穴位埋线对肾虚血瘀型子宫内膜异位症患者IL-1β、TNF-α、VEGF和MMP-2水平的影响  

Effect of Acupoint Catgut Embedding on the Levels of IL-1β,TNF-α,VEGF and MMP-2 in Patients with Endometriosis of Kidney Deficiency and Blood Stasis

作　　者：左冬冬[1] 韩凤娟[1] 彭艳[1] 国旭熳[1] 付杨[2] ZUO Dongdong;HAN Fengjuan;PENG Yan;GUO Xuman;FU Yang(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2020年第4期44-49,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省中医药科研项目,编号:2018-006。

摘　　要：目的:基于PI3K/Akt/mTOR信号通路,探讨穴位埋线疗法治疗肾虚血瘀型子宫内膜异位症的临床疗效及对IL-1β、TNF-α、VEGF和MMP-2等相关信号通路下游细胞因子的水平的影响。方法:选取肾虚血瘀型子宫内膜异位症的门诊和住院患者86例,按照随机数字表法随机分为穴位埋线组和西药组,西药组口服孕三烯酮胶囊(内美通),穴位埋线组在西药组的基础上采用穴位埋线进行治疗,治疗3个月后观察两组患者的临床疗效和IL-1β、TNF-α、VEGF、MMP-2等相关信号通路下游细胞因子的水平。结果:治疗后穴位埋线组总有效率93.02%(40/43),西药组总有效率83.72%(36/43),两组比较差异无统计学意义(P>0.05)。治疗3个月后,穴位埋线组和西药组的VAS评分、血清IL-1β、TNF-α、VEGF和MMP-2水平均较治疗前改善(P<0.01),但穴位埋线组较西药组改善更为明显(P<0.05或P<0.01)。治疗过程中,西药组不良反应发生率为18.60%(8/43),穴位埋线组不良反应发生率为4.65%(2/43),两组不良反应发生率比较,差异有统计学意义(P<0.05)。结论:穴位埋线可以显著改善子宫内膜异位症患者的临床症状和体征,并能显著降低孕三烯引起的不良反应,可见穴位埋线疗法可以作用PI3K/Akt/mTOR信号通路,通过改善通路下游的IL-1β、TNF-α、VEGF和MMP-2水平,发挥治疗子宫内膜异位症的作用。Objective:To explore the clinical effect of acupoint catgut embedding on endometriosis of Kidney deficiency and blood stasis and its influence to the levels of IL-1β,TNF-α,VEGF and MMP-2 related cytokines in the downstream of the signal pathways based on PI3K/Akt/mTOR signal pathway.Methods:86 patients with endometriosis of Kidney deficiency and blood stasis were randomly divided into the acupoint catgut embedding group and the western medication group.The western medication group was treated with Gestrinone;on which basis,the acupoint catgut embedding group was also treated with acupoint catgut embedding.After 3 months of treatment,the clinical effect and the levels of cytokines,such as IL-1β,TNF-α,VEGF and MMP-2 in the downstream,were observed in the two groups.Results:The total effective rate was 93.02%(40/43)in the acupoint catgut embedding group,which was slightly higher than 83.72%(36/43)in the western medication group;of which there was no statistical difference between the two groups(P>0.05).The VAS scores,serum levels of IL-1β,TNF-α,VEGF and MMP-2 were all improved after 3 months of treatment than those before the treatment in the two groups(P<0.01);of which the improvements in the acupoint catgut embedding group were more significant(P<0.05,P<0.01).The incidence of adverse reactions was 4.65%(2/43)in the acupoint catgut embedding group,which was significantly lower than 18.60%(8/43)in the western medication group(P<0.05).Conclusion:Acupoint catgut embedding can significantly improve the clinical symptoms and signs of the patients with endometriosis,and it can significantly reduce the adverse reactions caused by Gestrine.It can be seen that acupoint catgut embedding can play a regulating role in PI3K/Akt/mTOR signaling pathway,by improving the levels of IL-1β,TNF-α,VEGF and MMP-2.

关 键 词：针刺 肾虚血瘀 子宫内膜异位症 PI3K/Akt/mTOR信号通路 

分 类 号：R246.3[医药卫生—针灸推拿学]