神经节苷脂辅助治疗脊髓损伤患者的临床疗效及对炎症反应的影响

Clinical efficacy of adjuvant treatment of ganglioside spinal cord injury and its influence on inflammatory response

目的研究神经节苷脂联合康复训练治疗脊髓损伤患者的临床疗效及对炎症反应的影响。方法选取我院2013年6月至2017年1月收治的脊髓损伤患者60例,采用随机数字法将其分为对照组和观察组,每组30例。两组患者均给予康复训练干预,在此基础上,观察组联合静脉滴注神经节苷脂治疗。比较两组患者的治疗总有效率和不良反应发生率,同时于治疗前后比较两组各炎症因子水平和运动、痛觉及触觉等神经功能康复指标评分。结果观察组的治疗总有效率(93. 34%)明显高于对照组(73. 33%)(χ~2=4. 89,P=0. 02);治疗后,观察组的血清TNF-α、IL-8、IL-1β水平均显著低于对照组(P <0. 01),运动、痛觉及触觉的ASIA评分均明显高于对照组(P <0. 01),肌力恢复正常时间、住院时间及可离床行走时间较对照组缩短(P <0. 01)。两组患者均未出现明显不良反应,两组不良反应发生率比较,差异无统计学意义(P> 0. 05)。结论神经节苷脂联合康复训练能明显提高脊髓损伤的疗效,抑制炎症反应发生,促进患者的神经功能康复,且安全性较高,具有较高的应用价值,值得临床推广。

Objective To study the clinical efficacy of ganglioside combined with rehabilitation training in the treatment of spinal cord injury and its influence on inflammatory response. Methods Totally 60 patients with spinal cord injury were selected in our hospital from June 2013 to January 2017,and were randomly divided into control group and observation group,30 cases in each group. Both groups were given rehabilitation training intervention,on the basis of it,the observation group combined with intravenous drip ganglioside treatment. The total effective rate and the incidence of adverse reactions were compared between the two groups,and the levels of inflammatory factors and the scores of nerve function rehabilitation index,including motion,pain and touch were compared before and after treatment. Results The total effective rate of observation group（ 93. 34%） was significantly higher than that of control group（ 73. 33%）（ χ~2= 4. 89,P = 0. 02）; after treatment,the serum levels of TNF-α,IL-8 and IL-1β in observation group were significantly lower than those in control group（ P〈0. 01）,while the ASIA scores of motion,pain and touch were significantly higher in observation group（ P〈0. 01）,and the time of muscle strength recovery,hospitalization and ambulation were significantly shorter in observation group（ P〈0. 01）. No obvious adverse reaction occurred in the two groups,and there was no significant difference between the two groups（ P〈0. 05）. Conclusion Ganglioside combined with rehabilitation training can significantly improve the therapeutic efficacy of spinal cord injury,inhibit the occurrence of inflammation,and promote the rehabilitation of neurological function,and have high safety and application value,which is worthy of clinical promotion.