周春言 李琴 王福祖 张玉兰 张文广 宋维海 星媛 庄志毅 贺明元

〔摘要〕 目的 探討皮内针法对气阴两虚型干燥综合征患者的疗效。方法 选择本院接诊的气阴两虚型干燥综合征患者79例进行研究，根据治疗方法分为两组，对照组39例行常规西医治疗，观察组40例在对照组基础上加以皮内针治疗。对比两组临床疗效、中医证候积分、口干眼干客观指标、免疫功能、炎症因子。结果 观察组总有效率为82.50%，明显高于对照组的61.54%（P<0.05）;治疗后两组患者中医证候积分明显下降，且观察组低于对照组（P<0.05）;治疗后两组患者唾液流率及Schirmer氏泪液试验结果均明显升高，且观察组高于对照组（P<0.05）;治疗后两组患者IgG、补体C3、补体C4均明显升高，且观察组高于对照组（P<0.05）;治疗后两组患者TNF-α、CRP及IL-6均明显下降，且观察组低于对照组（P<0.05）。结论 皮内针法联合常规西医治疗较单独使用常规西医治疗气阴两虚型干燥综合征患者，可明显提高疗效、改善其中医证候及临床症状、提高免疫功能、降低炎症反应。

〔关键词〕 干燥综合征;皮内针;气阴两虚;免疫功能;炎症因子

〔中图分类号〕R246       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.07.021

〔Abstract〕 Objective To explore the clinical effects of intradermal acupuncture on patients with Sjogren syndrome with deficiency of Qi and Yin. Methods A total of 79 patients with Sjogren syndrome of Qi-Yin deficiency treated in our hospital were selected for study. They were divided into 2 groups according to the treatment methods. 39 cases in the control group were treated with conventional western medicine and 40 cases in the observation group were treated with intradermal acupuncture based on the control group. The clinical efficacy， traditional Chinese medicine （TCM） syndrome scores， objective indicators of dry mouth and dry eye， immune function and inflammatory factors were compared between the 2 groups. Results The total effective rate of the observation group was 82.50%， which was significantly higher than 61.54% of the control group （P<0.05）. After treatment， the TCM syndrome scores of the 2 groups of patients decreased significantly， and the observation group was lower than the control group （P<0.05）. After treatment， the results of saliva flow rate and Schirmer's tear test increased significantly， and the observation group was higher than the control group （P<0.05）. After treatment， the IgG， complement C3， and complement C4 in the 2 groups were significantly increased， and the observation group was higher than the control group （P<0.05）. After treatment， the levels of TNF-α， CRP and IL-6 in the 2 groups were significantly decreased， but the observation group was lower than the control group （P<0.05）. Conclusion Intradermal acupuncture combined with conventional western medicine treatment can significantly improve the efficacy in the treatment of patients with Sjogren syndrome with Qi and Yin deficiency， significantly improve clinical efficacy， TCM syndromes and clinical symptoms， improve immune function and reduce inflammatory response.

〔Keywords〕 Sjogren's syndrome; intradermal acupuncture; Qi and Yin deficiency; immune function; inflammatory factor

干燥综合征为以外分泌腺体受累为主要表现的慢性炎症性自身免疫疾病，主要有口腔、呼吸道、生殖器黏膜、眼结膜干燥等表现，该病除外分泌腺受损症状外，还有皮疹、关节炎、肌肉疼痛等表现[1-3]。数据显示国内干燥综合征患病率为0.3%～0.7%，老年人群中患病率为3%～4%，该病女性多发，发病年龄多在40～50岁[4]。该病的确切病因及发病机制尚未完全清楚，普遍认为该病发生与环境、遗传、自身免疫、免疫病理损伤等多方面因素有关，对于该病的西医治疗主要以对症支持治疗及系统调节免疫治疗为主，但上述疗法药物毒副作用明显，使其临床使用受到一定限制[5-6]。中医学并无干燥综合征一说，根据其症状归于“燥证”或“燥痹”的范畴，认为燥证主要是因阴虚化燥、燥毒亢盛灼伤津液而致阴血亏虚，诸窍失于濡养，日久瘀血痹阻，脉络不通，累及皮肤、筋骨，深达脏腑发为本病[7]。……