针灸治疗类风湿性关节炎免疫研究进展

随着针灸对于机体免疫调节作用的深入研究,针灸对于免疫系统疾患的治疗作用及作用机制,日益成为学者关注的热点.而类风湿性关节炎(RA)作为一种常见的、针灸治疗有效的全身性免疫系统疾病,则成为了针灸免疫调节及其机制研究的切入点.已有大量临床及动物实验证实,针灸治疗类风湿性关节炎,对机体免疫功能有良好的调整作用.现将针灸治疗类风湿性关节炎免疫研究状况综述如下.

Primary osteoporosis, a commonly encountered metabolic bone disease in the postmenopausal women and the aged people, can be classified by modern medicine into postmenopausal osteoporosis (Type I) and senile osteoporosis (Type II). The disease seriously affects health and quality of life of the people as it often cause ostealgia, fracture and the secondary symptoms or diseases. Presently, the pharmacotherapy (including both Chinese herbal drugs and western drugs) remains the first among all other therapeutic methods which are mainly adopted in treatment of the disease at home and abroad. Studies related have been curried out quite early and systematically, and considerable progress has been made, but limit of the pharmacotherapy has also been found. Certain non-drug treatments (such as dietetic therapy, physical exercise, acupuncture and moxibustion, and qigong, especially acupuncture and moxibustion therapy, although with a late start, have been proved effective with satisfactory results. The following is a summary of all the contributions concerned.

Objective: To observe the therapeutic effect of acupuncture plus psychological intervention for postpartum depression.
Methods: By random number table, 85 patients with postpartum depression were divided into a treatment group and a control group. Forty-three cases in the treatment group were treated by acupuncture plus psychological intervention, once every day, five sessions per week, and rest at weekend. Forty-two cases in the control group were treated by oral administration of Fluoxetine Hydrochloride, 20 mg, once per day. The two groups were treated continuously for six weeks. The change of the score in Hamilton depression scale (HAMD) was observed and the therapeutic effect was summarized.
Results:The total effective rate was 90.7%in the treatment group and 90.5% in the control group. The difference in the total effective rate between two groups was not statistically significant (P>0.05). In the intra-group comparisons of HAMD scores two, four and six weeks after treatment in both groups with those before treatment, the differences were statistically significant (all P<0.05). In comparison between the two groups at the same time point, the differences in HAMD scores were not statistically significant (all P>0.05). Regarding the adverse events, 5 cases had nausea, 3 cases had dizziness, and 6 cases had poor appetite in the control group; no obvious adverse events happened in the treatment group.
Conclusion:Acupuncture plus psychological intervention for postpartum depression is as same as oral administration of Fluoxetine Hydrochloride in therapeutic effects, but it does not have adverse reaction.

Objective:To observe the clinical efficacy of acupuncture-moxibustion in treating Alzheimer’s disease (AD).
Methods: Forty-eight eligible AD patients were enrolled to receive acupuncture plus herb-partitioned moxibustion. Mini-mental state examination (MMSE) was adopted for evaluation before and after intervention, and the therapeutic efficacy was observed.
Results: After intervention, the MMSE score changed significantly (P<0.01), and the total effective rate was 83.3%.
Conclusion: Acupuncture-moxibustion can significantly improve the cognitive function of AD patients, beneficial to the general promotion of the quality of life.

Objective:To observe the clinical effect of warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) in treatment of urinary retention after gynecological surgery.
Methods: Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36). Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment.
Results:The total effective rate was 95.0%in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05).
Conclusion: Warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) is more effective than inductive urination in treating urinary retention after gynecological surgery.

Objective:To observe the clinical effect of warm needling moxibustion for knee osteoarthritis (KOA) by a randomized controlled trial.
Methods: Sixty cases with KOA were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated by warm needling moxibustion. The control group was treated by simple acupuncture. Ten sessions made one course and the two groups were treated for two courses. The scores of knee joint pain, stiffness and knee functions before and after the treatment were observed.
Results: The scores of Western Ontario and McMaster Universities osteoarthritis index (WOMAC) on pain, stiffness and joint functions before and after treatment in both groups were statistically different (all P<0.05). The comparisons of the scores in pain, stiffness and joint function after treatment between the two groups were all statistically different (all P<0.05). The total effective rate was 93.3%in the observation group and 80.0%in the control group. The differences of the clinical effects between the two groups were statistically significant (P<0.05).
Conclusion: Warm needling moxibustion can improve the clinical symptoms and functions of the patients with KOA, and is better than ordinary acupuncture in the therapeutic effect.

By computer research, the literature of clinical and experimental studies on moxibustion therapy for chronic gastritis in the recent fifteen years was collected, sorted and analyzed, in order to understand the general situation about the clinical and experimental studies on moxibustion therapy for chronic gastritis, summarize the regularity of moxibustion therapy for chronic gastritis, so as to guide the treatment of chronic gastritis.