火针联合外用5%米诺地尔酊对肝肾不足型斑秃患者外周血Th17细胞、Treg细胞和心理状态的影响

摘要 目的：观察火针联合外用5%米诺地尔酊对肝肾不足型斑秃患者外周血辅助性T细胞17（Th17）、调节性T细胞（Treg）和心理状态的影响。方法：选取2019年3月~2021年4月期间我院收治的102例肝肾不足型斑秃患者，按随机数字表法分为对照组和研究组，各为51例。对照组患者接受5%米诺地尔酊外用治疗，研究组患者接受火针联合外用5%米诺地尔酊治疗，治疗3个月后，观察两组疗效，对比两组外周血Th17细胞、Treg细胞占CD4⁺T淋巴细胞比例及相关细胞因子水平、心理状态、斑块面积的变化，记录两组毳毛长出时间、毳毛变黑时间以及治疗期间不良反应情况。结果：与对照组相比，研究组的临床总有效率明显更高（P<0.05）。两组治疗后Th17细胞比例、白介素-6（IL-6）、白介素-23（IL-23）水平较治疗前下降，Treg细胞比例较治疗前升高，且研究组变化程度大于对照组（P<0.05）。两组治疗后斑块面积均缩小，且研究组小于对照组（P<0.05）；研究组的毳毛长出时间、毳毛变黑时间均短于对照组（P<0.05）。两组治疗后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分较治疗前下降，且研究组低于对照组（P<0.05）。两组不良反应发生率比较无统计学差异（P<0.05）。结论：火针联合外用5%米诺地尔酊治疗肝肾不足型斑秃，可有效改善患者临床症状，调节外周血Th17细胞、Treg细胞比例及相关细胞因子水平，有效改善患者焦虑抑郁情绪，安全可靠。

Effects of Fire Acupuncture Combined with 5% Minoxidil Tincture on Peripheral Blood Th17 Cells, Treg Cells and Psychological State in Patients with Alopecia Areata with Liver and Kidney Deficiency

ABSTRACT Objective: To observe the effects of fire acupuncture combined with 5% minoxidil tincture on peripheral blood helper T cell 17 (Th17), regulatory T cell (Treg) cells and psychological state in patients with alopecia areata with liver and kidney deficiency. Methods: 102 patients with alopecia areata who were treated in our hospital from March 2019 to April 2021 were selected, and they were randomly divided into control group and study group by random number table method, with 51 cases in each group. The patients in the control group were treated with 5% minoxidil tincture, and the patients in the study group were treated with fire acupuncture combined with 5% minoxidil tincture. 3 months after treatment, the curative effects of the two groups were observed, the proportion of peripheral blood Th17 cells and Treg cells in CD4⁺T lymphocytes, the levels of related cytokines, psychological state and plaque area were compared between the two groups. The vellus hair growth time, vellus hair blackening time and adverse reactions during treatment were recorded. Results: Compared with the control group, the total clinical effective rate of the study group was significantly higher (P<0.05). After treatment, the proportion of Th17 cells, the levels of interleukin-6(IL-6) and interleukin-23 (IL-23) in the two groups decreased, and the proportion of Treg cells increased, and the change degree in the study group was greater than that in the control group (P<0.05). After treatment, plaque area in two groups decreased, and the study group was smaller than the control group(P<0.05). The vellus hair growth time and vellus hair blackening time in the study group were shorter than those in the control group(P<0.05). After treatment, the scores of self-rating anxiety Scale(SAS) and self-rating depression Scale(SDS) in the two groups were lower than those before treatment, and those in the study group were lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Fire acupuncture combined with 5% minoxidil tincture for external use in the treatment of alopecia areata with liver and kidney deficiency can effectively improve the clinical symptoms of patients, regulate the proportion of peripheral blood Th17 cells and Treg cells and the levels of related cytokines, and effectively improve the anxiety and depression of patients, which is safe and reliable.