弩药针对类风湿性关节炎HPAA的调控研究  

Clinical Study and Mechanism of HPAA in Patients with Rheumatoid Arthritis Treated by Crossbow Medicine Needle

作　　者：何锦 张宏 吴晓勇 熊芳丽 刘嵘 唐东昕 HE Jin;ZHANG Hong;WU Xiaoyong;XIONG Fangli;LIU Rong;TANG Dongxin(Clinical College of Acupuncture and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Department of Miao Acupuncture and Moxibustion,The First Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550001,Guizhou,China;Department of Imaging,The First Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550001,Guizhou,China)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510405 [2]贵州中医药大学第一附属医院苗医针灸科,贵州贵阳550001 [3]贵州中医药大学第一附属医院影像科,贵州贵阳550001

出　　处：《中华中医药学刊》2020年第9期64-67,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局项目(QZY-FJS-2017-53)。

摘　　要：目的探究弩药针对类风湿性关节炎(RA)患者神经内分泌免疫(neuron endocrine immune,NEI)网络机制的调节,主要以对下丘脑-垂体-肾上腺轴(HPAA)功能的改善及阐述其治疗RA的作用机制为主。方法将符合纳入标准的60例RA患者随机分为两组:弩药针组,弩针组(不加药物),每组30例。隔日1次,5次1个疗程,疗程间隔2 d,共2个疗程。观察两组RA患者临床疗效、临床症状评价量表的变化以及治疗前后两组血清中白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor,TNF-α)、类风湿因子(Rheumatoid factor,RF)、红细胞沉降率(Erythrocyte sedimentation rate,ESR)、血清皮质醇(serum cortisol,CS)的改变。结果弩药针组有效率为83.33%(25/30),弩针组(不加药物)有效率为73.33%(22/30)。在改善临床症状方面均取得明显疗效,弩药针组优于弩针组(不加药物)。弩药针组治疗前后IL-6、TNF-α、RF、ESR、CS有显著性差异(P<0.05),与弩针组(不加药物)比较有显著性差异(P<0.05)。结论弩药针组通过对NEI网络系统整合调控,改善HPAA的功能,制炎性细胞因子的释放,从而发挥对RA的治疗作用。Objective To study the regulation of neuron endocrine immune(NEI)network system in patients with rheumatoid arthritis(RA)by crossbow medicine needle,explore the improvement of hypothalamic-pituitary-adrenal axis(HPAA)function andelucidate its therapeutic mechanism for RA.Methods Sixty RA patients who met the inclusion criteria were randomly divided into two groups:the crossbow medicine needle group and the crossbow medicine needle group(without drugs),30 cases in each group.The needling was given once every other day,five times as a course of treatment.There were two days interval between courses and a total of two courses of treatment.The changes of clinical efficacy,clinical symptom evaluation scale and serum levels of interleukin-6(IL-6),tumor necrosis factor(TNF-α),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR)and changes of serum cortisol(CS)were observed in two groupsbefore and after treatment.Results The effective rate of the crossbow medicineneedle group was 83.33%(25/30)and that of the crossbow medicine needle group(without drugs)was 73.33%(22/30).Both groups had obvious effect on improving the symptoms and the the crossbow medicine needle group was superior to the the crossbow medicine needle group(without drugs).The levels of IL-6,TNF-α,RF,ESR and CS of the crossbow medicine needle group before and after treatment were significant(P<0.05)and there was a significant difference compared with those of the crossbow medicine needle group(without drugs)(P<0.05).Conclusions The crossbow medicine needle group can improve the function of HPAA,inhibit the release of inflammation factors by regulating NEI so as to treat RA.

关 键 词：弩药针 类风湿性关节炎 NEI HPAA 

分 类 号：R245.3[医药卫生—针灸推拿学] R259.932.2[医药卫生—中医临床基础]