臭氧自體血回輸療法對帶狀皰疹后神經痛患者血清IL-2、IL-6水平的影響

張廣建  王 超  王 微 任婷婷 閆清華 金文哲 李仁淑

（延邊大學附屬醫院疼痛科，延吉133000）

摘 要 目的：探討臭氧自體血回輸療法對帶狀皰疹后神經痛患者IL-2、IL-6水平的影響。方法：選取帶狀皰疹后神經痛患者40例，隨機分成兩組，包括實驗組21例、對照組19例。對照組只接受常規治療，實驗組在常規治療的基礎上聯合臭氧自體血回輸療法10次（隔日1次）治療。兩組患者分別在治療前、治療1d、10d及20d時收集血樣，采用RIA測定IL-2和IL-6水平的變化。結果：對照組治療前、治療1d、10d及20d之間IL-2水平的差異均無顯著性（P>0.05），實驗組治療前、治療1d、10d及20d之間IL-2水平的差別具有顯著性（P<0.01），且IL-2水平隨時間延長呈線性升高趨勢（P<0.01）；實驗組治療前和治療1d與對照組之間IL-2水平的差異無顯著性（P>0.05），實驗組在治療10d和20d時IL-2水平顯著高于對照組（P<0.01）。實驗組和對照組IL-6水平隨時間延長呈線性下降趨勢，實驗組在治療前和治療10~20d期間與對照組之間IL-6水平差異無顯著性（P>0.05），治療1~10d期間實驗組IL-6水平下降較對照組差異具有顯著性（P<0.01）。結論：聯合臭氧自體血回輸療法不僅隨療程顯著升高PHN患者IL-2水平，同時在治療1~10d期間可顯著減低IL-6水平。

關鍵詞臭氧自體血回輸療法；帶狀皰疹后神經痛；白介素-2；白介素-6

THE influence OF ozone autohemotherapy treatmentON THE SERUM LEVELS OF IL-2 AND IL-6 IN PATIENTS WITHpostherpeticneuralgia

(ZHANG Guang-Jian，WANG Chao，WANG Wei，REN Ting-Ting，YAN Qing-Hua，JIN Wen-Zhe，LI Ren-Shu^D. Department of Pain Management，Affiliated Hospital of YanBian University，Yanji 133000)

Abstract Objective：To investigate the influence of ozone autohemotherapy treatment (O₃-AHT) on the serum levelsof IL-2、IL-6 in patients with PHN. Methods：40 patients with PHN were randomly divided into two groups：the experimental group (n=21) and the control group (n=19).The patients in control group only accepted conventional treatment. The patients in experimental group combined O₃-AHT(once every other day)on the basis of conventional treatment. Blood samples of both groups were collected before treatment and 1d，10d and 20dafter treatment respectively. The changes of the serum levelsof IL-2，IL-6 were measured by radioimmunoassay(RIA).Results：There were no significant difference onthe serum levels of IL-2 before treatment and 1d，10d and 20d after treatment in control group (P＞0.05). There were significant difference on the serum levels ofIL-2 before treatment and 1d，10d and 20d after treatment in experimental group (P＜0.01) ，and the serum levels of IL-2 increased linearly with the extension of time (P＜0.01).There was no significant difference on the serum levels of IL-2 between two groups(P＞0.05). The serum levels of IL-2 10d and 20d after treatment in experimental group were significantly higher than thosein control group(P＜0.01). The serum levels of IL-6 reduced over time in two groups. There was no significant difference on the serum levels of IL-6 before treatment and 10~20d after treatment in experimental group (P＞0.05). Compared with control group，the serum levels ofIL-6 significantly reduced 1~10dafter treatment in experimental group（P<0.05）. Conclusion:The serum levels of IL-2 reduced with course of treatment and those of IL-6 reduced by O₃-AHTduring 1~10din patients with PHN.

Key words：O3-AHT；PHN；IL-2；IL-6

帶狀皰疹后神經痛（postherpetic neuralgia，PHN）發病率相對較高，多見于免疫功能低下的人群，據報道約10%的帶狀皰疹患者遺留有PHN，超過60歲的老年人PHN發生率可高達50%-75%^[1]。目前治療此病諸多方法的療效均不夠理想，PHN的發病機理和治療研究仍是當前一項迫切而艱難的課題。

多年來，對于PHN的分子水平的基礎研究尚未取得顯著的進展。現有研究^[2-5]指出機體免疫功能低下，CD4+T細胞數量及活性明顯下降、TH1/TH2輔助細胞比例失衡引起免疫紊亂，是造成HZ及PHN的重要因素。王英^[6]等在觀察HZ預后的對照試驗中發現，實驗組中HZ患者經治療后仍發展為PHN的與對照組（未患HZ）相比較，其CD4+T淋巴細胞含量降低，患者體內Th1/Th2持續性失衡，Th1細胞功能低下、Th2細胞功能亢進，引起血清IL-2偏低、IL-6偏高^[7-11]，這可能是患者遺留PHN的原因。臭氧具有免疫調節及鎮痛等作用，近年來，臭氧自體血回輸療法(ozone autohemotherapy treatment O₃-AHT)用于PHN的治療及機體免疫因子影響的報道極少見。本實驗擬通過觀察O₃-AHT對于PHN患者血清IL-2和IL-6水平的影響，證實O₃-AHT對PHN患者通過免疫調節作用起到治療作用。

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