[Acupuncture regulates the Th17/Treg axis for chronic spontaneous urticaria: a randomized controlled trial]

To observe the clinical efficacy of acupuncture for chronic spontaneous urticaria (CSU) and its effect on the helper T cell 17(Th17)/regulatory T cell (Treg) axis.

Eighty CSU patients were randomly divided into an observation group (40 cases, 2 cases dropped out) and a control group (40 cases, 2 cases dropped out). The observation group received acupuncture at bilateral Jianyu (LI15), Shousanli (LI10), Quchi (LI11), Pianli (LI6), Xuehai (SP10), Zusanli (ST36) and Sanyinjiao (SP6), each session lasting for 30 min, 3 times per week. The control group received oral ebastine tablets, 10 mg each time, once daily. Both groups were treated for 8 weeks. The 7-day urticaria activity score (UAS7), dermatology life quality index (DLQI) score and Hamilton anxiety scale (HAMA) score were observed, peripheral blood Th17 and Treg cell proportions, and serum levels of interleukin (IL)-17, IL-23, IL-10, and IL-35 were detected, and the ratio of Th17/Treg was calculated before and after treatment in the two groups.

After treatment, the UAS7, DLQI and HAMA scores in the two groups were decreased compared with those before treatment (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). After treatment, the peripheral blood Th17 cell proportions, the ratios of Th17/Treg and serum levels of IL-17, IL-23 in the two groups were decreased compared with those before treatment (P<0.05), those indexes in the observation group were lower than those in the control group (P<0.05). After treatment, the peripheral blood Treg cell proportions, and serum levels of IL-10, IL-35 in the two groups were increased compared with those before treatment (P<0.05), those indexes in the observation group were higher than those in the control group (P<0.05).

Acupuncture can effectively alleviate the symptoms of CSU, and its mechanism of action may be related to the regulation of the Th17/Treg axis.