针灸对头臂动脉型大动脉炎患者免疫功能的影响  

Effect of Acupuncture Plus Moxibustion on Immune Function in Patients with Bra-chiocephalic Takayasu Arteritis

作　　者：倪光夏[1] 石学敏[2] 韩景献[2] 高其芳[2] 阎莉[2] 蔡刚强 张新昌[1] 宋扬扬 NI Guang-xia;SHI Xue-min;HAN Jing-xian;GAO Qi-fang;YAN Li;CAI Gang-qiang;ZHANG Xin-chang;SONG Yang-yang(The Second Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing 210029,China;Department of Acu-moxibustion Departrnent of Clinical Lab,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193)

机构地区：[1]南京中医药大学第二临床医学院,南京210029 [2]天津中医药大学第一附属医院针灸部,天津300193 [3]天津中医药大学第一附属医院检验科,天津300193

出　　处：《针刺研究》2018年第12期777-780,共4页Acupuncture Research

基　　金：国家中医药管理局中医药科学技术研究基金项目(No.00-01LP 53)

摘　　要：目的:观察针灸对头臂动脉型大动脉炎(BCTA)患者体液免疫和细胞免疫相关指标的影响。方法:对31例BCTA患者进行针灸治疗,以人迎为主穴,并随症配穴,留针20min,每日2次(上下午各1次),4周为1个疗程,共治疗1个疗程。观察患者治疗前后体液免疫相关指标免疫球蛋白IgG、IgA、IgM、IgE,补体C3、C4和细胞免疫相关指标T淋巴细胞亚群CD3^+、CD4^+、CD8^+T细胞的变化情况。结果:31例BCTA患者在刚入院未治疗时均给予体液免疫和细胞免疫检测,IgG增高10例,IgM增高3例,IgE增高3例,C3增高11例;CD3^+降低11例,CD4^+降低7例,CD4^+增高6例,CD8^+降低4例,CD8^+增高9例。所有患者按治疗前的测定结果分组。根据体液免疫指标分为增高组、正常组;根据细胞免疫指标分为增高组、降低组和正常组。针灸治疗后,体液免疫指标增高组IgG、IgM、C3水平均降低(P<0.05),IgE的变化差异无统计学意义(P>0.05);正常组IgG、IgA、IgM、IgE、C3、C4前后的变化差异无统计学意义(P<0.05)。针灸治疗后,细胞免疫指标增高组CD4^+、CD8^+水平均降低(P<0.05);降低组CD3^+、CD4^+、CD8^+T细胞水平均提高(P<0.05);正常组CD3^+、CD8^+T细胞水平前后的变化差异无统计学意义(P>0.05),CD4^+T细胞水平有所降低(P<0.05),但在正常值范围内。结论:针灸可以降低BCTA患者异常增高的IgG、IgM、C3水平,调整细胞免疫CD3^+、CD4^+、CD8^+T细胞紊乱状态,针灸治疗BCTA可能与调节体液免疫及细胞免疫功能相关。Objective To observe the influence of acupuncture and moxibustion on humoral immunity and cellular immunity related indexes in patients with bra-chiocephalic Takayasu arteritis (BCTA). so as to explore its underlying mechanisms in the treatment of Takayasu arteritis (TA). Methods A total of 31 BCTA patients (9 men and 22 women at age of 16 70 years) were treated by manual acupuncture stimulation of main acupoint RenyingCST 9) and auxiliary acupoints as Jiquan (HT 1), Chize (LU 5),Fengchi (GB 20). bilateral Xinshu (BL15),Feishu (BL 13) and Geshu (BL 17),Jingming (BL 1), etc. according to clinical symptoms, with the needles retained for 20 min. Additionally, moxibustion was applied to Taiyuan (LU 9), BL 15. BL 13 and BL 17. The treatment was conducted twice daily for 4 weeks. Serum IgG. IgA. IgM. IgE, C3, C4 contents, and CD 3^+,CD 4^+, CD 8^+ T lymphocytes contents were assayed by using immue turbidimetry and cell counting. Results Before the treatment and in these 31 BCTA patients, an abnormal increase was found in serum IgG content in 10 cases. IgM in 3 cases, IgE in 3 cases. C3 in 11 cases. CD 4+ in 6 cases, and CD 8^+ in 9 cases, and an abnormal decrease was found in serum CD 3+ level in 11 cases. CD 4^+ in 7 cases, as well as CD 8^+ in 4 cases. After the treatment, the increased levels of IgG,IgM, C3^+ CD 4^+ and CD 8+ in patients with abnormally higher values were considerably down-regulated ( P<0.05), the decreased levels of CD 3^+ , CD 4^+ and CD 8^+ in patients with abnormally lower values were evidently up-regulated (P<0. 05). No significant changes were found in IgG. IgA. IgM. IgE,C3 and C4, CD 3+ and CD 8+ in patients with normal values of these indexes after the treatment ( P〉0.05).The CD 4+ level in patients with normal value was significantly deun-regulated after the treatment ( P<0. 05). but still in the range of normal value. Conclusion Acupuncture plus moxibustion can regulate some of the abnormally elevated and lowered humoral immunity and cellular immunity related indexes in BCTA patients, po

关 键 词：针灸 头臂动脉型大动脉炎 体液免疫 细胞免疫 

分 类 号：R246.1[医药卫生—针灸推拿学]