壮医脐环穴针刺法治疗血虚风燥型慢性湿疹的疗效观察及其对Th1/Th2免疫平衡的影响

Efficacy of acupuncture at Qihuan acupoints of Zhuang Medicine for treatment of chronic eczema withsyndrome of wind-dryness due to blood deficiency and its impact on Th1/Th2 immune balance

目的观察壮医脐环穴针刺法治疗血虚风燥型慢性湿疹的疗效及其对Th1/Th2免疫平衡的影响。方法将84例血虚风燥型慢性湿疹患者随机分为治疗组和对照组,每组42例,治疗组采用壮医脐环穴针刺法,对照组口服复方甘草酸苷片和外涂糠酸莫米松乳膏,疗程均为4周。观察两组临床疗效、不良反应发生情况,比较两组治疗前后血清γ-干扰素、白细胞介素(IL)-2、IL-4、IL-5以及外周血单个核细胞中JAK激酶1(JAK1)、信号转导与转录激活子5(STAT5)、细胞因子信号转导抑制因子3(SOCS3)mRNA表达水平。结果治疗第2、4周时,治疗组总有效率分别为64.29%、83.33%,对照组分别为38.10%、59.52%,治疗组疗效均好于对照组(P<0.05)。治疗后,治疗组血清γ-干扰素、IL-2水平及SOCS3 mRNA表达水平高于治疗前且高于对照组,血清IL-4、IL-5水平及JAK1、STAT5 mRNA表达水平低于治疗前且低于对照组(P<0.05)。两组在治疗期间均无明显不良反应发生。结论壮医脐环穴针刺法治疗血虚风燥型慢性湿疹安全、有效,其机制可能与其调节γ-干扰素、IL-2、IL-4、IL-5水平,影响JAK1、STAT5、SOCS3 mRNA的表达,以纠正Th1/Th2免疫失衡有关。

Objective To observe the efficacy of acupuncture at Qihuan acupoints of Zhuang Medicine for treating chronic eczema with syndrome of wind-dryness due to blood deficiency as well as its impact on Th1/Th2 immune balance.Methods Eighty-four patients with chronic eczema with syndrome of wind-dryness due to blood deficiency were randomly divided into treatment group and control group,with 42 cases in each group.The treatment group received acupuncture at Qihuan acupoints of Zhuang Medicine,while the control group was given Compound Glycyrrhizin Tablets orally and Mometasone Furoate Cream externally.Both groups were treated for four weeks.The clinical efficacy and the incidence of adverse reactions of the two groups were observed,and the two groups were compared in terms of serum levels ofγ-interferon,interleukin(IL)-2,IL-4 and IL-5 before and after treatment,as well as mRNA expression levels of Janus kinase 1(JAK1),signal transducer and activator of transcription 5(STAT5)and suppressor of cytokine signaling 3(SOCS3)in peripheral blood mononuclear cell(PBMC).Results At the 2nd and 4th week of treatment,the total effective rates were 64.29%and 83.33%in the treatment group,and 38.10%and 59.52%in the control group,respectively,the treatment group achieved better efficacy than the control group(P<0.05).After treatment,the treatment group had higher serumγ-interferon and IL-2 levels,elevated expression level of SOCS3 mRNA,lower serum IL-4 and IL-5 levels,and decreased expression levels of JAK1 and STAT5 mRNAs as compared with pretreatment and the control group(P<0.05).No obvious adverse reactions occurred during treatment period in the two groups.Conclusion Acupuncture at Qihuan acupoints of Zhuang Medicine is safe and effective in the treatment of chronic eczema with syndrome of wind-dryness due to blood deficiency,and its mechanism might be related to its modulating the levels ofγ-interferon,IL-2,IL-4 and IL-5,influencing the expression of JAK1,STAT5 and SOCS3 mRNAs,and correcting Th1/Th2 immune imbalance.