白虎汤加味联合神经节苷脂对小儿病毒性脑炎外周血细胞因子指标及脑脊液中SP-D和Gal-9表达的影响
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摘要
目的:探讨白虎汤加味联合神经节苷脂对小儿病毒性脑炎外周血细胞因子指标及脑脊液中SP-D和Gal-9的表达影响。方法:选取符合纳入标准的小儿病毒性脑炎患儿80例,按随机数字表将其分为对照组(40例)和观察组(40例)。对照组给予神经节苷脂治疗,观察组在对照组的基础上给予白虎汤加味治疗,对比两组患儿外周血细胞因子TNF-α、IL-6、IL-8、IFN-α及脑脊液SP-D、Gal-9水平的变化。结果:治疗前,两组患儿外周血TNF-α、IL-6、IL-8及IFN-α水平无显著差异(P> 0. 05);治疗后,两组患儿外周血TNF-α、IL-6、IL-8及IFN-α水平均低于治疗前,差异有统计学意义(P <0. 05),且观察组低于对照组,差异有统计学意义(P <0. 05);两组患儿治疗前脑脊液SP-D及Gal-9水平无显著差异(P> 0. 05),治疗后,两组患儿脑脊液SP-D水平均显著高于治疗前,差异有统计学意义(P <0. 05),且观察组高于对照组,差异有统计学意义(P <0. 05);治疗后,两组患儿脑脊液Gal-9均显著低于治疗前,差异有统计学意义(P <0. 05),且观察组低于对照组,差异有统计学意义(P <0. 05)。结论:白虎汤加味联合神经节苷脂治疗小儿病毒性脑炎能降低外周血细胞因子的水平,促进脑脊液SP-D的表达,抑制脑脊液Gal-9的表达水平,维持免疫反应保持平衡稳定,缓解神经细胞的损伤,加快神经系统的恢复,值得临床推广。
Objective: To explore the effect of Modified Baihu Decoction combined with ganglioside on cytokine index in peripheral blood and expressions of SP-D and Gal-9 in cerebrospinal fluid in children with viral encephalitis. Methods: A total of 80 children with viral encephalitis were randomly divided into the control group(n = 40) and the observation group(n = 40). The control group was treated with ganglioside; on which basis,the observation group was also treated with modified Baihu Decoction. The changes of TNF-α,IL-6,IL-8,IFN-α,SP-D,and Gal-9 were compared between the two groups. Results: There were no significant differences in peripheral blood levels of TNF-α,IL-6,IL-8,and IFN-α before the treatment between the two groups(P > 0. 05); they were lowered after the treatment in the two groups(P < 0. 05); and the decrease was more significant in the observation group(P < 0. 05). There were no significant differences in the expressions of SP-D and Gal-9 before the treatment between the two groups(P > 0. 05); SP-D expression was increased and Gal-9 expression was decreased after the treatment(P < 0. 05); and the expression changes were more significant in the observation group(P < 0. 05). Conclusion: Modified Baihu Decoction combined with ganglioside can reduce the level of peripheral blood cytokinesin,promote SP-D expression,and inhibit Gal-9 expression in children with viral encephalitis. It can maintain a balanced and stable immune response,relieve nerve cell damage,and accelerate the recovery of the nervous system,which is worthy of clinical promotion.
Objective: To explore the effect of Modified Baihu Decoction combined with ganglioside on cytokine index in peripheral blood and expressions of SP-D and Gal-9 in cerebrospinal fluid in children with viral encephalitis. Methods: A total of 80 children with viral encephalitis were randomly divided into the control group(n = 40) and the observation group(n = 40). The control group was treated with ganglioside; on which basis,the observation group was also treated with modified Baihu Decoction. The changes of TNF-α,IL-6,IL-8,IFN-α,SP-D,and Gal-9 were compared between the two groups. Results: There were no significant differences in peripheral blood levels of TNF-α,IL-6,IL-8,and IFN-α before the treatment between the two groups(P > 0. 05); they were lowered after the treatment in the two groups(P < 0. 05); and the decrease was more significant in the observation group(P < 0. 05). There were no significant differences in the expressions of SP-D and Gal-9 before the treatment between the two groups(P > 0. 05); SP-D expression was increased and Gal-9 expression was decreased after the treatment(P < 0. 05); and the expression changes were more significant in the observation group(P < 0. 05). Conclusion: Modified Baihu Decoction combined with ganglioside can reduce the level of peripheral blood cytokinesin,promote SP-D expression,and inhibit Gal-9 expression in children with viral encephalitis. It can maintain a balanced and stable immune response,relieve nerve cell damage,and accelerate the recovery of the nervous system,which is worthy of clinical promotion.
引文
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[19]王凯萍,曾雪飞,何颖慧,等.白虎汤加味联合氢溴酸东莨菪碱治疗重症手足口病并发病毒性脑炎[J].中医药学报,2016,44(3):108-110.
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[22]赵传丽.神经节苷脂联合更昔洛韦对病毒性脑炎患者血清及脑脊液指标影响的研究[J].神经损伤与功能重建,2017,12(2):159-160.
[23]王文娟,王学禹.病毒性脑炎患儿血清和脑脊液中肺表面活性物质相关蛋白D的变化[J].临床儿科杂志,2015,33(6):535-538.
[24]李翠君,魏海亮,周咏梅.甲泼尼龙联合人血清蛋白对病毒性脑炎患儿血清及脑脊液中SP-D和Gal-9的影响[J].现代医学,2017,45(9):1261-1265.
[25]李育蓉,韩根成,黎燕.半乳凝素-9(galectin-9)的免疫调节作用研究进展[J].军事医学,2011,35(7):549-552.
[26]王学禹,王文娟,张秀芳.病毒性脑炎患儿血清和脑脊液中Gal-9的变化[J].临床儿科杂志,2016,34(11):811-814.
[27]徐泳华,罗海燕,卢秀兰,等.儿童病毒性脑炎血清细胞因子的临床意义初探[J].现代医学,2011,39(5):591-592.
[2]安涛,郭晓清,蒲秀红,等.病毒性脑炎患儿血清及脑脊液TNF-α、IL-6、NSE的变化及其临床意义[J].临床军医杂志,2009,37(1):69-71.
[3]潘可达,方慧,郑默,等.大剂量丙种球蛋白对病毒性脑炎患者脑脊液中血清神经功能指标及相关炎症因子表达水平的影响[J].中华医院感染学杂志,2017,27(9):1929-1932.
[4]王文娟.病毒性脑炎患儿血清和脑脊液中SP-D和Gal-9的变化[D].济南:山东大学,2015:1-10.
[5]胡亚美,江载芳.诸福棠实用儿科学[M].北京:人民卫生出版社,2002:759-766.
[6]魏桂荣,张敏,梅元武.病毒性脑炎发病机制研究进展[J].国外医学·流行病学传染病学分册,2004,31(1):55-57.
[7]孙浩,韩虹,李朝阳,等.儿童病毒性脑炎外周血T淋巴细胞亚群及体液免疫临床研究[J].中国药物与临床,2012,12(11):1496-1497.
[8]王燕.病毒性脑炎诊治现状及中西医结合治疗进展[J].中西医结合心脑血管病杂志,2006,4(9):795-796.
[9]王甜甜,华青,徐以风,等.病毒性脑炎病儿脑脊液中IL-2和IL-10变化及其临床意义[J].齐鲁医学杂志,2014,29(3):219-221.
[10]吴革菲,刘智胜,余春涛,等.病毒性脑炎儿脑脊液细胞因子测定的临床意义[J].实用儿科临床杂志,2002,17(2):126-127.
[11]齐旭升,李云,邵玲,等.病毒性脑炎患儿IL-6、IL-8及TNF-α水平的测定及其临床意义[J].华中医学杂志,2002,26(2):71-72.
[12]吕海生,蒋晓媛,周一明,等.奥卡西平对病毒性脑炎后癫痫患儿脑电图特征及炎性因子水平的影响[J].疑难病杂志,2017,16(3):275-278.
[13]张跃军,张立梅,焦春发,等.高压氧辅助阿昔洛韦联合炎琥宁治疗病毒性脑炎临床效果[J].临床误诊误治,2016,29(S1):86-88.
[14]丁勇,何宏蕴.病毒性脑膜脑炎患儿脑脊液细胞学和细胞因子检测的意义[J].实用儿科临床杂志,2012,27(22):1772-1773.
[15]范超.白虎汤加味治疗小儿病毒性脑炎临床疗效观察[J].临床医药文献电子杂志,2016,3(48):9626.
[16]唐传锋,高树迎.白虎汤加味治疗小儿病毒性脑炎36例[J].山东中医杂志,2012,31(5):329+337.
[17]吴鸣,张佩华,金松华,等.病毒性脑炎患儿脑脊液IL-2、TNF-α、NSE变化的临床研究[J].浙江实用医学,2008,13(1):7-8.
[18]李显取,金国信,王逊.儿童病毒性脑炎脑脊液肿瘤坏死因子检测及其临床意义[J].实用医学杂志,2009,25(13):2186.
[19]王凯萍,曾雪飞,何颖慧,等.白虎汤加味联合氢溴酸东莨菪碱治疗重症手足口病并发病毒性脑炎[J].中医药学报,2016,44(3):108-110.
[20]马建波.白虎汤加味联合通腑合剂治疗脑出血急性期合并中枢性高热疗效及对机体细胞因子水平影响[J].现代中西医结合杂志,2017,26(22):2475-2477.
[21]李以菊.白虎汤加味治疗北京地区儿童病毒性脑炎的临床研究[J].中国中医基础医学杂志,2013,19(12):1443-1444+1461.
[22]赵传丽.神经节苷脂联合更昔洛韦对病毒性脑炎患者血清及脑脊液指标影响的研究[J].神经损伤与功能重建,2017,12(2):159-160.
[23]王文娟,王学禹.病毒性脑炎患儿血清和脑脊液中肺表面活性物质相关蛋白D的变化[J].临床儿科杂志,2015,33(6):535-538.
[24]李翠君,魏海亮,周咏梅.甲泼尼龙联合人血清蛋白对病毒性脑炎患儿血清及脑脊液中SP-D和Gal-9的影响[J].现代医学,2017,45(9):1261-1265.
[25]李育蓉,韩根成,黎燕.半乳凝素-9(galectin-9)的免疫调节作用研究进展[J].军事医学,2011,35(7):549-552.
[26]王学禹,王文娟,张秀芳.病毒性脑炎患儿血清和脑脊液中Gal-9的变化[J].临床儿科杂志,2016,34(11):811-814.
[27]徐泳华,罗海燕,卢秀兰,等.儿童病毒性脑炎血清细胞因子的临床意义初探[J].现代医学,2011,39(5):591-592.