in moxibustion groups were shorter than that in control group(P<0.05).After treatment,the APACHEⅡ score,WBC,CRP,PCT of moxibustion group were lower than those of the control group(P<0.05),but there was no significant difference in the28 d mortality between the two groups(P>0.05).The rates of CD3+,CD4+/CD8+,CD14+ monocyte HLA-DR in two groups increased after treatment compared with before treatment(P<0.05),and the rates of CD3+,CD4+/CD8+,CD14+ monocyte HLA-DR in the moxibustion group were higher than those in the control group(P<0.05).Conclusion:Moxibustion can control the infection by regulating the immune function,thus improving the clinical prognosis of patients with sepsis.