针灸对肝癌射频消融术后免疫功能改善研究进展  

Research Progress of Acupuncture on Immune Function ImprovementAfter Radiofrequency Ablation of Primary Liver Cancer

作　　者：黄玉迎 杨培伟[2] 周铖 赵晨露 刘建鹏 赵文霞[2] HUANG Yuying;YANG Peiwei;ZHOU Cheng;ZHAO Chenu;LIU Jianpeng;ZHAO Wenxia(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《辽宁中医药大学学报》2024年第3期104-109,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：中国博士后科学基金面上项目(2022M711082)。

摘　　要：射频消融术(radiofrequency ablation,RFA)是原发性肝癌(primary liver cancer,PLC)的常见根治疗法之一,在临床上应用广泛。然而,术后机体免疫抑制状态是影响患者生活质量及总生存期的重要因素,联合免疫药物治疗虽有一定获益,但会面临耐药及不良反应等问题的发生。近年来,越来越多的研究发现针灸可作为PLC免疫抑制的辅助疗法。该文综述了针灸通过释放细胞因子等途径促进抗炎反应、抑制转化生长因子-β(transforming growth factor-β,TGF-β)的表达、提高自然杀伤细胞(natural killer cell,NK细胞)水平、改善T淋巴细胞亚群比例、恢复肠道菌群平衡等,多方面调节RFA术后机体免疫抑制状态,并且针灸与免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)、酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)等联合还能发挥一定的协同作用,可有效改善药物的免疫毒性,减少临床不良反应事件的发生,弥补了现代医学治疗的短板,为RFA后防止复发转移、延长患者生存时间、提高患者生存质量提供了新的治疗方向。最后,文章也对针灸改善PLC患者免疫功能的有效穴位进行了归纳总结,并指出当前研究所存在的问题与不足,旨在为今后PLC患者的临床治疗及相关研究提供一定参考价值。Radiofrequency ablation(RFA)is one of the common radical therapies for primary liver cancer(PLC)and is widely used in clinical practice.However,the immunosuppressed state of the body after surgery is an important factor affecting the quality of life and overall survival of patients.Although combined immune drug therapy has certain benefits,it must face the occurrence of drug resistance and adverse reactions.In recent years,more and more studies have found that acupuncture and moxibustion can be used as an adjuvant therapy for PLC immunosuppression.This paper reviews that acupuncture and moxibustion can promote anti-inflammatory response,inhibit TGF-βexpression,increase NK cell level,improve T lymphocyte subpopulation ratio,restore intestinal flora balance,etc.through releasing cytokines and other pathways to regulate the immunosuppressed state of the body after RFA.And the combination of acupuncture and moxibustion with immune checkpoint inhibitors(ICIs)and tyrosine kinase inhibitors(TKI)can also play a certain synergistic effect,which can effectively reduce the immunotoxicity of drugs,decrease the occurrence of clinical adverse events,make up for the shortcomings of modern medical treatment,and provide a new treatment direction to prevent recurrence and metastasis,prolong patients'survival time,and improve their survival quality after RFA.Finally,this paper also summarizes the effective acupoints of acupuncture and moxibustion to improve the immune function of PLC patients,and points out the problems and shortcomings of the current research,aiming to provide a certain reference value for the future clinical treatment of PLC patients and related research.

关 键 词：针灸 原发性肝癌 射频消融术 免疫 

分 类 号：R245[医药卫生—针灸推拿学]