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| 经皮穴位电刺激对乳腺癌改良根治术患者IL-6-Th17-IL-17免疫调节网的影响孙华琴 梁哲浩 代群 胡弘毅浙江中医药大学附属第一医院 浙江 杭州 310006 |
| The effect of percutaneous acupoint electrical stimulation on il-6-th17-il-17 immune regulatory network in patients undergoing modified radical mastectomy for breast cancer |
| 投稿时间：2019-09-06 修订日期：2019-09-06 |
| DOI： |
| 中文关键词: 经皮穴位电刺激 乳腺癌改良根治术 免疫调节网 不良反应 |
| 英文关键词: Transdermal acupoint electrical stimulation Modified radical mastectomy for breast cancer Immunoregulatory network Adverse reactions |
| 基金项目:浙江省中医药科技计划 经皮穴位电刺激对乳腺癌改良根治术患者IL-6-Th17-IL-17免疫调节网的影响 编号：2012ZA048 |
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| 中文摘要: |
| 目的 探究经皮穴位电刺激(TEAS)对乳腺癌改良根治术患者IL-6-Th17-IL-17免疫调节网的影响。方法 研究纳入40例乳腺癌改良根治术患者,采取随机数字表法将患者分为未干预组(20例)和干预组(20例),干预组患者均实行经皮穴位电刺激,同时选取参加健康体检的20名患者,将其作为健康对照组,分析健康对照组、未干预组、干预组患者手术前、术后1d、术后5d外周血清IL-6、IL-17浓度和Th17细胞水平变化,并对比未干预组(20例)和干预组术后6h、术后12h、术后24h、术后48h患者疼痛评分(VAS)及不良反应情况。结果 较健康对照组,未干预组、干预组患者术前外周血清IL-6、IL-17浓度和Th17细胞均一定程度升高,p＜0.05；较健康对照组,干预组术后1d IL-6未见明显变化,p＞0.05,干预后5d IL-6明显上升,p＜0.05,术后1d、5d干预组IL-17水平上升,Th17cells数量增加,p＜0.05；干预组术后第1d,患者血清IL-6、IL-17浓度降低,与术前比较有显著性差异(P＞0.05),术后第5d血清浓度升高与术后第1d比较差异有显著性(P<0.05)。未干预组术后1d血清IL-6、IL-17浓度降低与术前比较差异有显著性(P<0.05),而术后第5d血清浓度与术后第1d比较无显著差异(P＞0.05)。干预组与未干预组术后第1d血清IL-6、IL-17浓度比较无显著差异,术后5d,干预组血清IL-6、IL-17浓度与未干预组比较(P<0.05)；干预组术后第1d,患者外周血中Th17细胞与术前比较有显著性差异(P<0.05),术后第5d患者外周血中Th17细胞频率升高与术后第1d比较差异有显著性(P<0.05),与术前比较显著降低(P<0.05)。未干预组术后第1d,患者外周血中Th17细胞与术前比较有显著性差异(P<0.05),术后第5d患者外周血中Th17细胞比例继续下降,与术前比较差异有显著性(P<0.05),与术后第1d比较没有显著差异(P＞0.05)。干预组术后6h、术后12h、术后24h、术后48h患者疼痛评分明显优于未干预组,p＜0.05；干预组患者术后不良反应率(0.00%)明显低于未干预组(20.00%),p＜0.05。结论 TEAS对乳腺癌改良根治术患者Th17数量、IL-6、IL-17的表达和IL-6-Th17-IL-17所组成的免疫调节网具有一定影响,TEAS在调节机体肿瘤免疫过程中发挥重要作用,且有利于缓解患者术后疼痛,降低患者术后不良反应率。 |
| 英文摘要: |
| Purpose To investigate the effect of electrical stimulation at percutaneous acupoints on the immune regulatory network of il-6-th17-il-17 in patients undergoing modified radical mastectomy for breast cancer.Methods Studies in 40 patients with breast cancer modified radical, by our hospital from February 2016 to January 2019 were analyzed, take a random number table method divided the patients into intervention group (20 cases) and intervention group (20 cases), intervention group patients were transcutaneous point electric stimulation, and in February 2016 to January 2019 to participate in physical examination of 20 people, as a healthy control group, analysis of the health control group and intervention group and intervention group patients before surgery, postoperative 1 d, 5 d after peripheral blood concentration of IL - 6, IL - 17 and Th17 cells level change, VAS pain scores and adverse reactions were compared between the non-intervention group (20 cases) and the intervention group (6h, 12h, 24h and 48h postoperatively. Results Compared with the healthy control group, the concentration of il-6, il-17 and Th17 cells in peripheral blood of patients in the non-intervention group and the intervention group were increased to some extent before operation, p < 0.05. Compared with the healthy control group, there was no significant change in il-6 on the first day after the intervention group (p > 0.05), but il-6 increased significantly on the 5d after the intervention group (p < 0.05). The level of il-17 increased and the number of Th17cells increased on the first and 5d after the intervention group (p < 0.05). In the intervention group, serum il-6 and il-17 concentrations decreased on the first day after the operation, with significant differences from the preoperative level (P > 0.05). The serum concentration increased on the fifth day after the operation and the first day after the operation showed significant differences (P<0.05). The serum il-6 and il-17 concentrations of the non-intervention group decreased significantly on the first day after the operation compared with that before the operation (P<0.05), while there was no significant difference between the serum concentration on the fifth day after the operation and that on the first day after the operation (P > 0.05). There was no significant difference in serum il-6 and il-17 concentrations between the intervention group and the non-intervention group on the first day after the operation (P<0.05). On the first day after the operation of the intervention group, there was a significant difference between Th17 cells in peripheral blood of patients and that before the operation (P<0.05). On the fifth day after the operation, there was a significant difference between Th17 cells in peripheral blood of patients and that on the first day after the operation (P<0.05), and a significant difference between Th17 cells and that before the operation (P<0.05). On the first day after the operation, Th17 cells in the peripheral blood of patients in the non-intervention group showed a significant difference (P<0.05). On the fifth day after the operation, the proportion of Th17 cells in the peripheral blood of patients continued to decline, showing a significant difference (P<0.05) compared with that before the operation, but no significant difference compared with that on the first day after the operation (P > 0.05). Pain scores of patients in the intervention group were significantly better than those in the non-intervention group 6h after surgery, 12h after surgery, 24h after surgery and 48h after surgery (p < 0.05). The postoperative adverse reaction rate (0.00%) in the intervention group was significantly lower than that in the non-intervention group (20.00%), p < 0.05.Conclusion As has a positive impact on the immune regulation network formed by the number of Th17, the expression of il-6 and il-17 and il-6-th17-il-17 in patients undergoing modified radical mastectomy for breast cancer. As it plays an important role in the regulation of tumor immunity in the body, it is conducive to easing postoperative pain of patients and reducing the rate of postoperative adverse reactions of patients, which is conducive to in-depth research. |
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