电针与单纯针刺对类风湿关节炎患者外周血与关节滑液中白介素改变作用的观察  

Effects of electroacupuncture and simple acupuncture on changes of IL-1,IL-4,IL-6 and IL-10 in peripheral blood and joint fluid in patients with rheumatoid arthritis

作　　者：欧阳八四[1] 车建丽[2] 高洁[1] 张音[1] 李俊[1] 杨海洲[1] 胡天燕[3] 吴元建[4] 杨熳[4] 

机构地区：[1]苏州市中医医院针灸科,江苏苏州215003 [2]苏州大学附属第一医院 [3]苏州大学附属儿童医院 [4]南京中医药大学

出　　处：《中国针灸》2010年第10期840-844,共5页Chinese Acupuncture & Moxibustion

基　　金：苏州市科技发展计划(社会发展和三药攻关)资助项目:SS0528

摘　　要：目的:探讨电针对类风湿关节炎(RA)患者的作用机制。方法:采用随机对照的研究方法,将63例类风湿关节炎患者随机分为电针组(32例)与单纯针刺组(31例)。采取整体与局部相结合的配穴方法,穴取百会、风池、曲池、外关、关元、足三里等,电针组在疼痛关节附近选一组阿是穴接电针仪,采用连续波,留针30min,然后针背俞穴,接电针仪,留针15min;单纯针刺组取穴、针法均与电针组相同,只是不予接电针仪。均隔日治疗1次,10次为一疗程,治疗3个疗程。观察患者外周血和关节滑液中白介素变化。结果:电针与单纯针刺对患者外周血和关节滑液中白介素系列IL-1、IL-4、IL-6、IL-10均有较显著的作用(P<0.01,P<0.05),但从治疗后指标变化的绝对值和改善值来看,电针降低外周血和关节滑液中IL-1的作用优于单纯针刺组(均P<0.05);升高关节滑液中IL-4作用优于单纯针刺(P<0.05);降低外周血和关节滑液中IL-6作用两组基本相当(P>0.05),但改善值上外周血中IL-6的变化,电针组优于单纯针刺组(P<0.05);治疗后在外周血和关节滑液中IL-10升高的绝对值上电针组与单纯针刺组作用基本相当(均P>0.05),但其改善值电针组优于单纯针刺组(均P<0.05)。结论:电针能有效降低RA患者外周血和关节滑液中致炎性IL-1、IL-6的含量,提高抑炎性IL-4、IL-10的含量,改善RA发生、发展的内环境。Objective To explore the mechanism of electroacupuneture on rheumatoid arthritis （RA）. Methods In a randomized and controlled trial, sixty-three cases with RA were randomly divided into an electroacupuncture group （n=32） and a simple acupuncture group（n= 31）. Baihui （GV 20）, Fengchi （GB 20）, Quchi （LI 11）, Waiguan （TE 5）, Guanyuan （CV 4） and Zusanli （ST 36） were selected by coordination method combined whole and local acupoints. The electroacupuncture group was treated with electroacupuncture at the local acupoints near painful joints, continuous wave, retaining needle for 30 minutes, and then electroacupuncture at Back-shu acupoints, retaining needle for 15 minutes, and the simple acupuncture group was treated with the same acupoints selection and acupuncture manipuIation without electroacupuncture apparatus. They were all treated once every other day for 20 days as one course. After 3 courses, changes of interleukins in peripheral blood and joint fluid of patients were observed. Results Both of electroacupuncture and simple acupuncture had significant effect on IL-1, IL-4, IL-6 and IL-10 in peripheral blood and joint fluid of patients with RA （ P〈0. 01 ,P〈0.05）. But after electroacupuncture, the absolute value and improvement value of decreasing IL-1 in peripheral blood and joint fluid were super than those of simple acupuncture （all P〈0.05）, and of IL-4 in joint fluid was super than that after simple acupuncture （P〈0.05）, and of IL-6 and the absolute value of decreasing IL-10 were almost the same after both treatment （all P〈0. 05）,and after electroacupuncture, the improvement value of IL-10 in peripheral blood and joint fluid were super than those after simple acupuncture （both P〈0. 05）. Conclusion Electroacupuncture can effectively decrease the proin- flammatory cytokine of IL-1 and IL-6 and increase the inhibition cytokine of IL-4 and IL-10 and improve the internal environment of occurrence and progression of RA.

关 键 词：电针 针刺 类风湿关节炎 白介素 

分 类 号：R246.2[医药卫生—针灸推拿学]