基于调节Th1/Th2免疫偏移与皮损局部微生态失衡探讨自血穴位注射治疗痤疮的作用机制

Autohemotherapy is the featured therapy of Jin’s Three Needle Therapy, it is effective to treat acne, and the research showed that it has better effect in treating severe acne and reducing recurrence rate. We found in the early stage that Autohemotherapy can reduce the expression of TLR2, regulate Th1 (IFN-, T-bet) /Th2 (IL-4, IL-5).The latest research at home and abroad also indicated that, Th1/Th2 immune deviation may be the important mechanism of severe acne. The local microenvironment of skin lesions interacts with immune response, which is closely related to the recurrence of acne. So we propose that regulating TLR-NF-κB signal pathway and correcting Th1/Th2 immune deviation is one of the important way in the treatment on acne with Autohemotherapy. This study intends to take ear acne of rats as pathological model, uses pathology, immune and 16S rRNA high-throughput sequencing technology, study on the effect of Th1/Th2 immune deviation and local skin microecology with Autohemotherapy and its relationship for providing new ideas for studying the mechanism of Autohemotherapy from the perspective of immune theory and scientific evidence for the clinical application.

自血穴位注射是靳瑞教授“靳三针”特色疗法之一，治疗痤疮疗效确切，研究提示其治疗重度痤疮，降低复发率疗效较好。我们前期发现其可以降低TLR2表达，调节Th1(IFN-γ、T-bet) /Th2(IL-4、IL-5)，国内外最新研究进展也表明，Th1/Th2免疫偏移可能是重度痤疮的重要机制，皮损局部微生态环境与免疫应答相互作用，与痤疮复发关系密切。据此我们提出调节Th1/Th2免疫偏移与皮损局部微生态失衡是自血穴位注射治疗痤疮的重要途径之一。本研究拟以耳部痤疮大鼠为病理模型，运用病理、免疫、16S rRNA高通量测序等技术，研究自血穴位注射对Th1/Th2免疫偏移及皮损局部微生态失衡的影响及其关系，从免疫角度为研究自血穴位注射的机制提供新的思路，为其临床应用提供一定的科学依据。

自血穴位注射是靳瑞教授“靳三针”特色疗法之一，目前临床上自血穴位注射疗法的优势病种主要集中在皮肤科，其中痤疮使用频次最多，占30.07%。痤疮是一种常见、高发、复杂的损容性皮肤病,严重影响患者容貌和身心健康。深入探讨自血穴位注射疗法干预痤疮的效应机制，将有助于该疗法作用机制的阐明，为其临床推广应用提供科学依据。.本项目研究自血穴位注射对Th1/Th2免疫偏移及皮损局部微生态失衡的影响及其关系，验证了痤疮小鼠TNF-α/IL-4比值较正常小鼠降低，且与痤疮皮损的严重程度呈显著负相关，存在Th1/Th2免疫偏移现象。自血穴注可通过上调TNF-α表达，增加TNF-α/IL-4比值，纠正Th1/Th2免疫偏移。自血穴注可改善小鼠痤疮皮损局部炎性细胞浸润、组织水肿并抑制表皮过度增生、增加真皮厚度，发挥改善痤疮炎性皮损的作用，这可能是自血穴位注射治疗痤疮的重要途径之一，为本法“调和阴阳、以平为期”作用提供实验依据，从免疫角度为研究自血穴注的作用机制提供了新的思路。本研究通过系统评价显示自血穴注治疗痤疮、荨麻疹、银屑病的治愈率优于对照组，且安全性较好；通过数据挖掘技术分析自血疗法治疗痤疮可使用足三里-曲池、合谷-颊车组合，并搭配肺俞、血海、三阴交、丰隆等穴位进行辨证施治，操作可采用采血量4ml、单穴注血量1ml，3d/次、10次/疗程。为本法临床推广应用提供了科学依据。