灯火灸配合刺络放血治疗斑秃的疗效及对患者血清IL-10、TNF-α及IFN-γ水平的影响  

Effect of Burning Rush Moxibustion Combined with Bloodletting Puncture in Treatment of AA and Its Influence to Serum Levels of IL-10,TNF-αand IFN-γ

作　　者：宋莉敏 林津仪 林笑笑 陈惠姣 韦惠宁 吴健文[1] SONG Limin;LIN Jinyi;LIN Xiaoxiao;CHEN Huijiao;WEI Huining;WU Jianwen(Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学,广西南宁530001

出　　处：《针灸临床杂志》2022年第11期16-20,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：广西中医药大学研究生科研创新项目,编号:YCSY2020027。

摘　　要：目的:探究灯火灸配合刺络放血治疗斑秃(AA)的疗效及对血清IL-10、TNF-α和IFN-γ水平的影响。方法:将64例AA患者随机分为治疗组(32例,脱落1例)与对照组(32例,脱落2例)。治疗组:灯火灸根据AA部位范围的大小选择燋数;辨证放血根据中医证型选取合适的穴位,对所选穴位进行拔罐放血。1周治疗3次。对照组:口服复方甘草酸苷片2片/d,3次/d;5%米诺地尔酊局部外用,每次1 mL,每日2次。两组均治疗8周。分别记录治疗前后、随访6个月后AA部位及面积评分(AAL)、新发生长评分(HG)、轻拉发试验评分(LPE)、血清白介素-10(IL-10)、肿瘤坏死因子α(TNF-α)和干扰素γ(IFN-γ)水平情况。结果:治疗组总有效率为93.6%(29/31),优于对照组的73.3%(22/30)。治疗组AA复发率14.3%(2/14),低于对照组的42.9%(3/7)(P<0.05)。两组治疗后、随访6个月后AA的AAL评分、HG评分、LPE评分、TNF-α和IFN-γ水平均较治疗前降低,差异具有统计学意义(P<0.05)。两组治疗后、随访6个月后IL-10水平均较治疗前升高,差异具有统计学意义(P<0.05)。结论:灯火灸配合刺络放血治疗AA疗效明显优于对照组,且复发率低,更能有效地改善AA患者的脱发情况。该法治疗AA的机理可能是通过升高IL-10、降低TNF-α和IFN-γ水平实现的,从而启动毛囊自身免疫功能,促使毛发生长。Objective:To explore the effect of burning rush moxibustion combined with bloodletting puncture in treatment of alopecia areata(AA)and its influence to serum levels of IL-10,TNF-αand IFN-γ.Methods:64 patients with AA were randomly divided into the treatment group and the control group,with 32 cases in each group.There were 1 case lost in the treatment group and 2 cases lost in the control group.The treatment group was treated with burning rush moxibustion combined with bloodletting puncture,the moxibustion amount was based on the size of AA,the points in the bloodletting puncture was selected according to TCM syndrome differentiation,and the patients in the treatment group were treated 3 times a week.The control group was treated with Compound Glycyrrhizin Tablet,2 tablets per time,3 times a day;5%Minoxidil Tincture was used for external application,1 ml each time,twice a day.Both groups were treated for 8 weeks.Area and location(AAL)score,hair growth(HG)score,light pull experiment(LPE)score,serum levels of interleukin-10(IL-10),tumor necrosis factorα(TNF-α)and interferonγ(IFN-γ)were recorded before and after the treatment and during 6 months follow-up.Results:The total effective rate of the treatment group was 93.6%(29/31),which was better than 73.3%(22/30)of the control group(P<0.05).The recurrence rate of AA was 14.3%(2/14)in treatment group,which was significantly lower than 42.9%(3/7)in the control group(P<0.05).AAL score,HG score,LPE score,the levels of TNF-αand IFN-γwere lower after the treatment and during 6 months follow-up than those before the treatment in the two groups(P<0.05).The level of IL-10 was higher after the treatment and during 6 months follow-up than that before the treatment in the two groups(P<0.05).Conclusion:The effect of burning rush moxibustion combined with bloodletting puncture is significantly better than Compound Glycyrrhizin Tablet in treatment of AA,with its low recurrence rate,and it can effectively improve the alopecia situation of AA patients.The mechanism may be to a

关 键 词：斑秃 灯火灸 放血 随机对照 

分 类 号：R246.2[医药卫生—针灸推拿学]