火针联合刺络放血治疗带状疱疹的疗效及对外周血Thl7 Treg细胞比例及其相关细胞因子的影响

doi:10.3969/j.issn.1006-6233.2024.02.09

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Abstract Objective: To explore the efficacy of fire needle combined with blood-letting acupoint pricking in the treatment of herpes zoster (HZ) and analyze its impact on peripheral blood Th17, regulatory T (Treg) cell ratio, and related cytokines. Methods: Eighty patients with HZ admitted to our hospital from January 2019 to December 2020 were selected and divided into control group and study group according to the random single or double number allocation principle, with 40 cases in each group. The control group received western medicine antiviral treatment, while the study group received fire needle combined with blood-letting acupoint pricking plus western medicine antiviral treatment. The treatment effects, recovery process, pre and post-treatment HZ symptom scores (erythema, vesicles, skin lesion pain), peripheral blood Th17, Treg cell ratios were compared. The levels of Th17/Treg cell-related cytokines (IL-6, IL-17, TGF-β₁) and neural pain factors [prostaglandin E2 (PGE2), serotonin (5-HT)] were detected using CytoFLEX flow cytometry and ELISA, respectively. The pain levels (VAS scores) were compared before and after treatment. Results: The total effective rate in the study group 97.50% was higher than that in the control group 80.00% (P<0.05). The study group showed better recovery process than the control group (P<0.05). Three days after treatment, erythema score, vesicle score, and skin lesion pain score in the study group were (1.24±0.35), (1.94±0.42), and (1.27±0.36), respectively, lower than those in the control group (P<0.05). Seven days after treatment, erythema score, vesicle score, and skin lesion pain score in the study group were (0.82±0.24), (0.94±0.30), and (0.68±0.22), respectively, lower than those in the control group (P<0.05). Three and seven days after treatment, the Th17 cell ratios in peripheral blood were (1.58±0.46)% and (1.05±0.33)% in the study group, Treg cell ratios were (4.21±0.95)% and (3.53±0.87)%, serum IL-6 levels were (14.53±2.61) pg/mL and (10.12±2.14) pg/mL, IL-17 levels were (22.68±3.86) pg/mL and (18.65±3.42) pg/mL, PGE2 levels were (126.85±12.69) ng/L and (95.42±9.35) ng/L, 5-HT levels were (65.32±14.19) ng/mL and (42.86±10.74) ng/mL, all lower than those in the control group (P<0.05). Three and seven days after treatment, TGF-β1 levels were (0.48±0.05) pg/mL and (0.51±0.05) pg/mL in the study group, higher than those in the control group (P<0.05). Three and seven days after treatment, VAS scores in the study group were (3.15±0.82) and (1.87±0.59), respectively, lower than those in the control group (P<0.05). Conclusion: The treatment of herpes zoster with fire needle combined with blood-letting acupoint pricking is effective, improves clinical symptoms, shortens the recovery process, and relieves pain. The mechanism of action may be related to correcting the imbalance of Th17/Treg cells.

Key words： Herpes zoster Fire needle Blood-letting acupoint pricking Cupping Th17 Treg

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.02.09 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I2/223

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