针刺联合康复治疗对脑瘫患儿外周血单个核细胞IL-17信号转导途径的影响

Effect of Acupuncture Combined with Rehabilitation Treating on Signal Transduction Pathway of IL-17 in Peripheral Blood Mononuclear Cells in Children with Cerebral Palsy

目的:观察针刺联合康复治疗对脑瘫患儿外周血单个核细胞(PBMCs)白细胞介素-17(IL-17)信号转导途径的影响。方法:选取86例脑瘫患儿作为研究对象,按随机数字表法分为对照组及针刺组各43例。对照组接受常规康复治疗,针刺组接受常规康复治疗联合针刺治疗,2组均治疗3个月评价疗效。观察2组临床疗效,比较2组治疗前后临床痉挛指数(CSI)、改良肌张力分级量表(Ashworth)、Berg平衡量表(BBS)、修订版跌倒效能量表(MFES)、6 min步行距离、10 m步行时间、IL-17含量及PBMCs中JAK2、STAT3、IL-17 mRNA表达水平的变化。结果:治疗后,针刺组总有效率为93.02%,对照组为69.77%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组CSI评分、Ashworth评分均较治疗前降低,BBS评分、MFES评分均较治疗前上升;针刺组CSI评分、Ashworth评分均低于对照组,BBS评分、修订版MFES评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组1 min步行距离均较治疗前增加,10 m步行时间均较治疗前缩短;针刺组1 min步行距离长于对照组,10 m步行时间短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清IL-17水平均较治疗前下降,针刺组血清IL-17水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组PBMCs中JAK2、STAT3、IL-17的m RNA表达水平较治疗前降低,针刺组PBMCs中JAK2、STAT3、IL-17的mRNA表达水平低于对照组,差异均有统计学意义(P<0.05)。结论:常规康复治疗的基础上加用针刺治疗能缓解脑瘫的临床症状,改善肢体痉挛、肌张力异常及运动功能。

Objective:To observe the effect of acupuncture combined with rehabilitation treating on signal transduction pathway of interleukin-17(IL-17)in peripheral blood mononuclear cells(PBMCs)in children with cerebral palsy.Methods:A total of 86 cases of children with cerebral palsy were divided into the control group and the acupuncture group according to the random number table method,with 43 cases in each group.The control group was treated with routine rehabilitation,and the acupuncture group was treated with routine rehabilitation combined with acupuncture.Both groups were treated for three months.The clinical effects in the two groups were observed.Before and after treatment,the changes of clinical spasm index(CSI),Modified Ashworth Scale(Ashworth),Berg Balance Scale(BBS),Modified Falls Efficacy Scale(MFES),6-min walking distance,10-m walking time,IL-17 content and mRNA expression levels of JAK2,STAT3 and IL-17 in PBMCs were compared between the two groups.Results:After treatment,the total effective rate was 93.02%in the acupuncture group and 69.77%in the control group,the difference being significant(P<0.05).After treatment,the scores of CSI and Ashworth in the two groups were decreased when compared with those before treatment,and the scores of BBS and MFES were increased;the scores of CSI and Ashworth in the acupuncture group were lower than those in the control group,and the scores of BBS and MFES were higher,differences being significant(P<0.05).After treatment,the 1-min walking distances in the two groups were increased when compared with those before treatment,and the 10-min walking time was shortened;the 1-min walking distance in the acupuncture group was longer than that in the control group,and the 10-min walking time was shorter,differences being significant(P<0.05).After treatment,the IL-17 levels in serum in the two groups were decreased when compared with those before treatment,and the IL-17 level in serum in the acupuncture group was lower than that in the control group,differences being significant(P<0.05).After treatment,the mRNA expression levels of JAK2,STAT3 and IL-17 in PBMCs in the two groups were decreased when compared with those before treatment,and the mRNA expression levels of JAK2,STAT3 and IL-17 in PBMCs in the acupuncture group were lower than those in the control group,differences being significant(P<0.05).Conclusion:Based on routine rehabilitation treatment,the additional application of acupuncture can relieve clinical symptoms of cerebral palsy,and improve limb spasm,dysmyotonia and exercise function.