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

Effect of mouse nerve growth factor combined with acupuncture and moxibustion on pediatric facial neuritis and on the expression of reg/Th17 related cytokines

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 paral- ysis 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 pro- posed neural ＂40 points method＂, and the classification of facial neuritis were evaluated by House-Brachmann （H-B） hierar- chical classification evaluation, the expression of nerve electromyography, Trcg/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 classifica- tion 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 inter- leukin-17 （ IL-17 ） , IL-6 levels were decreased （ P 〈 0.05 ） , and IL-IO, transforming growth factor β1 （ TGF-β1 ） were signifi- cantly 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 bal- ance, promote the recovery of facial nerve function, and the safety is good in the treatment for pediatric facial neuritis.