苓桂术甘汤联合针刺治疗对干燥综合征患者的唾液腺、泪腺分泌功能及免疫功能的改善作用

侯小双; 李林; 刘飞; 罗亚萍; 侯冬杰

doi:10.13748/j.cnki.issn1007-7693.20233243

苓桂术甘汤联合针刺治疗对干燥综合征患者的唾液腺、泪腺分泌功能及免疫功能的改善作用

Effects of Linggui Zhugan Decoction Combined with Acupuncture on the Improvement of Salivary Gland, Lacrimal Gland Secretion Function, and Immune Function in Patients with Sjögren's Syndrome

摘要

摘要:
目的研究苓桂术甘汤联合针刺治疗对干燥综合征患者唾液腺、泪腺分泌功能及免疫功能的影响。
方法选择2020 年10 月—2023 年1 月河北省中医院收治的141 例干燥综合征患者，按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4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。
结果治疗后2、3个月，4组患者泪腺分泌功能和唾液流率比治疗前明显提高，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；4组患者欧洲抗风湿联盟干燥综合征患者报告指数(EULAR Sjögren's syndrome patient reported index，ESSPRI)、干燥综合征疾病活动性指数(EULAR Sjögren's syndrome disease activity index，ESSDAI)和中医症候积分、红细胞沉降率(erythrocyte sedimentation rate，ESR)和免疫球蛋白G(immunoglobulin G，IgG)比治疗前明显降低，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3个月后，针药治疗组患者总有效率为94.29%，明显高于针刺对照组(60.00%)、中药对照组(65.71%)和西药对照组(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%，虽高于针刺对照组(8.33%)、中药对照组(5.71%)和西药对照组(8.33%)，但差异无统计学意义(χ²=1.638，P=0.651)。
结论苓桂术甘汤联合针刺可有效改善唾液腺和泪腺分泌功能，缓解临床症状，降低中医症候积分，改善免疫功能，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 effects of Linggui Zhugan Decoction combined with acupuncture therapy on salivary gland and lacrimal gland secretion function, and immune function in patients with Sjögren's syndrome.
METHODS From October 2020 to January 2023, a cohort of 141 patients diagnosed with Sjögren's syndrome was recruited at Hebei Hospital of Traditional Chinese Medicine. Using a random number table method, the patients were allocated into 4 groups: western medicine control group, herbal medicine control group, acupuncture control group, and acupuncture combined with herbal medicine treatment group. The lacrimal gland secretion function, saliva flow rate, symptom severity, traditional Chinese medicine syndrome score, immune function, clinical efficacy and adverse reactions were compared among the 4 groups.
RESULTS At 2 and 3 months post-treatment, the lacrimal gland secretion function and salivary flow rate significantly improved in all 4 patient groups compared to pre-treatment levels. 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 4 patient groups showed significant reductions in EULAR Sjögren's syndrome patient reported index(ESSPRI), EULAR Sjögren's syndrome disease activity index(ESSDAI) scores, traditional Chinese medicine symptom scores, erythrocyte sedimentation rate(ESR), and immunoglobulin G(IgG) compared to pre-treatment values. The acupuncture combined with 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 3 months’ treatment, the overall effective rate for the acupuncture combined with herbal medicine treatment group was 94.29%, significantly higher than that of 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 combined with herbal medicine treatment group was 14.29%, slightly higher than that of 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.

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