摘要
目的探究大肠经原合配穴电针治疗肺炎所致脓毒症的效果及其对胆碱能抗炎通路的影响。方法选取2014—2017年中国中医科学院广安门医院收治的肺炎所致脓毒症患者120例,采用SAS统计软件产生的随机分配表分为对照组和试验组,每组60例。对照组患者给予常规治疗及抗感染治疗,试验组患者在对照组基础上给予合谷穴联合曲池穴电针治疗。比较两组患者退热起效时间、退热时间,治疗前及治疗后4 h血清肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)、白介素8(IL-8)、白介素10(IL-10)、乙酰胆碱(ACh)、乙酰胆碱转移酶(ChAT)水平及CD_4^+细胞分数、CD_8^+细胞分数、CD_4^+/CD_8^+细胞比值。结果 (1)试验组患者退热起效时间、退热时间短于对照组(P<0.05)。(2)两组患者治疗前血清TNF-α、IL-1β、IL-8、IL-10水平比较,差异无统计学意义(P>0.05);治疗后4 h试验组患者血清TNF-α、IL-1β、IL-8水平低于对照组,而血清IL-10水平高于对照组(P<0.05)。(3)两组患者治疗前血清ACh、ChAT水平比较,差异无统计学意义(P>0.05);治疗后4 h试验组患者血清ACh、ChAT水平高于对照组(P<0.05)。(4)两组患者治疗前CD_4^+细胞分数、CD_8^+细胞分数、CD_4^+/CD_8^+细胞比值比较,差异无统计学意义(P>0.05);治疗后4 h试验组患者CD_4^+细胞分数、CD_4^+/CD_8^+细胞比值高于对照组,CD_8^+细胞分数低于对照组(P<0.05)。结论合谷穴联合曲池穴电针治疗可快速降低肺炎所致脓毒症患者体温,减轻炎性反应,改善免疫功能,其作用机制可能与刺激迷走神经而激活胆碱能抗炎通路及升高ACh、ChAT水平有关。
ObjectiveTo investigate the curative effect of electroacupuncture of large intestine meridian YUAN point combined with HE-sea point in treating sepsis patients caused by pneumonia and the impact on cholinergic anti-inflammatory pathway. MethodsA total of 120 sepsis patients caused by pneumonia were selected in Guang＇anmen Hospital China Academy of Chinese Medical Science from 2014 to 2017,and they were divided into control group and test group according to the random assignment table generated by SAS statistical software,each of 60 cases. Patients in control group received conventional treatment and anti-infections treatment,while patients in test group received electroacupuncture of Point LI4 （HEGU）combined with Point LI11（QUCHI） based on that of control group. Onset time of abatement of fever,fever clearance time,serum levels of TNF-α,IL-1β,IL-8,IL-10,ACh and ChAT,CD4＋ cell percentage,CD8＋ cell percentage and CD4＋/CD8＋ cell ratio before and 4 hours after treatment were compared between the two groups. Results（1）Onset time of abatement of fever and fever clearance time in test group were statistically significantly shorter than those in control group（P〈0.05）.（2）No statistically significant differences of serum levels of TNF-α,IL-1β,IL-8 or IL-10 was found between the two groups before treatment（P〉0.05）;4 hours after treatment,serum levels of TNF-α,IL-1β and IL-8 in test group were statistically significantly lower than those in control group,while serum IL-10 level in test group was statistically significantly higher than that in control group（P〈0.05）.（3）No statistically significant differences of serum level of ACh or ChAT was found between the two groups before treatment（P〉0.05）,while serum levels of ACh and ChAT in test group were statistically significantly higher than those in control group 4 hours after treatment（P〈0.05）.（4）No statistically significant differences of CD4＋ cell percentage, CD8＋ cell percentage or CD4＋/CD8＋ cell ratio was found between the two groups before treatment （P〉0.05） ;4 hours after treatment,CD4＋ cell percentage and CD4＋/CD8＋ cell ratio in test group were statistically significantly higher than those in control group,while CD8＋ cell percentage in test group was statistically significantly lower than that in control group（P〈0.05）. ConclusionElectroacupuncture of Point LI4（HEGU）combined with Point LI11（QUCHI）can quickly reduce the body temperature relieve the inflammatory reaction and improve the immunologic function in treating sepsis patients caused by pneumonia the mechanism may correlate with activate the cholinergic anti-inflammatory pathway and increase contents of ACh and ChAT through stimulation of nervi vagus.
作者
王硕
李丽娜
齐文升
杨秀捷
董锡臣
WANGShuo;LI Li-na;QI Wen-sheng;YANG Xiu-jie;DONG Xi-chen(Guang＇anmen Hospital China Academy of Chinese Medical Science,Beijing 100053,China;Basic Medical College,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《实用心脑肺血管病杂志》
2018年第8期66-69,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
中国中医科学院基本科研自由探索项目(ZZ0708080)
关键词
脓毒症
肺炎
穴位
大肠经
穴
原
穴
合(五输)
电针
胆碱能神经元
Sepsis
Pneumonia
Points,large intestine meridian
Points,YUAN （source）
Points,HE-sea （five SHU）
Electroacupuncture
Cholinergic neurons
