基于外周血T淋巴细胞亚群及...多发性跖疣治疗中的疗效观察_石卉.pdf

取物均能降低嗜酸性粒细胞水平,减少 IgE 生成,进而改善鼻黏膜炎症15-16。综上所述,自拟温阳通窍汤联合西药治疗 AR 疗效显著,可明显改善患者鼻部症状与免疫功能,有效抑制炎症反应,促进生活质量提高,值得应用。参考文献1 张莹,张景波,赵静维,等.健脾清肺方合并神阙灸对儿童过敏性鼻炎 IgE、EOS 的影响及临床疗效研究 J.河北中医药学报,2019,34(2):30-32.2 江雅宜,岳仁宋,周建龙.基于 黄帝内经“心部于表”探讨鼻鼽病机 J.中国中医基础医学杂志,2020,26(11):1593-1594,1597.3 李璐,田传玺,王雪茹,等.杨道文教授治疗过敏性鼻炎的临床经验 J.中日友好医院学报,2021,35(2):122,128.4 舒福,袁一林,邱凯玲,等.基于古今医案云平台採析中医药治疗过敏性鼻炎的组方用药规律 J.世界科学技术-中医药现代化,2022,24(2):822-829.5 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015 年,天津)J.中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.6 国家中医药管理局.中医病证诊断疗效标准 M.南京:南京大学出版社,1994:125-126.7 张丽,虞成飞,符健.重灸治疗变应性鼻炎的疗效观察及对 IL-33、EOS 的影响 J.上海针灸杂志,2021,40(8):963-967.8 贺梦雪,孙增涛.中医治疗成人过敏性鼻炎哮喘综合征的研究概况 J.中国中医急症,2021,30(3):551-553.9 崔红生,吕明圣,王济,等.中医药防治过敏性鼻炎-哮喘综合征研究述评 J.北京中医药大学学报,2021,44(3):203-208.10 付海生.鼻炎康片联合丙酸氟替卡松鼻喷剂对过敏性鼻炎的鼻腔功能和血清相关因子的影响 J.中南医学科学杂志,2018,46(6):650-652,663.11 吴嘉朔,常晓燕,李壮壮,等.泽泻汤降脂及抗炎作用分子机制研究进展 J.中国实验方剂学杂志,2021,27(2):224-232.12 汪景,位佳琳,何蕊,等.网络药理学方法预测附子-熟地黄配伍治疗 COPD 作用机制以及初步验证研究 J.中国免疫学杂志,2022,38(4):419-426.13 孔晨先,肖波,柳全文,等.山药多糖对动物机体免疫调节作用的 Meta 分析 J.食品研究与开发,2021,42(19):206-213.14 刘宇,王成.附子多糖血管保护作用的研究进展 J.医学研究杂志,2021,50(2):20-22.15 江泽强,贾珊珊,孟翔鹤,等.基于网络药理学探讨乌梅治疗哮喘的作用机制 J.中华中医药学刊,2021,39(2):81-84+7.16 王康,孟泳,王玉洁,等.苍耳子治疗过敏性鼻炎的分子机制研究 J.转化医学杂志,2021,10(5):330-334.(收稿日期 2022-08-19)通讯作者:段凌云,本科,研究方向:理疗,康复,针灸。第一作者:石卉,本科,研究方向:理疗,康复,针灸,E-mail:。基于外周血 T 淋巴细胞亚群及共刺激分子 CD28、CD40 水平变化探究针灸联合消瘊方外洗在多发性跖疣治疗中的疗效观察石卉,段凌云,徐军(鄂东医疗集团市中医医院(市传染病医院、黄石市中医医院),湖北 黄石 435000)摘要:目的:研究针灸联合消瘊方外洗在多发性跖疣治疗中的疗效及对患者外周血 T 淋巴细胞亚群及共刺激分子CD28、CD40 水平的影响。方法:将2018 年1 月2021 年1 月我院收治的84 例多发性跖疣患者纳入研究,按照随机数表法均分为观察组(针灸联合消瘊方外洗)和对照组(液氮冷冻治疗)各 42 例,比较两组患者治疗 8 周后临床疗效,比较两组治疗前及治疗 8 周后症状积分、T 淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、共刺激分子(CD28、CD40),比较两组不良反应发生情况和复发情况。结果:治疗 8 周后,观察组总有效率明显高于对照组(P0.05);治疗 8 周后,两组症状积分明显低于治疗前,观察组明显低于对照组(P0.05);治疗 8 周后,两组 CD4+、CD4+/CD8+水平明显高于治疗前(P0.05);治疗 8 周后,两组 CD28 水平明显低于治疗前,CD40 水平高于治疗前,观察组 CD28 水平明显低于对照组(P0.05);两组不良反应发生情况比较差异无统计学意义(P0.05),观察组复发率明显低于对照组(P0.05)。结论:针灸联合消瘊方外洗可有效治疗多发性跖疣,能够有效改善症状和免疫功能,降低复发率。481四 川 中 医Journal of Sichuan of Traditional Chinese Medicine2023 年第 41 卷第 2 期Vol.41,No.2,2023 关键词:针灸;消瘊方;多发性跖疣;T 淋巴细胞;共刺激分子 中图分类号:R 752.5 文献标志码:A 文章编号:1000-3649(2023)02-0184-05 Curative Observation of Applying Acupuncture and Moxibustion Combined with Xiaohou Recipe for ExternalWashing in the Treatment of Multiple Plantar Warts Based on the Changes in Levels of Peripheral Blood T LymphocyteSubsets and Costimulatory Molecules CD28 and CD40/SHI Hui,DUAN Lingyun,XU Jun/Edong Medical Group MunicipalHospital of Traditional Chinese Mmedicine Municipal Hospital of Infectious Diseases,Huangshi Hospital of Traditional ChineseMedicine(Huangshi Hubei 435000,China)Abstract:Objective:To study the efficacy of applying acupuncture and moxibustion combined with Xiaohou Recipe for ex-ternal washing in the treatment of multiple plantar warts and its influence on levels of peripheral blood T lymphocyte subsets andcostimulatory molecules CD28 and CD40.Methods:84 patients with multiple plantar warts admitted to the hospital between Janu-ary 2018 and January 2021 were included in the study.According to the random number table method,they were equally dividedinto an observation group(acupuncture and moxibustion combined with external washing with Xiaohou recipe)and a controlledgroup(liquid nitrogen cryotherapy),with 42 cases in each group.The clinical efficacy after 8 weeks of treatment,symptomsscores,T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and costimulatory molecules(CD28,CD40)before treatmentand after 8 weeks of treatment and occurrence of adverse reactions and recurrence were compared between the two groups.Re-sults:After 8 weeks of treatment,the total effective rate in the observation group was significantly higher than that in the con-trolled group(P0.05).After 8 weeks of treatment,the symptoms scores in the two groups were significantly lower than thosebefore treatment,and the scores were significantly lower in the observation group than those in the controlled group(P0.05).The levels of CD4+and CD4+/CD8+in the two groups after 8 weeks of treatment were significantly higher than those before treat-ment(P0.05).After 8 weeks of treatment,the level of CD28 in the two groups was significantly lower while the level of CD40 was higher com-pared to before treatment,and the level of CD28 in the observation group was significantly lower compared with that in the con-trolled group(P0.05).Thedifferences in the occurrence of adverse reactions were not statistically significant between the two groups(P0.05),and the re-currence rate was significantly lower in the observation group compared to the controlled group(P0.05),见表 1。5812023 年第 41 卷第 2 期Vol.41,No.2,2023四 川 中 医Journal of Sichuan of Traditional Chinese Medicine表 1 两组一般资料比较 x-s,n(%)分组n性别男女年龄(岁)病程(月)发病部位脚趾脚掌脚跟多处观察组4223(54.76)19(45.24)36.486.3311.583.698(19.05)16(38.10)6(14.29)12(28.57)对照组4220(47.62)22(52.38)37.236.8512.073.557(16.67)20(47.62)5(11.90)10(23.81)注:与观察组相比,P0.051.2治疗方法(1)对照组:采用液氮冷冻治疗,棉签蘸液氮后置于疣体,冷冻范围为疣体周围 2mm组织均呈白色,根据疣体大小、角质层厚度和患者耐受程度确定棉签压力。去除棉签后疣体颜色正常为 1 个冷