雷火炙结合大活络胶囊对神经根型颈椎病患者炎症因子、血液流变学指标和T淋巴细胞亚群的影响

Effects of thunder-fire moxibustion combined with Dahuoluo Capsules on inflammatory factors,hemorheological indicators,and T lymphocyte subsets in patients with cervical spondylotic radiculopathy

目的探究雷火灸结合大活络胶囊对神经根型颈椎病(CSR)患者炎症因子、血液流变学指标和T淋巴细胞亚群的影响。方法前瞻性选取2021年10月至2023年10月广州市中西医结合医院收治的120例CSR患者作为研究对象,按照随机数字表法将其分为对照组和观察组,每组各60例。对照组给予大活络胶囊(口服,3次/d,每次服用4粒)治疗,观察组给予雷火灸结合大活络胶囊治疗,雷火灸每次30 min,1次/d,每周5次,两组均持续治疗2周。比较两组患者的临床疗效,治疗前和治疗2周的疼痛程度[视觉模拟评分法(VAS)评分]、症状积分、炎症因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)]、血液流变学指标[全血高切黏度、全血低切黏度、血浆黏度、红细胞比容(HCT)]及T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化。结果观察组临床总有效率为91.67%,高于对照组(76.67%),差异有统计学意义(P<0.05)。治疗2周后,两组VAS均较治疗前降低,症状积分均较治疗前升高,且观察组的VAS评分为(1.74±0.55)分,低于对照组[(2.82±0.83)分],症状积分为(16.20±3.26)分,高于对照组[(14.85±3.47)分],差异均有统计学意义(P<0.05)。治疗2周后,两组血清IL-6、IL-8、TNF-α水平均较治疗前降低,且观察组的血清IL-6、IL-8、TNF-α水平分别为(27.37±3.47)ng/L、(56.54±15.21)g/L、(8.61±2.13)ng/L,均低于对照组[(38.34±4.64)ng/L、(81.91±16.78)g/L、(13.57±2.42)ng/L],差异均有统计学意义(P<0.05)。治疗2周后,两组全血高切黏度、全血低切黏度、血浆黏度及HCT水平均较治疗前降低,且观察组的全血高切黏度、全血低切黏度、血浆黏度及HCT分别为(3.11±0.45)mPa/s、(6.62±2.17)mPa/s、(1.35±0.1)mPa/s、(38.95±3.08)%,均低于对照组[(3.62±0.68)mPa/s、(8.35±2.36)mPa/s、(1.78±0.26)mPa/s、(42.97±2.85)%],差异均有统计学意义(P<0.05)。治疗2周后,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)水平均较治疗前降低,且观察组的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)分别为(75.32±7.23)%、(47.58±6.33)%、2.17±0.77,均高于对照组[(68.04±8.01)%、(42.49±7.47)%、1.79±0.72],CD8^(+)水平为(20.15±4.45)%,低于对照组[(23.75±4.54)%],差异均有统计学意义(P<0.05)。结论雷火灸结合大活络胶囊治疗CSR疗效显著,可有效减轻患者疼痛,缓解临床症状,抑制炎症反应、改善血液流变学指标、增强免疫力可能是其疗效的作用机制。

Objective To investigate the effects of thunder-fire moxibustion combined with Dahuoluo Capsules on inflammatory factors,hemorheological indicators,and T lymphocyte subsets in patients with cervical spondylotic radiculopathy(CSR).Methods A total of 120 CSR patients admitted to Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2021 to October 2023 were prospectively selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 60 cases in each group.The control group was treated with Dahuoluo Capsules(orally,3 times/d,4 capsules each time).The observation group was treated with thunder-fire moxibustion combined with Dahuoluo Capsules,30 min each time,once a day,5 times a week.Both groups were treated for 2 weeks.The clinical efficacy,pain degree[visual analogue scale(VAS)score],symptom score,inflammatory factors[interleukin(IL)-6,IL-8,tumor necrosis factor-α(TNF-α)],hemorheological indicators[whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,hematocrit(HCT)]and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared between the two groups before and 2 weeks after treatment.Results The total effective rate of the observation group was 91.67%,which was higher than that of the control group(76.67%),and the difference was statistically significant(P<0.05).After 2 weeks of treatment,the VAS scores of the two groups were lower than those before treatment,and the symptom scores were higher than those before treatment,the VAS score of the observation group was(1.74±0.55)points,which was lower than that of the control group[(2.82±0.83)points],the symptom score of the observation group was(16.20±3.26)points,which was higher than that of the control group[(14.85±3.47)points],and the differences were statistically significant(P<0.05).After 2 weeks of treatment,the levels of serum IL-6,IL-8 and TNF-αin the two groups were lower than those before treatment,and the levels of serum IL-6,IL-8 and TNF-αin the observation group were(27.37±3.47)ng/L,(56.54±15.21)mg/L and(8.61±2.13)ng/L,respectively,which were lower than those in the control group[(38.34±4.64)ng/L,(81.91±16.78)mg/L,(13.57±2.42)ng/L],the differences were statistically significant(P<0.05).After 2 weeks of treatment,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and HCT levels of the two groups were lower than those before treatment,and the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and HCT of the observation group were(3.11±0.45)mPa/s,(6.62±2.17)mPa/s,(1.35±0.1)mPa/s,(38.95±3.08)%,respectively,which were lower than those in the control group[(3.62±0.68)mPa/s,(8.35±2.36)mPa/s,(1.78±0.26)mPa/s,(42.97±2.85)%],the differences were statistically significant(P<0.05).After 2 weeks of treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those before treatment,and the level of CD8^(+)was lower than that before treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were(75.32±7.23)%,(47.58±6.33)%and 2.17±0.77,respectively,which were higher than those in the control group[(68.04±8.01)%,(42.49±7.47)%and 1.79±0.72],and the level of CD8^(+)in the observation group was(20.15±4.45)%,which was lower than that in the control group[(23.75±4.54)%],the differences were statistically significant(P<0.05).Conclusion The combination of thunder-fire moxibustion and Dahuoluo Capsules has a significant therapeutic effect on CSR.It can effectively alleviate patient pain,alleviate clinical symptoms,inhibit inflammatory reactions,improve hemorheological indicators,and enhance immunity,which may be the mechanism of its therapeutic effect.