罗海丽 陈淑敏 余细妹 李颖 陈秀华 王聪

[摘要] 目的 評价比较雷火灸、清艾条悬灸神阙穴治疗慢性疲劳综合征患者的效果和安全性，并探讨其对外周血CD3+、CD4+和CD8+T淋巴细胞亚群的影响。 方法 选取2016年10月～2017年6月广州中医药大学第二临床医学院传统疗法中心收治的慢性疲劳综合征患者85例作为研究对象，分为试验组和对照组，试验组采用雷火灸，对照组采用传统清艾条悬灸，两组均选用神阙穴，隔日1次，3次为1个疗程，连续治疗4个疗程，最终完成病例试验组38例，对照组37例。观察治疗前后慢性疲劳综合征临床症状量表的评分变化，同时观察外周血CD3+、CD4+和CD8+T淋巴细胞亚群水平变化。 结果 两组均能降低慢性疲劳综合征的临床症状量表评分，试验组优于对照组，差异有统计学意义（P < 0.05）。两组均可提高CD3+含量，试验组与对照组的有效率分别为65.79%、43.24%，差异有统计学意义（P < 0.05）；两组均能双向调节CD4+/CD8+比值，试验组和对照组有效率分别为50.00%、21.62%，差异有统计学意义（P < 0.05）。两组均未见明显不良反应。 结论 雷火灸和清艾条悬灸神阙穴均可有效改善慢性疲劳综合征患者的临床症状，提高CD3+含量及促进CD4+/CD8+比值恢复平衡，但雷火灸的效果更佳。两者均具有安全、易于自行操作的特点，值得临床推广应用。

[关键词] 雷火灸；神阙穴；慢性疲劳综合征；T淋巴细胞亚群；CD3+；CD4+/CD8+；艾灸

[中图分类号] R255.5 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0107-05

[Abstract] Objective To evaluate the efficacy and safety of thunder-fire moxibustion in the treatment of chronic fatigue syndrome （CFS） on Shenque acupoint （CV8） comparing with common moxa-stick moxibustion therapy， and to investigate its influence on CD3+， CD4+， CD8+ T lymphocyte subsets in peripheral blood. Methods From October 2016 to June 2017， 85 cases of patients diagnosed as CFS in Center of Traditional Remedies， the Second Clinical Medical College， Guangzhou University of Chinese Medicine were selected as research objects and divided into the experimental group and the control group. The experimental group was treated with thunder-fire moxibustoin， while the control group was treated with common moxa-stick moxibustion. Both groups chose CV8， once every other day， three times were as one course， for 4 courses. Finally， 38 cases in the experimental group and 37 cases in the control group finished the study. The changes of CFS clinical syndrome scale and the levels of T lymphocyte subsets （CD3+， CD4+， CD8+） in peripheral blood before and after treatment were observed. Results Both groups could decrease the scores of clinical syndrome scale， and the experimental group was better than that of the control group， the difference was statistically significant （P < 0.05）. Both groups could increase the number of CD3+， and the effective rate in the experimental group and control group was 65.79%， 43.24% respectively， the difference was statistically significant （P < 0.05）. Both groups could two-way regulate the ratio of CD4+/CD8+， and the effective rate in the experimental group and control group was 50.00%， 21.62% respectively， the difference was statistically significant （P < 0.05）. There were no obvious adverse events in both groups. Conclusion Both thunder-fire moxibustion and common moxa-stick moxibustion can effectively improve the clinical symptoms of CFS， increase the number of CD3+ and restore the balance of CD4+/CD8+ ratio， but the effect of thunder-fire moxibustion is better. Both are safe， easy to operate， and valuable for clinical application.

[Key words] Thunder-fire moxibustion； Shenque acupoint； Chronic fatigue syndrome； T lymphocyte subsets； CD3+； CD4+/CD8+； Moxibustion

慢性疲劳综合征（chronic fatigue syndrome，CFS）是于1988年由美国疾病控制中心正式命名的一组症候群[1]，是指以极度疲劳反复发作或持续6个月以上为主要临床表现，休息后不能缓解，各项常规实验室检查及体格检查均无异常，并未发现引起疲劳的相关内科或精神疾病，可同时伴有低热或自觉发热、头痛、咽喉痛、肌痛、淋巴结肿大、注意力不集中、记忆力差、睡眠障碍、抑郁和认知损害等非特异性症状[2]。目前普遍认为CFS的发生可能与过度劳累、遗传、病毒感染、过敏和营养元素缺乏等多种因素有关，其病理过程涉及内分泌、代谢、免疫和心理等功能的广泛异常。……