摘要
目的本研究旨在评估针灸联合中药对急性上呼吸道病毒感染(URTI)患者症状缓解及免疫功能的调节作用。方法本研究纳入2023年1月至2024年1月在本院确诊为急性上呼吸道病毒感染的患者120例,按照1:1比例随机分为针灸联合中药组(治疗组,n=60)和常规西医治疗组(对照组,n=60)。治疗组接受每日一次的针灸治疗并配合中药方剂,疗程为7d;对照组接受常规抗病毒西药治疗。所有患者在治疗前后分别进行症状评分(包括发热、咽痛、流涕、鼻塞、咳嗽等),并使用视觉模拟评分(VAS)评估症状严重程度。同时监测免疫球蛋白IgA、IgG水平,T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)细胞百分比及CD4^(+)/CD8^(+)比值),以及炎症因子(IL-6、TNF-α、CRP)的变化。定义“症状完全缓解”为所有症状评分为0,且体温恢复正常(连续48h无发热)。通过多因素logistic回归分析评估针灸联合中药的独立疗效,控制混杂因素如年龄、性别和基础疾病。结果经过7d治疗,治疗组的症状评分由5.2±1.3降至1.0±0.6(P<0.01),对照组由5.0±1.4降至2.5±0.8(P<0.05),且治疗组的改善更显著(P<0.05)。第7天,治疗组的症状完全缓解率为65%(39/60),显著高于对照组的45%(27/60)(P<0.05)。治疗组的IgA水平由1.35±0.32g/L增至1.87±0.28g/L(P<0.01),对照组由1.32±0.35g/L增至1.52±0.34g/L(P<0.05);IgG水平在治疗组由10.24±1.82g/L增至12.56±1.75g/L(P<0.01),对照组由10.12±1.75g/L增至11.04±1.68g/L(P<0.05)。治疗组的免疫球蛋白上升幅度显著高于对照组(P<0.05)。治疗组的CD4^(+)细胞百分比由31.6%升至38.6%(P<0.01),对照组由30.9%升至33.8%(P<0.05),两组在CD4^(+)百分比及CD4^(+)/CD8^(+)比值改善上差异显著(P<0.05)。治疗后,治疗组在第7天的IL-6、TNF-α和CRP水平下降显著高于对照组(P<0.05)。多因素logistic回归分析表明,针灸联合中药对症状完全缓解具有独立影响(OR=4.291,95%CI:1.157~15.914,P=0.029),且IgA、IgG水平的上升及CD4^(+)/CD8^(+)比值的改善与症状完全缓解显著相关(P<0.05)。结论针灸联合中药对急性上呼吸道病毒感染患者的症状缓解和免疫功能调节具有显著优势。常规西医治疗组在改善症状和增强免疫功能方面也表现出一定疗效,但在症状完全缓解率、免疫球蛋白水平及T细胞免疫功能改善方面显著低于针灸联合中药组。多因素分析进一步证实了针灸联合中药的独立疗效,提示该疗法在中西医结合治疗中的应用潜力。
Objective This study aims to evaluate the effects of acupuncture combined with traditional Chinese medicine(TCM)on symptom relief and immune function regulation in patients with acute upper respiratory tract viral infections(URTI).Methods A total of 120 patients diagnosed with acute URTI at our hospital from January 2023 to January 2024 were included in this study.Patients were randomly divided into the acupuncture combined with TCM group(treatment group,n=60)and the conventional Western medicine treatment group(control group,n=60)at a 1:1 ratio.The treatment group received acupuncture once daily combined with TCM decoction for 7 days,while the control group received standard antiviral therapy.Symptom scores,including fever,sore throat,runny nose,nasal congestion,and cough,were recorded before and after treatment.The visual analogue scale(VAS)was used to assess symptom severity.Immunoglobulin levels(IgA,IgG),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)percentages,and CD4^(+)/CD8^(+)ratio),and inflammatory markers(IL-6,TNF-α,CRP)were monitored."Complete symptom relief"was defined as the resolution of all symptoms(symptom score of o)and the return to normal body temperature(no fever for 48 consecutive hours).Multivariate logistic regression analysis was performed to evaluate the independent efficacy of acupuncture combined with TCM,adjusting for confounding factors such as age,sex,and underlying conditions.R1esultsAfter 7 days of treatment,symptom scores in the treatment group significantly decreased from 5.2±1.3 to 1.0±0.6(P<0.01),while the control group saw a reduction from 5.0±1.4 to 2.5±0.8(P<0.05),with the treatment group showing a more pronounced improvement(P<0.05).On day 7,the complete symptom relief rate was 65%(39/60)in the treatment group,significantly higher than the 45%(27/60)in the'control group(P<0.05).IgA levels in the treatment group increased from 1.35±0.32g/L to 1.87±0.28 g/L(P<0.01),compared to an increase from 1.32±0.35g/L to1.52±0.34g/L in the control group(P<0.05).IgG levels in the treatment group rose from 10.24±1.82 g/L to 12.56±1.75 g/L(P<0.01),while the control group showed an increase from 10.12±1.75 g/L to 11.04±1.68 g/L(P<0.05).The increases in immunoglobulin levels were significantly higher in the treatment group than in the control group(P<0.05).CD4^(+)percentages in the treatment group increased from 31.6%to 38.6%(P<0.01),whereas in the control group,they rose from 30.9%to 33.8%(P<0.05),with significant differences in CD4^(+)percentages and CD4^(+)/CD8^(+)ratio improvements between the two groups(P<0.05).Additionally,on day 7,the reductions in IL-6,TNF-α,and CRP levels were significantly greater in the treatment group compared to the control group(P<0.05).Multivariate logistic regression analysis showed that acupuncture combined with TCM was independently associated with complete symptom relief(OR=4.291,95%CI:1.157±15.914,P=0.029).Increases in IgA,IgG levels,and improvements in the CD4^(+)/CD3^(+)ratio were significantly correlated with complete symptom relief(P<0.05).Conclusion Acupuncture combined with TCM demonstrates significant advantages in relieving symptoms and regulating immune function in patients with acute URTI.While conventional Western medicine also showed efficacy in symptom improvement and immune function enhancement,it was significantly inferior to acupuncture combined with TCM in terms of complete symptom relief rate,immunoglobulin levels,and T-cell immune function improvement.Multivariate analysis further confirmed the independent efficacy of acupuncture combined with TCM,highlighting its potential in integrative medicine for the treatment of viral infections.
作者
夏征
高希言
李世永
李薇薇
赵栋梁
XIA Zheng;GAO Xiyan;LI Shiyong;LI Weiwei;ZHAO Dongliang(Henan Vocational College of Massage,Luoyang 471023,Henan,China;Department of Acupuncture and Moribustion,The Third Affiliated Hospital of Henan University of Chinese Medicine;Henan University of Traditional Chinese Medicine;Department of Oncology,The Third Affiliated Hospital of Henan University of Chinese Medicine;Department of Respiratory Medicine,the Third Affiliated Hospital of Henan University of Chinese Medicine)
出处
《中国病原生物学杂志》
CSCD
北大核心
2024年第12期1511-1515,1520,共6页
Journal of Pathogen Biology
关键词
针灸
中药
急性上呼吸道病毒感染
症状缓解
免疫调节
acupuncture
traditional Chinese medicine
acute upper respiratory tract infection
symptom relief
immune modulation
