鼠神经生长因子联合针灸治疗小儿面神经炎的疗效及对reg/Th17相关细胞因子表达的影响
|
摘要
目的观察鼠神经生长因子联合针灸治疗小儿面神经炎的疗效及对Treg/Th17相关细胞因子表达的影响。方法将90例面神经炎患儿随机分为观察组45例和对照组45例,对照组给予鼠神经生长因子治疗,观察组在对照组治疗基础上给予针灸治疗,治疗前后采用日本神经研究会提议的"40分法"对临床症状进行评分,采用House-Brachmann(HB)分级评估患儿治疗前后面神经麻痹分级情况;检测2组治疗前后神经肌电图、Treg/Th17相关细胞因子表达情况。结果 2组治疗后静止、轻闭眼、重闭眼、蹙额、动鼻翼、患侧闭眼、示齿、吹哨、鼓腮、口呈一字型评分均显著升高(P均<0.05),且观察组上述评分均高于对照组(P均<0.05);观察组治疗后H-B分级改善情况优于对照组(P<0.05);2组治疗后面神经传导速度、面神经运动传导诱发电位R1潜伏期与CAMP波幅均显著改善(P均<0.05),血清白细胞介素-17(IL-17)、IL-6水平降低(P均<0.05),而IL-10、转化生长因子-β1(TGF-β1)水平均显著升高(P均<0.05),且观察组的改善情况优于对照组(P均<0.05)。2组治疗期间均未发现有严重不良反应。结论鼠神经生长因子联合针灸治疗面神经炎患儿能够显著改善临床症状,调节外周血Th17/Treg免疫平衡,促进面神经功能恢复,且安全性好。
Objective It is to observe the effect of mouse nerve growth factor combined with acupuncture and moxibustion on pediatric facial neuritis and on the expression of reg/Th17 related cytokines.Methods 90 cases of children with facial paralysis were randomly divided into observation group and control group,each group had 45 cases.The control group was treated with mouse nerve growth factor,the observation group was treated with acupuncture and moxibustion on the basis of treatment in the control group.Before and after treatment in both groups,the clinical symptoms were evaluated by Japanese society proposed neural "40 points method",and the classification of facial neuritis were evaluated by House-Brachmann(H-B) hierarchical classification evaluation,the expression of nerve electromyography,Treg/Th17 related cytokines were detected.Results After treatment the scores of static,gently eye closure,hard eye closure,frown,nasal flaring,eye closure at disease side,showing teeth,whistle,drum cheeks,slotted mouth were significantly increased in both groups(P<0.05),the scores in the observation group were higher than that in the control group(P<0.05).After treatment,the improvements of H-B classification was better than that in the control group(P<0.05).After treatment the nerve conduction velocity,facial nerve motor conduction evoked potential R1 incubation period and CAMP amplitude were significantly improved(P<0.05),serum interleukin-17(IL-17),IL-6 levels were decreased(P<0.05),and IL-10,transforming growth factor β1(TGF-β1) were significantly increased in both groups(P<0.05),and the improvements of these indexes were better than those in the control group(P<0.05).No serious adverse reactions was found during treatment.Conclusion Mouse nerve growth factor combined with acupuncture and moxibustion can significantly improve clinical symptoms,regulate peripheral blood Th17/Treg immune balance,promote the recovery of facial nerve function,and the safety is good in the treatment for pediatric facial neuritis.
Objective It is to observe the effect of mouse nerve growth factor combined with acupuncture and moxibustion on pediatric facial neuritis and on the expression of reg/Th17 related cytokines.Methods 90 cases of children with facial paralysis were randomly divided into observation group and control group,each group had 45 cases.The control group was treated with mouse nerve growth factor,the observation group was treated with acupuncture and moxibustion on the basis of treatment in the control group.Before and after treatment in both groups,the clinical symptoms were evaluated by Japanese society proposed neural "40 points method",and the classification of facial neuritis were evaluated by House-Brachmann(H-B) hierarchical classification evaluation,the expression of nerve electromyography,Treg/Th17 related cytokines were detected.Results After treatment the scores of static,gently eye closure,hard eye closure,frown,nasal flaring,eye closure at disease side,showing teeth,whistle,drum cheeks,slotted mouth were significantly increased in both groups(P<0.05),the scores in the observation group were higher than that in the control group(P<0.05).After treatment,the improvements of H-B classification was better than that in the control group(P<0.05).After treatment the nerve conduction velocity,facial nerve motor conduction evoked potential R1 incubation period and CAMP amplitude were significantly improved(P<0.05),serum interleukin-17(IL-17),IL-6 levels were decreased(P<0.05),and IL-10,transforming growth factor β1(TGF-β1) were significantly increased in both groups(P<0.05),and the improvements of these indexes were better than those in the control group(P<0.05).No serious adverse reactions was found during treatment.Conclusion Mouse nerve growth factor combined with acupuncture and moxibustion can significantly improve clinical symptoms,regulate peripheral blood Th17/Treg immune balance,promote the recovery of facial nerve function,and the safety is good in the treatment for pediatric facial neuritis.
引文
[1]任继欣,李雪梅,王旭东.牵正补阳还五贴剂与针灸配合西药治疗小儿面神经炎疗效观察[J].陕西中医,2014,35(8):1006-1007
[2]靳梅,刘静,陈芳,等.小儿面神经炎的神经电生理观察[J].中华物理医学与康复杂志,2016,38(8):625-626
[3]张彤,戴国华.重灸翳风穴治疗青少年面瘫及其对细胞免疫功能的影响[J].中国针灸,2000,20(10):11-12
[4]Greco A,Gallo A,Fusconi M,et al.Bell's palsy and autoimmunity[J].Autoimmunity Reviews,2012,12(2):323-328
[5]郭良景.周围性面神经炎患儿Treg/Th17相关细胞因子表达的研究[D].济南:山东大学,2015
[6]王维治.神经病学[M].5版.北京:人民卫生出版社,2005:90-91
[7]赵英,何浪,张秋航.三种不同方法治疗周围性面神经麻痹的疗效比较[J].中国临床康复,2005,9(29):41-43
[8]中华耳鼻咽喉头颈外科杂志编辑委员会中华医学会耳鼻咽喉科学分会.面神经功能评价标准[J].中华耳鼻咽喉头颈外科杂志,2006,41(1):22-24
[9]Huang B,Zhou ZL,Wang LL,et al.Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy:a comparative study[J].J Integr Med,2014,12(4):367-371
[10]金禹彤,虞彬艳,宣丽华.中西医疗法对难治性面神经炎免疫调节临床及实验研究进展[A].浙江省针灸学会2015学术年会论文汇编[C].浙江省针灸学会,2015:6
[11]贲莹,张凤华,张冬.免疫细胞及相关细胞因子在格林-巴利综合征和实验性自身免疫性神经炎中的作用研究进展[J].解放军医药杂志,2013,25(2):14-15
[12]陈力行,钟正,黄泳.针刺配合热砭锥疗法治疗恢复期周围性面瘫的临床观察[J].针灸临床杂志,2014,30(3):23-26
[13]石宏,蔡慧敏,相恒杰,等.小儿面神经炎56例神经肌电图检查及预后分析[J].中国当代医药,2012,19(21):250-251
[14]潘海泉,朱勇,李东方,等.调神法对急性面神经炎患者分型治疗的肌电图分析及远期疗效观察[J].中国实用神经疾病杂志,2016,19(10):109-110
[15]陈柏良,江明荣,周曙明,等.鼠神经生长因子对危重型小儿手足口病患者体液免疫和细胞因子的影响[J].中国医药导报,2016,13(12):121-124
[16]沈巍.鼠神经生长因子、丹红注射液联合治疗对糖尿病周围神经病变患者血液流变学、神经传导速度的改善效果[J].中国老年学杂志,2013,33(12):2749-2750
[17]韩长明.鼠神经生长因子联合丙种球蛋白对吉兰巴雷综合征患儿IL-17、IL-23的影响[J].国际医药卫生导报,2016,22(18):2835-2838
[18]解锦鼎,安宁,曹文慧,等.针灸联合康复治疗对脊髓损伤患者神经功能的影响[J].针灸临床杂志,2016,32(3):34-36
[19]高明,吴瑛,盛泽田,等.针灸预处理对摔跤运动员大负荷训练阶段NK细胞和T淋巴细胞亚群的影响[J].上海体育学院学报,2014,38(3):67-72
[20]雷征.小儿面瘫的针灸治疗[J].内蒙古中医药,2013,32(36):75-76
[2]靳梅,刘静,陈芳,等.小儿面神经炎的神经电生理观察[J].中华物理医学与康复杂志,2016,38(8):625-626
[3]张彤,戴国华.重灸翳风穴治疗青少年面瘫及其对细胞免疫功能的影响[J].中国针灸,2000,20(10):11-12
[4]Greco A,Gallo A,Fusconi M,et al.Bell's palsy and autoimmunity[J].Autoimmunity Reviews,2012,12(2):323-328
[5]郭良景.周围性面神经炎患儿Treg/Th17相关细胞因子表达的研究[D].济南:山东大学,2015
[6]王维治.神经病学[M].5版.北京:人民卫生出版社,2005:90-91
[7]赵英,何浪,张秋航.三种不同方法治疗周围性面神经麻痹的疗效比较[J].中国临床康复,2005,9(29):41-43
[8]中华耳鼻咽喉头颈外科杂志编辑委员会中华医学会耳鼻咽喉科学分会.面神经功能评价标准[J].中华耳鼻咽喉头颈外科杂志,2006,41(1):22-24
[9]Huang B,Zhou ZL,Wang LL,et al.Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy:a comparative study[J].J Integr Med,2014,12(4):367-371
[10]金禹彤,虞彬艳,宣丽华.中西医疗法对难治性面神经炎免疫调节临床及实验研究进展[A].浙江省针灸学会2015学术年会论文汇编[C].浙江省针灸学会,2015:6
[11]贲莹,张凤华,张冬.免疫细胞及相关细胞因子在格林-巴利综合征和实验性自身免疫性神经炎中的作用研究进展[J].解放军医药杂志,2013,25(2):14-15
[12]陈力行,钟正,黄泳.针刺配合热砭锥疗法治疗恢复期周围性面瘫的临床观察[J].针灸临床杂志,2014,30(3):23-26
[13]石宏,蔡慧敏,相恒杰,等.小儿面神经炎56例神经肌电图检查及预后分析[J].中国当代医药,2012,19(21):250-251
[14]潘海泉,朱勇,李东方,等.调神法对急性面神经炎患者分型治疗的肌电图分析及远期疗效观察[J].中国实用神经疾病杂志,2016,19(10):109-110
[15]陈柏良,江明荣,周曙明,等.鼠神经生长因子对危重型小儿手足口病患者体液免疫和细胞因子的影响[J].中国医药导报,2016,13(12):121-124
[16]沈巍.鼠神经生长因子、丹红注射液联合治疗对糖尿病周围神经病变患者血液流变学、神经传导速度的改善效果[J].中国老年学杂志,2013,33(12):2749-2750
[17]韩长明.鼠神经生长因子联合丙种球蛋白对吉兰巴雷综合征患儿IL-17、IL-23的影响[J].国际医药卫生导报,2016,22(18):2835-2838
[18]解锦鼎,安宁,曹文慧,等.针灸联合康复治疗对脊髓损伤患者神经功能的影响[J].针灸临床杂志,2016,32(3):34-36
[19]高明,吴瑛,盛泽田,等.针灸预处理对摔跤运动员大负荷训练阶段NK细胞和T淋巴细胞亚群的影响[J].上海体育学院学报,2014,38(3):67-72
[20]雷征.小儿面瘫的针灸治疗[J].内蒙古中医药,2013,32(36):75-76