针灸治疗浆细胞性乳腺炎的疗效观察及对JAK2/STAT3信号通路关键蛋白的影响  

Efficacy observation of acupuncture-moxibustion in treating plasma cell mastitis and the effects on key proteins of JAK2/STAT3 signaling pathway

作　　者：赵莉 栗粟 ZHAO Li;LI Su(Henan Province Hospital of TCM,Zhengzhou 450002,China)

机构地区：[1]河南省中医院,郑州450002

出　　处：《上海针灸杂志》2024年第10期1091-1097,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省中医药科学研究专项课题(2022ZY1081)。

摘　　要：目的观察针灸治疗浆细胞性乳腺炎的临床疗效及对非受体型酪氨酸蛋白激酶2(Janus kinase 2,JAK2)/信号转导及转录激活蛋白3(signal transducer and activator of transcription 3,STAT3)信号通路关键蛋白的影响。方法将96例浆细胞性乳腺炎患者随机分为观察组和对照组,每组48例。对照组予甲泼尼龙,观察组在对照组基础上予针刺和艾灸治疗。比较两组临床疗效、复发情况及不良反应发生情况,观察两组治疗前后乳房症状(乳房肿块直径、乳房肿块范围、乳房疼痛和乳房皮肤)评分,血清炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)和C反应蛋白(C-reactive protein,CRP)]、血清免疫指标[免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)、补体C3和C4]以及乳房组织液中JAK2/STAT3信号通路关键蛋白[JAK2、磷酸化JAK2(phospho-JAK2,p-JAK2)和STAT3、磷酸化STAT3(phospho-STAT3,p-STAT3)]的水平。结果观察组总有效率为97.9%,高于对照组的75.6%(P<0.05);治疗后3个月随访时,观察组复发率2.2%,低于对照组的26.5%(P<0.05)。治疗后,观察组乳房肿块直径、乳房肿块范围、乳房疼痛和乳房皮肤评分均低于对照组(P<0.05),观察组TNF-α、IL-6、IL-8、CRP、IgG、IgM、补体C3、补体C4、JAK2、p-JAK2、STAT3和p-STAT3水平均低于对照组(P<0.05)。对照组不良反应发生率为31.1%,高于观察组的23.4%(P<0.05)。结论针灸联合甲泼尼龙治疗浆细胞性乳腺炎的临床疗效优于单纯甲泼尼龙治疗,可更好地缓解乳房肿块、疼痛等症状,降低复发,其作用机制可能与调节JAK2/STAT3信号通路关键蛋白有关。Objective To observe the clinical efficacy of acupuncture-moxibustion in treating plasma cell mastitis and the effects on key proteins of the Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Method Ninety-six patients with plasma cell mastitis were randomized into an observation group and a control group,each consisting of 48 cases.The control group was given Methylprednisolone,and the observation group received additional acupuncture and moxibustion treatment based on the intervention for the control group.The clinical efficacy,recurrence,and adverse reactions were compared between the two groups.Before and after the treatment,both groups were observed for breast symptom scores(breast lump diameter,breast lump extent,breast pain,and the skin of the breast),serum inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),and C-reactive protein(CRP)],serum immune indexes[immunoglobulin G(IgG),immunoglobulin M(IgM),complement 3(C3),and complement 4(C4)],and the levels of key protein levels of the JAK2/STAT3 signaling pathway in the breast tissue fluid[JAK2,phosphorylated JAK2(p-JAK2),STAT3,and phosphorylated STAT3(p-STAT3)].Result The total effective rate was 97.9%in the observation group,higher than 75.6%in the control group(P<0.05);at the 3-month post-treatment follow-up,the relapse rate was 2.2%in the observation group,lower than 26.5%in the control group(P<0.05).After the treatment,the breast lump diameter,breast lump extent,breast pain,and breast skin scores were lower in the observation group than in the control group(P<0.05),and the levels of TNF-α,IL-6,IL-8,CRP,IgG,IgM,C3,C4,JAK2,p-JAK2,STAT3,and p-STAT3 in the observation group were lower than those in the control group(P<0.05).The adverse reaction rate was 31.1%in the control group,higher than 23.4%in the observation group(P<0.05).Conclusion Acupuncture-moxibustion plus Methylprednisolone can produce more significant clinical efficacy than using Methylprednisolone alo

关 键 词：针灸疗法 艾条灸 乳腺炎 女性 非受体型酪氨酸蛋白激酶2 信号转导及转录激活蛋白3 

分 类 号：R246.3[医药卫生—针灸推拿学]