Yang Guang, Hu Rui-ying, Deng Ai-jing, Huang Yu, Li Jian
Intensive Care Unit, Guangdong Provincal Hospital of Traditional Chinese Medicine, Guangzhou, 510006, China.
Intensive Care Unit, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, 430000, China.
Chin J Integr Med. 2016 Mar;22(3):219-24. doi: 10.1007/s11655-016-2462-9. Epub 2016 Jan 29.
To evaluate the effect of electro-acupuncture on Zusanli (ST 36), Guanyuan (RN 4) in patients with sepsis, and explore its mechanism in term of immune regulation.
In this prospective randomized controlled trial, 60 patients with sepsis were randomly assigned to the control group and the intervention group equally by block randomization. Patients in the control group received routine treatment and those in the intervention group received electro-acupuncture at bilateral Zusanli and Guanyuan in addition to routine treatment, respectively. The mortality at 28 days, Acute Physiology and Chronic Health Evaluation (APACHE)-II score were compared to evaluate the effect, and the levels of T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and monocytes of human leukocyte antigen (HLA)-DR using flow cytometry were compared to explore the mechanism of this combined treatment.
Fifty-eight patients completed the trial with 29 in each group. There was no significant difference of mortality in the 28th day between the two groups, with 5 death of 29 patients in the intervention group (17.2%) and 9 of 29 in the control group (31.0%). After treatment, APACHE-II score of both groups was significantly decreased, however, score of the intervention group was lower than the control group (13.28±7.07 vs. 17.10±5.83; P<0.01). The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ ratio of the intervention group improved after treatment and were higher than the control group (59.71%±11.94% vs. 52.54%±11.86%; 36.46%±7.60% vs. 31.58%±10.23%; 18.40%±8.82% vs. 23.07%±7.30%; 2.38±1.14 vs. 1.54±0.80, respectively; all P<0.05). The expression of HLA-DR significantly increased after treatment in the intervention group than that in the control group (7.28%±9.26% vs. 1.27%±7.00%; P<0.01).
Electro-acupuncture at Zusanli and Guanyuan could improve clinical curative effect in patients with sepsis, which might be achieved by regulation of the immune system.
评价电针足三里（ST 36）、关元（RN 4）对脓毒症患者的影响，并从免疫调节方面探讨其作用机制。
在这项前瞻性随机对照试验中，60例脓毒症患者通过区组随机化法被等分为对照组和干预组。对照组患者接受常规治疗，干预组患者在常规治疗基础上分别加用电针双侧足三里和关元。比较两组患者28天死亡率、急性生理与慢性健康状况评分系统（APACHE）-II评分以评估疗效，采用流式细胞术比较两组患者T细胞亚群（CD3+、CD4+、CD8+、CD4+/CD8+）水平及人类白细胞抗原（HLA）-DR单核细胞水平以探讨联合治疗的机制。
58例患者完成试验，每组各29例。两组患者第28天死亡率无显著差异，干预组29例患者中有5例死亡（17.2%），对照组29例患者中有9例死亡（31.0%）。治疗后，两组患者APACHE-II评分均显著降低，但干预组评分低于对照组（13.28±7.07比17.10±5.83；P<0.01）。干预组治疗后CD3+、CD4+、CD8+水平及CD4+/CD8+比值升高，且高于对照组（分别为59.71%±11.94%比52.54%±11.86%；36.46%±7.60%比31.58%±10.23%；18.40%±8.82%比23.07%±7.30%；2.38±1.14比1.54±0.80；均P<0.05）。干预组治疗后HLA-DR表达显著高于对照组（7.28%±9.26%比1.27%±7.00%；P<0.01）。
电针足三里和关元可提高脓毒症患者的临床疗效，其机制可能是通过调节免疫系统实现的。
