中药联合针刺对阿尔茨海默病患者外周血IL-6、TNF-α表达的影响

摘要

目的:观察抵当汤加减结合针刺督脉穴位治疗阿尔茨海默病的临床疗效并从炎性反应的角度探讨其疗效机理.方法:将80例患者随机分为中药组、针刺组、针药组和西药组,每组各20例.中药组给予抵当汤加减,针刺组针刺百会、大椎穴,针药组服用抵当汤加减同时针刺百会、大椎穴,西药组给予多奈哌齐口服.12周疗程结束后观察临床疗效,同时治疗前后分别抽取患者外周血采用ELISA法进行IL-6、TNF-α检测.结果:治疗后针药组总有效率为90.0%,明显高于中药组的80.0%、针刺组的85.0%及西药组的60.0%,差异均有统计学意义(P<0.05).同时针药组可显著降低患者血清IL-6、TNF-α水平,疗效优于中药组、针刺组和西药组,差异均有统计学意义(P<0.01).结论:抵当汤加减联合针刺百会、大椎穴治疗阿尔茨海默病疗效确切,疗效机制可能与其降低患者血清IL-6、TNF-α等炎性因子水平有关.%Objective:To observe the clinical curative effect of Didang decoction combined with acupuncture in Du Meridian points of Alzheimer's disease and to explore its therapeutic mechanism from the point of the inflammatory response.Method:80 patients were randomly divided into traditional Chinese medicine group, acupuncture group, acupuncture combined with Chinese medicine group and Western medicine group, 20 cases in each group.The Chinese medicine group was treated with Jiajian Didang decoction, acupuncture group received acupuncture in Baihui and Dazhui acupoint, acupuncture combined with Chinese medicine group was treated with both Jiajian Didang decoction and acupuncture,the Western medicine group was given oral donepezil,the clinical efficacy was observed after 12 weeks, while before and after the treatment peripheral blood TNF-α and IL-6 expression of patients were detected by ELISA.Result:After treatment, the total effective rate of acupuncture combined with Chinese medicine group was 90%, which was significantly higher than 80% of traditional Chinese medicine group, 85% of acupuncture group and 60% of Western medicine group, the differences were statistically significant (P<0.05). The peripheral blood TNF-α and IL-6 expression of patients in acupuncture combined with Chinese medicine group were significantly lower than those in the traditional Chinese medicine group, acupuncture group and Western medicine group, the differences were statistically significant(P<0.01).Conclusion:The curative effect of Didang decoction combined with acupuncture in the treatment of Alzheimer's disease is exact and the effective mechanism may be related to reduce the levels of serum IL-6,TNF-a and other inflammatory factors.