综合外治法对支气管哮喘慢性持续期患者γ干扰素、白细胞介素4、白细胞介素17、免疫球蛋白E 及嗜酸性粒细胞计数的影响和作用机制研究  

Effect and mechanism of integrated external treatment on interferon-γ, interleukin-4, interleukin-17, immunoglobulin E and eosinophil count in patients with chronic persistent bronchial asthm

作　　者：闫红倩[1] 耿立梅[1] 任虹 于向艳[1] 牛晓燕 刘新发[1] 黄书花 Yan Hongqian;Geng Limei;Ren Hong(Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050011)

机构地区：[1]河北省中医院呼吸一科,河北石家庄050011 [2]哈励逊国际和平医院康复科,河北衡水053000 [3]河南省郑州市管城中医院内科,河南郑州450000

出　　处：《河北中医》2019年第5期667-672,678,共7页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省科技计划项目(编号:14277798D)

摘　　要：目的观察综合外治法对支气管哮喘慢性持续期患者γ干扰素(IFN-γ)、白细胞介素4(IL-4)、白细胞介素17(IL-17)、免疫球蛋白E(IgE)及嗜酸性粒细胞计数(EOS)的影响和作用机制。方法将120例支气管哮喘慢性持续期患者按照随机数字表法分为4组。对照组30例予沙美特罗替卡松粉吸入剂;穴位注射组29例在对照组治疗基础上应用卡介菌多糖核酸注射液穴位注射;拔罐组31例在对照组治疗基础上应用拔罐疗法;治疗组30例在对照组治疗基础上应用卡介菌多糖核酸注射液穴位注射联合拔罐疗法。4组均治疗4周。比较4组治疗前后及疗程结束后1、3个月哮喘控制测试(ACT)评分、呼出气一氧化氮(FeNO)变化;比较4组治疗前后血清IFN-γ、IL-4、IL-17、IgE水平及EOS;分析治疗组治疗前后EOS、IFN-γ及IL-17相关性。结果 4组治疗后、疗程结束后1个月ACT评分均较本组治疗前升高(P<0.05),治疗组、穴位注射组、拔罐组疗程结束后3个月ACT评分均较本组治疗前升高(P<0.05),而对照组疗程结束后3个月ACT评分与本组治疗前比较差异无统计学意义(P>0.05)。治疗组、穴位注射组、拔罐组治疗后及疗程结束后1、3个月ACT评分均高于对照组同期(P<0.05),且治疗组治疗后及疗程结束后1、3个月ACT评分均高于穴位注射组、拔罐组同期(P<0.05)。穴位注射组与拔罐组治疗后及疗程结束后1、3个月同期ACT评分比较差异无统计学意义(P>0.05)。4组治疗后、疗程结束后1个月FeNO均较本组治疗前降低(P<0.05),治疗组、穴位注射组、拔罐组疗程结束后3个月FeNO均较本组治疗前降低(P<0.05),而对照组疗程结束后3个月FeNO与本组治疗前比较差异无统计学意义(P>0.05)。治疗组、穴位注射组、拔罐组治疗后及疗程结束后1、3个月FeNO均低于对照组同期(P<0.05),且治疗组治疗后及疗程结束后1、3个月FeNO均低于穴位注射组、拔罐组同期(P<0.05)。穴位注射Objective To observe the effects and mechanism of comprehensive external treatment on interferon-γ(IFN-γ), interleukin-4(IL-4), interleukin-17(IL-17), immunoglobulin E(IgE) and eosinophil count(EOS) in patients with chronic persistent bronchial asthma. Methods 120 patients with chronic persistent bronchial asthma were divided into 4 groups according to the random number table method. In the control group, 30 patients were treated by salmeterol xinafoate and fluticasone propionate powder for inhalation. In the acupoint injection group, 29 patients were treated by bacilli calmette-giierin polysaccharide and nucleic acid injection on the basis of the control group. In the cupping group, 31 patients were treated by cupping therapy on the basis of the control group. In the treatment group, 30 patients were treated by bacilli calmette-giierin polysaccharide and nucleic acid injection combined with cupping therapy. All 4 groups were treated for 4 weeks. Asthma control test(ACT) score and the change of fractional exhaled nitric oxide(FeNO) before and after treatment were compared and 1 and 3 months after the end of the treatment period in the 4 groups. Serum IFN-γ, IL-4, IL-17, IgE levels and EOS of the four groups were compared before and after treatment. The correlation of EOS, IFN-γ and IL-17 before and after treatment in the treatment group was analyzed. Results The ACT scores of the four groups after treatment and one month after the end of treatment were all higher than those in the group before treatment(P<0.05). The ACT scores of the treatment group, acupoint injection group and cupping group at 3 months after the end of treatment were all higher than those in the group before treatment(P<0.05), while there was no statistically significant difference in ACT scores between the control group and the control group at 3 months after the end of treatment(P>0.05). The ACT scores of the treatment group, acupoint injection group and cupping group were all higher than those of the control group after treatment and at

关 键 词：慢性病 哮喘 中医疗法 水针 拔罐 

分 类 号：R256.12[医药卫生—中医内科学] R245.317[医药卫生—中医学]