毫火针联合得宝松及复方甘草酸苷胶囊对斑秃患者免疫功能的影响

丁小杰　蒋 培　宗淑芳　刘 霞　卢薇薇　孙彩虹　柏志芳

[關键词]毫火针;得宝松;复方甘草酸苷;斑秃;γ干扰素

[中图分类号]R758.71    [文献标志码]A    [文章编号]1008-6455（2021）12-0116-04

Efficacy of Milifire Needle Combined with Diprospan  and Compound Glycyrrhizin Capsules on Alopecia Areata and its Influence on Immune Function

DING Xiao-jie，JIANG Pei，ZONG Shu-fang，LIU Xia，LU Wei-wei，SUN Cai-hong，BAI Zhi-fang

（Department of Dermatology，the Second Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Second Chinese Medicine Hospital，Nanjing 210017，Jiangsu，China）

Abstract： Objective  To observe the effect of milifire needle needle combined with diprospan and compound glycyrrhizin capsules on alopecia areata and the effect of immune function. Methods  120 cases alopecia areata patients were randomly divided into 2 groups. The treatment group （60 cases） was treated with milifire needle needle combined with diprospan and compound glycyrrhizin capsules. The control group （60 cases） used milifire needle needle combined with compound glycyrrhizin capsules. The enzyme-linked immunosorbent assay was used to detect peripheral blood interferon-γ （IFN-γ）， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-8 （IL-8）. The flow cytometry was used to detect peripheral blood CD3+， CD4+， CD8+， CD4+/CD8+.  Results  The total effective rate of the treatment group was 91.67%， and the total effective rate of the control group was 73.33%. Compared with the control group， the total effective rate of the treatment group was significantly higher， the difference was statistically significant（P<0.05）. Before treatment， there was no significant difference in IFN-γ， TNF-α， IL-6， IL-8， CD3+， CD4+， CD8+， CD4+/CD8+ between 2 groups（P>0.05）. After treatment， the IFN-γ， TNF-α， IL-6， IL-8， CD8+ had decreased， the difference was statistically significant （P<0.05）， and CD3+， CD4+， CD8+， CD4+/CD8+ had increased， the difference was statistically significant （P<0.05）. Compared with the control group， the IFN-γ， TNF-α， IL-6， IL-8， CD8+ had decreased， and CD3+， CD4+， CD8+， CD4+/CD8+ had increasedin the observation group， the difference was statistically significant （P<0.05）. None of the patients had obvious adverse reactions. Conclusion  Milifire needle needle combined with diprospan and compound glycyrrhizin capsules are effective in treating alopecia areata and can reduce the serum IFN-γ.

Key words： milifire needle; diprospan; compound glycyrrhizin; alopecia areata; interferon-γ

斑秃（Alopecia areata，AA）是一种非瘢痕性脱发的慢性皮肤病，临床以边缘整齐的卵圆形或者圆形脱发为特征，是在精神创伤或者内分泌失调诱导下发生的免疫性疾病，导致Th1和Th2功能的失衡[1-4]。中医没有“斑秃”这个病名，但根据临床症状可知，斑秃是肝、脾和肾三脏失调导致气血不和，风邪袭腠，博于肌肤，致肌肤不得气血荣养。近年来，大量研究采用毫火针[5]、得宝松[6]、复方甘草酸苷胶囊[7]、毫火针联合得宝松或复方甘草酸苷胶囊[8-9]用于治疗斑秃。但毫火针联合得宝松及复方甘草酸苷胶囊对斑秃的机制尚不明确，本研究拟以免疫功能指标Th1细胞因子γ干扰素（Interferon-γ，IFN-γ）为评价指标，观察斑秃患者外周血免疫功能指标在毫火针联合得宝松及复方甘草酸苷胶囊治疗前后的变化，为临床治疗斑秃提供参考。

1  资料和方法

1.1 一般资料：选择2017年1月-2020年5月于笔者医院皮肤科诊治的120例患者，随机分成治疗组和对照组，每组60例。治疗组：男27例，女33例，年龄24～58岁，平均年龄（34.6±9.3）岁;对照组：男31例，女29例，年龄22～59岁（平均为32.2岁）;两组均为圆形或者卵圆形斑秃，两组患者性别、年龄及病情等均无显著性差异。所有患者均了解研究内容及可能风险，签署知情同意书和照片使用协議，本研究经医院伦理委员会同意批准。

1.2 纳入和排除标准

1.2.1 纳入标准：①确诊为斑秃，短时间内或突然脱发呈片状……