三风穴埋线联合当归饮子口服治疗血虚风燥型荨麻疹疗效观察

Therapeutic Effects and Mechanism of Catgut Embedding and Danggui Yinzi Oral Treatment for Chronic Urticaria Patients with Blood Deficiency Wind Dryness Syndrome

目的观察“三风穴”为主埋线联合当归饮子口服治疗血虚风燥型荨麻疹的疗效,探讨其对免疫调节因子的影响。方法将138例血虚风燥型荨麻疹患者采用随机数字加信封法分为联合治疗组(联合组)、中药组及西药组,每组各46例。联合组采用穴位埋线联合当归饮子口服治疗,中药组单用当归饮子口服治疗,西药组单用氯雷他定片口服治疗,治疗周期均为4周。比较3组患者症状及体征积分、荨麻疹活动性评分(UAS)、皮肤病生活质量评分(DLQI)、临床治疗有效率及3个月后复发率;采用ELISA法检测3组患者血清干扰素-γ(IFN-γ)和IL-4的含量。采用流式细胞仪检测3组患者血清T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平。结果3组患者治疗后UAS评分均降低,且联合组低于中药组及西药组(F=5.2541,P<0.05);联合组治疗有效率[93.48%(43/46)]高于中药组[80.43%(37/46)]及西药组[73.91%(34/46)],差异有统计学意义(χ^(2)=7.45,P<0.05);联合组随访复发率[6.52%(3/46)]低于中药组[19.57%(9/46)]及西药组[39.13%(18/46)],差异有统计学意义(χ^(2)=12.54,P<0.05);3组患者治疗后血清IL-4水平均降低(P<0.05),联合组和中药组治疗后血清IFN-γ水平均升高(P<0.05);联合组治疗后血清IL-4水平低于中药组和西药组,血清IFN-γ水平高于中药组和西药组(P<0.05);联合组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高,CD8^(+)水平降低(P<0.05);中药组治疗后CD3^(+)、CD4^(+)水平均升高,CD8^(+)水平降低(P<0.05);西药组治疗后CD3^(+)水平均升高,CD8^(+)水平降低(P<0.05)。结论“三风穴”为主埋线联合当归饮子可有效缓解血虚风燥型荨麻疹患者临床症状,其机制与调节免疫相关因子,升高CD4^(+)/CD8^(+)水平有关。

Objective To observe the curative effect of catgut embedding combined with oral administration of Danggui Yinzi(DGYZ)in treatment of chronic urticaria(UC)patients with blood deficiency wind dryness syndrome(BDWDS),and to explore its effects on immunoregulatory factors.Methods Totally 138 UC patients with BDWDS were assigned to a combination treatment group,a traditional Chinese medicine(TCM)group,and a Western medicine(WM)group by random digit+envelop sealing method,46 cases in each group.Patients in the combination group took DGYZ and received acupoint catgut embedding.Those in the TCM group took DGYZ alone.Those in the WM group took Loratadine Tablets alone.The treatment cycle for all was 4 weeks.The symptoms and signs scores,urticaria activity score(UAS),dermatology life quality index(DLQI),effective rate of clinical treatment,and recurrence rate after 3 months were compared among the 3 groups.The serum levels of IFN-γand IL-4 in the 3 groups were detected by ELISA.The serum levels of CD3^(+),CD4^(+),and CD8^(+)were detected by flow cytometry.Results The UAS scores all decreased after treatment in the 3 groups,and that in the combination group was lower than that in the TCM group and the WM group(F=5.2541,P<0.05).The effective rate of the combination group[93.48%(43/46)]was higher than that of the TCM group[80.43%(37/46)]and the WM group[73.91%(34/46)](χ^(2)=7.45,P<0.05).The follow-up recurrence rate of the combination group[6.52%(3/46)]was lower than that of the TCM group[19.57%(9/46)]and the WM group[39.13%(18/46)](χ^(2)=12.54,P<0.05).The serum IL-4 levels after treatment all decreased in the 3 groups(P<0.05),and serum IFN-γlevels increased after treatment in the combination group and the TCM group(P<0.05).The serum IL-4level after treatment in the combination group was lower than that of the TCM group and the WM group,and the serum IFN-γlevel in the combination group was higher than that of the TCM group and the WM group(P<0.05).The CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels increased and CD8^(+)level decreased after treatment in the combination group(P<0.05).The CD3^(+)and CD4^(+)levels increased and CD8^(+)+level decreased after treatment in the TCM group(P<0.05).CD3^(+)level increased and CD8^(+)level decreased after treatment in the WM group(P<0.05).Conclusion Catgut embedding combined with DGYZ effectively alleviated clinical symptoms of UC patients with BDWDS,and its mechanism was possibly related to regulating immune-related factors and increasing CD4^(+)/CD8^(+)levels.