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电针足三里(ST36)、关元(CV4)和气海(CV6)穴位通过 PD-1 通路调节脓毒症患者的免疫功能。

Electroacupuncture at Zusanli (ST36), Guanyuan (CV4), and Qihai (CV6) Acupoints Regulates Immune Function in Patients with Sepsis via the PD-1 Pathway.

机构信息

Department of Intensive Care Unit, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Guangzhou, China.

Guangzhou University of Chinese Medicine, 232 Waihuan East Road, Panyu District, Guangzhou, China.

出版信息

Biomed Res Int. 2022 Jul 11;2022:7037497. doi: 10.1155/2022/7037497. eCollection 2022.

Abstract

OBJECTIVE

The present study is aimed at investigating the biochemical and clinical effects of electroacupuncture in patients with sepsis.

METHODS

Patients with sepsis treated at Guangdong Provincial Hospital of Chinese Medicine from July 2019 to December 2020 were included. Patients were randomly assigned to treatment with routine Western medicine (WM group) or treatment with Western medicine plus electroacupuncture based on Western medicine (EA group). Indices associated with immune function and clinical efficacy were determined before and at 3 and 5 days after treatment. Indicators of immune function included the percentage of T lymphocyte subsets, natural killer (NK) cells, and soluble programmed death protein 1 (sPD-1) levels. Indicators of clinical efficacy included infection-related indicators in whole blood; levels of tumor necrosis factor- (TNF-), C-reactive protein (CRP), and interferon- (INF-); and assessments using acute physiology and chronic health evaluation-II (APACHE-II) and sequential organ failure assessment (SOFA) scores.

RESULTS

Baseline data were not different between WM ( = 30) and EA groups ( = 30). At day 5 following treatment, the level of sPD-1 in the EA group was lower than that in the WM group. Proportions of CD3 + T lymphocytes, CD4 + T lymphocytes, and NK cells, the percentage of lymphocytes, and INF- levels in the EA group were significantly higher than those in the WM group. Compared with the WM group, the white blood cell count (WBC), percentage and count of neutrophils, ratio of neutrophils to lymphocytes, and levels of CRP and TNF- were significantly decreased in the EA group 5 days after treatment. The APACHE-II score of the EA group was significantly lower than that of the WM group 5 days after treatment.

CONCLUSION

Electroacupuncture may regulate the immune function of patients with sepsis through the PD-1 pathway to achieve an anti-inflammatory state and improve clinical symptoms.

摘要

目的

本研究旨在探讨电针对脓毒症患者的生化和临床影响。

方法

纳入 2019 年 7 月至 2020 年 12 月在广东省中医院接受治疗的脓毒症患者。将患者随机分为常规西医治疗(WM 组)或西医联合电针治疗(EA 组)。治疗前及治疗后 3、5 天,测定与免疫功能和临床疗效相关的指标。免疫功能指标包括 T 淋巴细胞亚群、自然杀伤(NK)细胞和可溶性程序性死亡蛋白 1(sPD-1)水平的百分比。临床疗效指标包括全血感染相关指标;肿瘤坏死因子-(TNF-)、C 反应蛋白(CRP)和干扰素-(INF-)水平;以及急性生理学与慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)和序贯器官衰竭评估(SOFA)评分评估。

结果

WM 组( = 30)和 EA 组( = 30)的基线数据无差异。治疗后第 5 天,EA 组 sPD-1 水平低于 WM 组。EA 组 CD3+T 淋巴细胞、CD4+T 淋巴细胞和 NK 细胞比例、淋巴细胞百分比和 INF-水平明显高于 WM 组。与 WM 组相比,治疗后第 5 天 EA 组的白细胞计数(WBC)、中性粒细胞百分比和计数、中性粒细胞与淋巴细胞比值、CRP 和 TNF-水平明显降低,EA 组的 APACHE-Ⅱ评分明显低于 WM 组。

结论

电针对脓毒症患者的免疫功能可能通过 PD-1 途径进行调节,从而达到抗炎状态,改善临床症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad4e/9293513/806daf896238/BMRI2022-7037497.001.jpg

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