针灸治疗变应性鼻炎机制的研究进展
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摘要
变应性鼻炎是常见的呼吸系统疾病之一,严重影响患者的生活质量。笔者基于近10年国内外针灸治疗变应性鼻炎机制相关研究总结成以下几方面内容:(1)降低免疫球蛋白E;(2)调节Th1/Th2水平;(3)抑制炎性介质释放;(4)减少炎性细胞浸润;(5)降低炎性神经肽;(6)抑制Toll样受体和NFκB蛋白表达,指出研究的整体进展并对今后研究提出思考。
Allergic rhinitis( AR) is one of the common respiratory diseases,which seriously affects the patient's quality of life. National and international reasearch on the mechanism of acupuncture and moxibustion therapy in treating AR over the past10 years has been analyzed and summarized based on the related research,includes the following aspects: 1) Reductions in immunoglobulin E; 2) Regulation of the Th1/Th2 level; 3) Inhibition of inflammatory mediators' release; 4) Reduction in the infiltration of inflammatory cells; 5) Decreasing inflammation neuropeptides; 6) Inhibition of Toll like receptor and neuropeptide nuclear factor kappa B,the overall progress of the study is pointed out and some suggestions are provided for further researchs.
Allergic rhinitis( AR) is one of the common respiratory diseases,which seriously affects the patient's quality of life. National and international reasearch on the mechanism of acupuncture and moxibustion therapy in treating AR over the past10 years has been analyzed and summarized based on the related research,includes the following aspects: 1) Reductions in immunoglobulin E; 2) Regulation of the Th1/Th2 level; 3) Inhibition of inflammatory mediators' release; 4) Reduction in the infiltration of inflammatory cells; 5) Decreasing inflammation neuropeptides; 6) Inhibition of Toll like receptor and neuropeptide nuclear factor kappa B,the overall progress of the study is pointed out and some suggestions are provided for further researchs.
引文
[1]变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,0(1):6~24
[2] BOUSQUET J,KHALTAEV N,CRUZ AA,et al. AllergicRhinitis and its Impact on Asthma(ARIA)2008Update(in collaborationwith the World Health Organization,GA2LEN[J]. Allergy,2008,63:8~160
[3] MELTZER EO,BUKSTEIN DA. The economic impact of allergicrhinitis and current guidelines for treatment[J]. Ann Allergy Asthma Im-munol,2011,106(2Suppl):S12~16
[4] BLAISS MS. Allergic rhinitis:Direct and indirect costs[J].Allergy Asthma Proc,2010,31(5):375~380
[5] ZHANG L,HAN D,HUANG D,et al. Prevalence of self-re-ported allergic rhinitis in eleven major cities in china[J]. International Ar-chives of Allergy&Immunology,2009,149(1):47
[6] ZHAO J,BAI J,SHEN K,et al. Self-reported prevalence ofchildhood allergic diseases in three cities of China:a multicenter study[J]. Bmc Public Health,2010,10(1):551
[7] SEIDMAN MD,GURGEL RK,LIN SY,et al. Clinical practiceguideline:allergic rhinitis executive summary[J]. Otolaryngology--HeadAnd Neck Surgery:Official Journal Of American Academy Of Otolaryngolo-gy-Head And Neck Surgery,2015,152(2):197~206
[8]魏欣.变应性鼻炎的发病机制[J].海南医学,2011,22(10):8~12
[9]周志军,叶建明,管建丽.变应性鼻炎患者血Ig E及尿LTE4检测的临床分析[J].放射免疫学杂志,2010,23(1):119~120
[10] MCDONALD JL,SMITH PK,SMITH CA,et al. Effect of ac-upuncture on house dust mite specific Ig E,substance P,and symptoms inpersistent allergic rhinitis[J]. Annals Of Allergy,Asthma&Immunology:Official Publication Of The American College Of Allergy,Asthma,&Im-munology,2016,116(6):497~505
[11]谢怡琳,万文蓉,赵银龙,等.温针灸冬夏并治对变应性鼻炎患者生活质量的影响[J].中国针灸,2015,35(12):1215~1220
[12]张仲林,钟玲,袁明勇,等. Th1/Th2/Th17/Treg细胞因子在变应性鼻炎发病中的免疫机制研究[J].医学综述,2014,20(16):2906~2909
[13] HARRINGTON LE,HATTON RD,MANGAN PR,et al. D,Mangan PR,Turner H,Murphy TL,Murphy KM,Weaver CT. Interleu-kin17-producing CD4+effector T cells develop via a lineage distinct fromthe T helper type 1and 2lineages[J]. 2005
[14]兰建华,罗雪梅,曾友根,等.针刺穴位治疗变应性鼻炎对患者血清IL-2及IFN-γ的影响[J].中国医学创新,2016,13(20):97~99
[15]卢健敏.针刺对变应性鼻炎大鼠模型血清IL-5和鼻黏膜组织IL-5mRNA表达的影响[J].长春中医药大学学报,2013,29(1):37~38
[16]赵义造,黄益灯,黄加云,等.针刺对变应性鼻炎大鼠IL-4、IFN-γ水平影响的研究[J].福建中医药,2010,41(5):52~53
[17]崔星,吴云天,胡翀妮,等.针刺联合背俞穴埋线治疗变应性鼻炎临床研究[J].中国中医药信息杂志,2017,24(10):18~21
[18]张仲林,钟沁月,李莎,等.肥大细胞在变应性鼻炎中的研究进展[J].西南军医,2009,11(1):115~116
[19]杨莎莎,刘洋,李昕蓉,等.神经肽与肥大细胞之间的交互对变应性鼻炎发病机制的影响[J].辽宁中医杂志,2016,(12):2512~2515
[20]邰浩清,姜文芳.针刺下关穴治疗过敏性鼻炎的实验研究[J].浙江中西医结合杂志,2008,18(12):747~748
[21]陈劼.穴位敷贴治疗小鼠过敏性鼻炎免疫机制的研究[D]:广州中医药大学,2006
[22]凌永伟,欧阳贵平,谢洪亮,等.变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞的检测[J].中国耳鼻咽喉颅底外科杂志,2012,18(1):58~60
[23] BATES ME,SEDGWICK JB,ZHU Y,et al. Human AirwayEosinophils Respond to Chemoattractants with Greater Eosinophil-DerivedNeurotoxin Release,Adherence to Fibronectin,and Activation of the Ras-ERK Pathway When Compared with Blood Eosinophils[J]. Journal of Im-munology,2010,184(12):7125~7133
[24] MATSUMOTO K,FUKUDA S,HASHIMOTO N,et al. Hu-man eosinophils produce and release a novel chemokine,CCL23,in vitro[J]. International Archives of Allergy&Immunology,2011,155Suppl 1(Suppl. 1):34
[25] RUBY P,SACHIKO M,CHIKA O,et al. Overview on thepathomechanisms of allergic rhinitis[J]. Asia Pacific Allergy,2011,1(3):157
[26] GREINER AN,HELLINGS PW,ROTIROTI G,et al. Aller-gic rhinitis[J]. Lancet,2011,378(9809):2112~2122
[27]陈莹.针刺对变应性鼻炎大鼠血清Th1/Th2的调控[D]:南方医科大学,2012
[28]丁然然,杨帆,刘洋,等.针刺列缺穴对过敏性鼻炎模型大鼠鼻黏膜病理学的影响[J].中国中医急症,2015,24(10):1743~1745
[29]吴春晓,陈莹,陈静,等.针刺对变应性鼻炎模型大鼠的治疗作用及其机理研究[J].江苏中医药,2013,(12):69~71
[30] GILLESPIE MB,OSGUTHORPE JD. Pharmacologic manage-ment of chronic rhinosinusitis,alone or with nasal polyposis[J]. CurrentAllergy&Asthma Reports,2004,4(6):478~485
[31]李斯斯,阮标,余咏梅. P物质在变应性鼻炎发病机制和治疗中的作用[J].中华临床免疫和变态反应杂志,2013,7(2):193~197
[32]曹文忠,李爱敏,庞文儒,等.大椎穴施以三重法防治变应性鼻炎及对血清SP、IL-4的影响[J].上海针灸杂志,2016,35(2):134~138
[33]郑美凤,何芙蓉,宰风雷,等.针刺“蝶腭穴”治疗变应性鼻炎及其对血清P物质的影响[J].康复学报,2009,19(4):44~46
[34]刘洋.迎香穴针刺治疗变应性鼻炎作用机制的网络构建及临床疗效观察[D]:成都中医药大学,2015
[35] APPLEQUIST SE,WALLIN RP,LJUNGGREN HG. Variableexpression of Toll-like receptor in murine innate and adaptive immune celllines[J]. International Immunology,2002,14(9):1065
[36] CUI XY,CHEN X,YU CJ,et al. Increased expression of toll-like receptors 2and 4and related cytokines in persistent allergic rhinitis[J]. Otolaryngol Head Neck Surg,2015,152(2):233~238
[37]杨玉荣,佘锐萍,梁宏德. Toll-NF-kB信号途径及其介导的功能[J].中国细胞生物学学报,2007,29(4):483~486
[38]张乃元.针刺对过敏性鼻炎大鼠免疫调节作用机制的研究[D]:广州中医药大学,2011
[39] JUNG D,LEE S,HONG S. Effects of acupuncture and moxi-bustion in a mouse model of allergic rhinitis[J]. Otolaryngology--HeadAnd Neck Surgery:Official Journal Of American Academy Of Otolaryngolo-gy-Head And Neck Surgery,2012,146(1):19~25
[40] ROND N C,CANTO G,BLANCA M. Local allergic rhinitis:a new entity,characterization and further studies[J]. Current Opinion inAllergy&Clinical Immunology,2010,10(1):1~7
[41]刘争,李华斌,崔永华.局部变应性鼻炎[J].中华耳鼻咽喉头颈外科杂志,2011,46(11):962~964
[42] SHIUE HS,LEE YS,TSAI CN,et al. Gene expression pro-file of patients with phadiatop-positive and-negative allergic rhinitis treatedwith acupuncture[J]. J Altern Complement Med,2010,16(1):59~68
[43] SHIUE HS,LEE YS,TSAI CN,et al. Treatment of allergicrhinitis with acupoint herbal plaster:an oligonucleotide chip analysis[J].BMC Complement Altern Med,2016,16(1):436
[44] SEKI N,SHIRASAKI H,KIKUCHI M,et al. Expression andlocalization of TRPV1in human nasal mucosa[J]. Rhinology,2006,44(2):128~134
[45] DINH QT,GRONEBERG DA,PEISER C,et al. Substance Pexpression in TRPV1and trk A-positive dorsal root ganglion neurons innerva-ting the mouse lung[J]. Respiratory Physiology&Neurobiology,2004,144(1):15
[46] GEPPETTI P,MATERAZZI S,NICOLETTI P. The transientreceptor potential vanilloid 1:Role in airway inflammation and disease[J].European Journal of Pharmacology,2006,533(1–3):207~214
[47] MCDONALD JL,CRIPPS AW,SMITH PK. Mediators,Re-ceptors,and Signalling Pathways in the Anti-Inflammatory and Antihyperal-gesic Effects of Acupuncture[J]. Evidence-Based Complementray and Al-ternative Medicine,2015,(2015~8~3),2015,2015(2):975632
[2] BOUSQUET J,KHALTAEV N,CRUZ AA,et al. AllergicRhinitis and its Impact on Asthma(ARIA)2008Update(in collaborationwith the World Health Organization,GA2LEN[J]. Allergy,2008,63:8~160
[3] MELTZER EO,BUKSTEIN DA. The economic impact of allergicrhinitis and current guidelines for treatment[J]. Ann Allergy Asthma Im-munol,2011,106(2Suppl):S12~16
[4] BLAISS MS. Allergic rhinitis:Direct and indirect costs[J].Allergy Asthma Proc,2010,31(5):375~380
[5] ZHANG L,HAN D,HUANG D,et al. Prevalence of self-re-ported allergic rhinitis in eleven major cities in china[J]. International Ar-chives of Allergy&Immunology,2009,149(1):47
[6] ZHAO J,BAI J,SHEN K,et al. Self-reported prevalence ofchildhood allergic diseases in three cities of China:a multicenter study[J]. Bmc Public Health,2010,10(1):551
[7] SEIDMAN MD,GURGEL RK,LIN SY,et al. Clinical practiceguideline:allergic rhinitis executive summary[J]. Otolaryngology--HeadAnd Neck Surgery:Official Journal Of American Academy Of Otolaryngolo-gy-Head And Neck Surgery,2015,152(2):197~206
[8]魏欣.变应性鼻炎的发病机制[J].海南医学,2011,22(10):8~12
[9]周志军,叶建明,管建丽.变应性鼻炎患者血Ig E及尿LTE4检测的临床分析[J].放射免疫学杂志,2010,23(1):119~120
[10] MCDONALD JL,SMITH PK,SMITH CA,et al. Effect of ac-upuncture on house dust mite specific Ig E,substance P,and symptoms inpersistent allergic rhinitis[J]. Annals Of Allergy,Asthma&Immunology:Official Publication Of The American College Of Allergy,Asthma,&Im-munology,2016,116(6):497~505
[11]谢怡琳,万文蓉,赵银龙,等.温针灸冬夏并治对变应性鼻炎患者生活质量的影响[J].中国针灸,2015,35(12):1215~1220
[12]张仲林,钟玲,袁明勇,等. Th1/Th2/Th17/Treg细胞因子在变应性鼻炎发病中的免疫机制研究[J].医学综述,2014,20(16):2906~2909
[13] HARRINGTON LE,HATTON RD,MANGAN PR,et al. D,Mangan PR,Turner H,Murphy TL,Murphy KM,Weaver CT. Interleu-kin17-producing CD4+effector T cells develop via a lineage distinct fromthe T helper type 1and 2lineages[J]. 2005
[14]兰建华,罗雪梅,曾友根,等.针刺穴位治疗变应性鼻炎对患者血清IL-2及IFN-γ的影响[J].中国医学创新,2016,13(20):97~99
[15]卢健敏.针刺对变应性鼻炎大鼠模型血清IL-5和鼻黏膜组织IL-5mRNA表达的影响[J].长春中医药大学学报,2013,29(1):37~38
[16]赵义造,黄益灯,黄加云,等.针刺对变应性鼻炎大鼠IL-4、IFN-γ水平影响的研究[J].福建中医药,2010,41(5):52~53
[17]崔星,吴云天,胡翀妮,等.针刺联合背俞穴埋线治疗变应性鼻炎临床研究[J].中国中医药信息杂志,2017,24(10):18~21
[18]张仲林,钟沁月,李莎,等.肥大细胞在变应性鼻炎中的研究进展[J].西南军医,2009,11(1):115~116
[19]杨莎莎,刘洋,李昕蓉,等.神经肽与肥大细胞之间的交互对变应性鼻炎发病机制的影响[J].辽宁中医杂志,2016,(12):2512~2515
[20]邰浩清,姜文芳.针刺下关穴治疗过敏性鼻炎的实验研究[J].浙江中西医结合杂志,2008,18(12):747~748
[21]陈劼.穴位敷贴治疗小鼠过敏性鼻炎免疫机制的研究[D]:广州中医药大学,2006
[22]凌永伟,欧阳贵平,谢洪亮,等.变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞的检测[J].中国耳鼻咽喉颅底外科杂志,2012,18(1):58~60
[23] BATES ME,SEDGWICK JB,ZHU Y,et al. Human AirwayEosinophils Respond to Chemoattractants with Greater Eosinophil-DerivedNeurotoxin Release,Adherence to Fibronectin,and Activation of the Ras-ERK Pathway When Compared with Blood Eosinophils[J]. Journal of Im-munology,2010,184(12):7125~7133
[24] MATSUMOTO K,FUKUDA S,HASHIMOTO N,et al. Hu-man eosinophils produce and release a novel chemokine,CCL23,in vitro[J]. International Archives of Allergy&Immunology,2011,155Suppl 1(Suppl. 1):34
[25] RUBY P,SACHIKO M,CHIKA O,et al. Overview on thepathomechanisms of allergic rhinitis[J]. Asia Pacific Allergy,2011,1(3):157
[26] GREINER AN,HELLINGS PW,ROTIROTI G,et al. Aller-gic rhinitis[J]. Lancet,2011,378(9809):2112~2122
[27]陈莹.针刺对变应性鼻炎大鼠血清Th1/Th2的调控[D]:南方医科大学,2012
[28]丁然然,杨帆,刘洋,等.针刺列缺穴对过敏性鼻炎模型大鼠鼻黏膜病理学的影响[J].中国中医急症,2015,24(10):1743~1745
[29]吴春晓,陈莹,陈静,等.针刺对变应性鼻炎模型大鼠的治疗作用及其机理研究[J].江苏中医药,2013,(12):69~71
[30] GILLESPIE MB,OSGUTHORPE JD. Pharmacologic manage-ment of chronic rhinosinusitis,alone or with nasal polyposis[J]. CurrentAllergy&Asthma Reports,2004,4(6):478~485
[31]李斯斯,阮标,余咏梅. P物质在变应性鼻炎发病机制和治疗中的作用[J].中华临床免疫和变态反应杂志,2013,7(2):193~197
[32]曹文忠,李爱敏,庞文儒,等.大椎穴施以三重法防治变应性鼻炎及对血清SP、IL-4的影响[J].上海针灸杂志,2016,35(2):134~138
[33]郑美凤,何芙蓉,宰风雷,等.针刺“蝶腭穴”治疗变应性鼻炎及其对血清P物质的影响[J].康复学报,2009,19(4):44~46
[34]刘洋.迎香穴针刺治疗变应性鼻炎作用机制的网络构建及临床疗效观察[D]:成都中医药大学,2015
[35] APPLEQUIST SE,WALLIN RP,LJUNGGREN HG. Variableexpression of Toll-like receptor in murine innate and adaptive immune celllines[J]. International Immunology,2002,14(9):1065
[36] CUI XY,CHEN X,YU CJ,et al. Increased expression of toll-like receptors 2and 4and related cytokines in persistent allergic rhinitis[J]. Otolaryngol Head Neck Surg,2015,152(2):233~238
[37]杨玉荣,佘锐萍,梁宏德. Toll-NF-kB信号途径及其介导的功能[J].中国细胞生物学学报,2007,29(4):483~486
[38]张乃元.针刺对过敏性鼻炎大鼠免疫调节作用机制的研究[D]:广州中医药大学,2011
[39] JUNG D,LEE S,HONG S. Effects of acupuncture and moxi-bustion in a mouse model of allergic rhinitis[J]. Otolaryngology--HeadAnd Neck Surgery:Official Journal Of American Academy Of Otolaryngolo-gy-Head And Neck Surgery,2012,146(1):19~25
[40] ROND N C,CANTO G,BLANCA M. Local allergic rhinitis:a new entity,characterization and further studies[J]. Current Opinion inAllergy&Clinical Immunology,2010,10(1):1~7
[41]刘争,李华斌,崔永华.局部变应性鼻炎[J].中华耳鼻咽喉头颈外科杂志,2011,46(11):962~964
[42] SHIUE HS,LEE YS,TSAI CN,et al. Gene expression pro-file of patients with phadiatop-positive and-negative allergic rhinitis treatedwith acupuncture[J]. J Altern Complement Med,2010,16(1):59~68
[43] SHIUE HS,LEE YS,TSAI CN,et al. Treatment of allergicrhinitis with acupoint herbal plaster:an oligonucleotide chip analysis[J].BMC Complement Altern Med,2016,16(1):436
[44] SEKI N,SHIRASAKI H,KIKUCHI M,et al. Expression andlocalization of TRPV1in human nasal mucosa[J]. Rhinology,2006,44(2):128~134
[45] DINH QT,GRONEBERG DA,PEISER C,et al. Substance Pexpression in TRPV1and trk A-positive dorsal root ganglion neurons innerva-ting the mouse lung[J]. Respiratory Physiology&Neurobiology,2004,144(1):15
[46] GEPPETTI P,MATERAZZI S,NICOLETTI P. The transientreceptor potential vanilloid 1:Role in airway inflammation and disease[J].European Journal of Pharmacology,2006,533(1–3):207~214
[47] MCDONALD JL,CRIPPS AW,SMITH PK. Mediators,Re-ceptors,and Signalling Pathways in the Anti-Inflammatory and Antihyperal-gesic Effects of Acupuncture[J]. Evidence-Based Complementray and Al-ternative Medicine,2015,(2015~8~3),2015,2015(2):975632