干燥综合征患者在苓桂术甘汤和针刺联合治疗下的唾液、泪腺及免疫功能改善

Combined therapy of Linggui Zhugan Decoction and acupuncture improves salivary and lacrimal gland secretion function as well as immune function in patients with Sjogren"s syndrome

关键词:  苓桂术甘汤  针刺  干燥综合征  唾液流率  泪腺分泌功能  免疫功能

Key words:  Linggui Zhugan Decoction  acupuncture  Sjogren"s syndrome  salivary flow rate  lacrimal gland secretion function.  immune function

摘要:

目的 探讨苓桂术甘汤联合针刺对干燥综合征患者唾液和泪腺分泌功能及免疫功能的影响。方法 选择2020年10月至2023年1月本院收治的141例干燥综合征患者,随机数表法将患者分成西药对照组、中药对照组、针刺对照组及针药治疗组。比较四组患者泪腺分泌功能、唾液流率、症状严重程度、中医证候积分、免疫功能、临床疗效及不良反应等。结果 治疗后,四组患者泪腺分泌功能和唾液流率明显提高,且针药治疗组泪腺分泌功能和唾液流率明显高于针刺对照组、中药对照组和西药对照组。四组患者ESSPRI、ESSDAI评分和中医症候积分、ESR和IgG明显降低,且针药治疗组ESSPRI评分、ESSDAI评分、中医症候积分、ESR和IgG明显低于针刺对照组、中药对照组和西药对照组。治疗后,针药治疗组患者总有效率为94.29%,明显高于针刺对照组的60.00%、中药对照组的65.71%和西药对照组的61.11%,差异有统计学意义(χ2^=13.209, P=0.004) 治疗期间针药治疗组的总不良反应率为14.29%,高于针刺对照组的8.33%、中药对照组的5.71%和西药对照组的8.33%,差异无统计学意义(χ2^=1.638, P=0.651)。结论 苓桂术甘汤联合针刺可有效改善改善唾液和泪腺分泌功能,缓解临床症状,降低中医症候积分,纠正免疫功能,增强临床疗效,且安全性高,值得临床进一步研究并推广。

Abstract:

Objective To study the combined therapy of Linggui Zhugan Decoction and acupuncture improves salivary and lacrimal gland secretion function as well as immune function in patients with Sj?gren"s syndrome. Methods From October 2020 to January 2023, a cohort of 141 patients diagnosed with Sj?gren"s syndrome was recruited at our institution. Using a random number table method, the patients were allocated into four groups: Western medicine control group, traditional Chinese medicine control group, acupuncture control group, and acupuncture combined with medication treatment group. The lacrimal gland secretion function, saliva flow rate, symptom severity, TCM syndrome score, immune function, clinical efficacy and adverse reactions were compared among the four groups. Results Following treatment, the lacrimal gland secretion function and salivary flow rate of the four patient groups exhibited significant improvement. The group treated with acupuncture and herbal medicine demonstrated notably higher lacrimal gland secretion function and salivary flow rate in comparison to the acupuncture control group, herbal medicine control group, and western medicine control group.All four patient groups showed significant reductions in ESSPRI, ESSDAI scores, traditional Chinese medicine symptom scores, ESR, and IgG. The acupuncture and herbal medicine treatment group exhibited significantly lower ESSPRI scores, ESSDAI scores, traditional Chinese medicine symptom scores, ESR, and IgG compared to the acupuncture control group, herbal medicine control group, and western medicine control group.After treatment, the overall effective rate for the acupuncture and herbal medicine treatment group was 94.29%, significantly higher than the acupuncture control group (60.00%), herbal medicine control group (65.71%), and western medicine control group (61.11%), with statistically significant differences (χ²=13.209, P=0.004). During the treatment period, the total incidence of adverse reactions in the acupuncture and herbal medicine treatment group was 14.29%, slightly higher than the acupuncture control group (8.33%), herbal medicine control group (5.71%), and western medicine control group (8.33%), but without statistically significant differences (χ2^{=1.638, P=0.651).} Conclusion The combined therapy of Linggui Zhugan Decoction and acupuncture exhibits substantial efficacy in enhancing salivary and lacrimal gland secretion, mitigating clinical symptoms, diminishing Traditional Chinese Medicine syndrome scores, correcting immune function, and augmenting clinical effectiveness. Moreover, this therapeutic approach has demonstrated safety and warrants further investigation through meticulous clinical research and broader implementation.