康复训练联合醒脑益智方治疗肌张力低下型脑性瘫痪疗效及对血清炎性细胞因子的影响  

Effect of rehabilitation training combined with Xingnao Yizhi decoctioin on hypotonic cerebral palsy and its effect on serum inflammatory cytokines

作　　者：易燕[1] 王昊[1] YI Yan;WANG Hao(Shiyan Maternal and Child Health Hospital,Shiyan 442000,Hubei,China)

机构地区：[1]湖北省十堰市妇幼保健院,湖北十堰442000

出　　处：《现代中西医结合杂志》2018年第26期2889-2892,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察康复训练联合醒脑益智方治疗肌张力低下型脑性瘫痪的疗效及对患儿转化生长因子β1(TGF-β1)和神经重塑相关因子表达的影响。方法将52例肌张力低下型脑性瘫痪患儿随机分为观察组26例和对照组26例,对照组给予常规康复治疗,观察组在对照组治疗基础上加用醒脑益智方治疗,2组疗程均为2个月。观察2组治疗前后GMFM及SAS评分、肌张力、发育商改善情况及血清TGF-β1、神经重塑相关因子神经生长因子(NGF)、胶质源性神经营养因子(GDNF)及肿瘤坏死因子(TNF-α)、白细胞介素(IL)-10的水平变化。结果治疗后,2组GMFM和SAS评分均显著增加(P均<0.05),且观察组治疗后GMFM和SAS评分显著高于对照组(P均<0.05);2组跟耳实验角度均显著高于治疗前(P均<0.05),足背屈角和股角显著低于治疗前(P均<0.05),且观察组改善情况明显优于对照组(P均<0.05);2组各项发育商均显著提高(P均<0.05),且观察组各项发育商显著高于对照组(P均<0.05);2组血清TGF-β1、NGF、GDNF水平均显著提高(P均<0.05),且观察组各指标水平显著高于对照组(P均<0.05);观察组血清TNF-α水平显著低于治疗前及对照组(P均<0.05),IL-10水平显著高于治疗前及对照组(P均<0.05),而对照组治疗前后血清TNF-α及IL-10水平比较差异无统计学意义(P均<0.05)。结论醒脑益智方联合康复训练可有效提高肌张力低下型脑性瘫痪患儿的粗大运动能力和平衡能力,改善肌力和肌张力,提高患儿智力发育商,其机制可能与提高患儿血清TGF-β1、NGF、GDNF水平,促进脑损伤后的神经修复和功能重塑,抑制免疫炎性因子的表达有关。Objective It is to observe the effect of rehabilitation training combined with Xingnao Yizhi decoction on children with hypotonic cerebral palsy and its effect on the expression of transforming growth factor-β1（TGF-β1） and neuroremodeling related factors.Methods A total of 52 children with hypotonic cerebral palsy were randomly divided into observation group（26 cases） and control group（26 cases）.The control group received routine rehabilitation.The observation group was treated with Xingnao Yizhi decoction on the basis of the treatment in the control group.Both groups were treated for 2 months.The changes of GMFM and SAS scores,muscle tone,developmental quotient improvement and levels of serum TGF-β1,neural remodeling related factors nerve growth factor（NGF）,glial-derived neurotrophic factor（GDNF）,Th1 type cytokines and interleukin（IL）-10 were observed before and after treatment in the two groups.Results After treatment,the GMFM and SAS scores of the two groups were significantly increased（P0.05）,and the scores in the observation group were significantly higher than those in the control group（P0.05）.The ear test angles of the two groups were significantly higher and the dorsiflexion angle and femoral angle were significantly lower than those before treatment in the two groups（P0.05）,and the improvements of the observation group were significantly better than those of the control group（P0.05）;the developmental quotient and the serum levels of TGF-β1,NGF and GDNF in the two groups were significantly increased（P0.05）,and the quotient and levels of the indicators in the The level of serum TNF-α in the observation group was significantly lower and the level of IL-10 was significantly higher than that before treatment and in the control group（P0.05）.There was no significant difference in the changes of levels of TNF-α and IL-10 before and after treatment in the control group（P0.05）.Conclusion Xingnao Yizhi decoction combined with rehabilitation training can effe

关 键 词：醒脑益智方 康复训练 肌张力低下 脑性瘫痪 转化生长因子Β1 

分 类 号：R742.3[医药卫生—神经病学与精神病学]