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[基于理论采用放血疗法和耳穴贴压治疗慢性自发性荨麻疹:一项随机对照试验]

[Chronic spontaneous urticaria treated with bloodletting therapy and auricular point sticking on the base of theory: a randomized controlled trial].

作者信息

Wang Yan-Jun, Shi Yu, Li Hong-Kun, Sun Bin, Xue Wei-Hua, Liu Huan-Qiang

机构信息

Department of Acupuncture-Moxibustion, First Affiliated Hospital of Hebei University of TCM, Shijiazhuang 050011, China.

Department of Dematology, First Affiliated Hospital of Hebei University of TCM, Shijiazhuang 050011, China.

出版信息

Zhongguo Zhen Jiu. 2022 Feb 12;42(2):157-61. doi: 10.13703/j.0255-2930.20210719-0005.

Abstract

OBJECTIVE

To compare the clinical therapeutic effect and the impacts on recurrence rate on chronic spontaneous urticaria (CSU) between the combined treatment of bloodletting therapy and auricular point sticking on the base of theory and the oral solution of levocetirizine hydrochloride.

METHODS

A total of 86 patients with CSU were randomized into an observation group (43 cases, 1 case dropped off) and a control group (43 cases, 3 cases dropped off). In the observation group, bloodletting therapy at Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17) and Pishu (BL 20) was combined with auricular point sticking at lung (CO), kidney (CO), shenmen (TF) and heart (CO), etc. This combined treatment was given once every two days. In the control group, the oral solution of levocetirizine hydrochloride was prescribed, 10 mL each time, once daily. The treatment lasted for 4 weeks in the two groups. Before and after treatment, urticaria activity score 7 (UAS7), the score of dermatology life quality index (DLQI) and the levels of serum immune globulin E (IgE), interleukin 4 (IL-4) and interferon γ (IFN-γ) were compared in the patients between the two groups. The clinical therapeutic effect was evaluated in patients of the two groups and the recurrence rate was followed up 4, 8 and 12 weeks after treatment separately.

RESULTS

After treatment, the scores of UAS7 and DLQI, as well as the levels of serum IgE and IL-4 were all reduced as compared with those before treatment in the two groups (<0.05), and the level of serum IFN-γ was increased (<0.05). The total effective rate was 83.3% (35/42) in the observation group and was 85.0% (34/40) in the control group. There was no statistical significance for the difference in the clinical therapeutic effect between the two groups (>0.05). Eight and 12 weeks after treatment, the recurrence rates were 21.1% (4/19) and 26.3% (5/19) in the observation group, lower than 55.0% (11/20) and 65.0% (13/20) in the control group, respectively (<0.05).

CONCLUSION

The combined therapy of bloodletting and auricular point sticking on the base of theory relieves the clinical symptoms, regulates the levels of serum IgE, IL-4 and IFN-γ and improves the quality of life in the patients with CSU. The clinical therapeutic effect of this combined treatment is similar to the oral solution of levocetirizine hydrochloride. But, the recurrence rate of the combined treatment of bloodletting and auricular point sticking is lower and its long-term curative effect is better.

摘要

目的

比较在理论基础上采用放血疗法与耳穴贴压联合治疗慢性自发性荨麻疹(CSU)与盐酸左西替利嗪口服液的临床治疗效果及对复发率的影响。

方法

将86例CSU患者随机分为观察组(43例,脱落1例)和对照组(43例,脱落3例)。观察组在大椎(GV 14)、肺俞(BL 13)、膈俞(BL 17)、脾俞(BL 20)进行放血疗法,并在肺(CO)、肾(CO)、神门(TF)、心(CO)等耳穴进行耳穴贴压。这种联合治疗每两天进行一次。对照组给予盐酸左西替利嗪口服液,每次10 mL,每日一次。两组治疗均持续4周。比较两组患者治疗前后的荨麻疹活动度评分7(UAS7)、皮肤病生活质量指数(DLQI)评分以及血清免疫球蛋白E(IgE)、白细胞介素4(IL - 4)和干扰素γ(IFN - γ)水平。评估两组患者的临床治疗效果,并分别在治疗后4、8和12周随访复发率。

结果

治疗后,两组患者的UAS7和DLQI评分以及血清IgE和IL - 4水平均较治疗前降低(<0.05),血清IFN - γ水平升高(<0.05)。观察组总有效率为83.3%(35/42),对照组为85.0%(34/40)。两组临床治疗效果差异无统计学意义(>0.05)。治疗后8周和12周,观察组复发率分别为21.1%(4/19)和26.3%(5/19),低于对照组的55.0%(11/20)和65.0%(13/20),差异有统计学意义(<0.05)。

结论

基于理论的放血与耳穴贴压联合疗法可缓解CSU患者的临床症状,调节血清IgE、IL - 4和IFN - γ水平,提高患者生活质量。这种联合治疗的临床治疗效果与盐酸左西替利嗪口服液相似。但是,放血与耳穴贴压联合治疗的复发率较低,长期疗效较好。

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