"调理脾胃"针法治疗2型糖尿病皮肤瘙痒症的疗效观察及对T细胞亚群的影响OACSTPCD
Therapeutic observation of"Tiao Li Pi Wei"acupuncture for pruritus in type 2 diabetes and its effect on T cell subsets
目的 观察"调理脾胃"针法治疗 2 型糖尿病皮肤瘙痒症的临床疗效及对T细胞亚群水平的影响.方法 将 80例 2 型糖尿病皮肤瘙痒症患者随机分为观察组(40例,脱落 1 例)与对照组(40例,脱落 1 例).在西药常规治疗的基础上,对照组口服盐酸左西替利嗪片,观察组予"调理脾胃"针法.观察两组治疗前后瘙痒视觉模拟量表(visual analog scale,VAS)评分,瘙痒症状、皮损状态积分及外周血细胞中CD4﹢、CD8﹢及Th1和Th2亚群水平,并比较两组临床疗效.结果 观察组的总有效率高于对照组(P＜0.05).两组治疗后瘙痒VAS评分均较治疗前降低(P＜0.05),且观察组低于对照组(P＜0.05).两组治疗后瘙痒面积、程度、频率、持续时间积分较治疗前降低(P＜0.05),且观察组低于对照组(P＜0.05).两组治疗后皮肤鳞屑、干燥、搔抓瘢痕、丘疹、苔藓化积分较治疗前降低(P＜0.05),且观察组低于对照组(P＜0.05).两组治疗后CD4﹢细胞水平升高(P＜0.05),CD8﹢细胞水平均降低(P＜0.05);且观察组CD4﹢细胞水平高于对照组(P＜0.05),CD8﹢细胞水平低于对照组(P＜0.05).两组治疗后Th1 细胞水平降低(P＜0.05),Th2 细胞水平升高(P＜0.05);且观察组Th1 细胞水平低于对照组(P＜0.05),Th2 细胞水平高于对照组(P＜0.05).结论 在西药常规治疗的基础上,"调理脾胃"针法可减轻 2型糖尿病皮肤瘙痒症患者的临床症状,其作用机制可能与调节血清中CD4﹢、CD8﹢及Th1和Th2亚群水平有关.
Objective To observe the clinical efficacy of"Tiao Li Pi Wei"(regulating the spleen and stomach)acupuncture in treating pruritus in type 2 diabetes and its effect on T cell subsets.Method Eighty patients with type 2 diabetes complicated by pruritus were randomized into an observation group(40 cases,including 1 dropout)and a control group(40 cases,including 1 dropout).In addition to routine Western medications,the control group received oral Levocetirizine hydrochloride tablets,and the observation group received"Tiao Li Pi Wei"acupuncture.Before and after the intervention,the visual analog scale(VAS)score for assessing itching,itching symptoms,skin lesion score,and the peripheral blood cell subset levels CD4﹢,CD8﹢,Th1 and Th2 were observed for the two groups.The clinical efficacy was also compared.Result The total effective rate in the observation group was higher than that in the control group(P＜0.05).After the treatment,the VAS itching score dropped in both groups(P＜0.05)and was lower in the observation group than in the control group(P＜0.05).The scores of the size,intensity,attack frequency,and duration of pruritus decreased after the intervention in both groups(P＜0.05)and were lower in the observation group than in the control group(P＜0.05).The scores of skin scales,dryness,scratch scars,papules,and lichenization dropped after the treatment in the two groups(P＜0.05)and were lower in the observation group than in the control group(P＜0.05).In both groups,the CD4﹢ level increased(P＜0.05),and the CD8﹢ level decreased(P＜0.05)after the treatment;the observation group had a higher CD4﹢ level(P＜0.05)and a lower CD8﹢ level(P＜0.05)compared with the control group.After the intervention,the Th1 level dropped(P＜0.05),and the Th2 level increased(P＜0.05)in both groups;the observation group had a lower Th1 level(P＜0.05)and a higher Th2 level(P＜0.05)compared with the control group.Conclusion In addition to routine Western medications,"Tiao Li Pi Wei"needling method can reduce the clinical symptoms of pruritus in type 2 diabetes patients.The mechanism may be associated with the regulation of serum levels CD4﹢,CD8﹢,Th1 and Th2.
解衍龙
天津市中医药研究院附属医院,天津 300120
中医学
针刺疗法糖尿病瘙痒症T细胞亚群
Acupuncture therapyDiabetes mellitusPruritusT cell subsets
《上海针灸杂志》 2024 (001)
10-16 / 7
天津市中医药管理局中医中西医结合课题重点项目(2019027)
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