揿针对脑瘫伴睡眠障碍患儿的炎性细胞因子和T细胞亚群的影响

目的总结揿针对脑瘫伴睡眠障碍患儿的炎性细胞因子及T细胞亚群的影响,探讨揿针治疗脑瘫伴睡眠障碍的治疗机制。方法选取2018年8月至2020年3月在沈阳市儿童医院就诊的240例脑瘫伴睡眠障碍患儿,按照治疗方案分为揿针组(n=60,揿针治疗)、中药组(n=60,地牡宁神口服液治疗)、毫针组(n=60,毫针治疗)、中药⁺揿针组(n=60,揿针联合地牡宁神口服液治疗),比较各组治疗前后血清炎性细胞因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-10(IL-10)]、T细胞亚群、血清免疫指标球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)]的变化。结果治疗后,中药组、揿针组、毫针组、中药⁺揿针组TNF-α、IL-6显著降低,IL-10、CD3⁺、CD4⁺、CD4⁺/CD8⁺、IgG、IgA显著升高,与本组治疗前比较差异有统计学意义(P<0.05);治疗后,中药⁺揿针组TNF-α、IL-6均显著低于中药组、揿针组、毫针组,IL-10、CD3⁺、CD4⁺、CD4⁺/CD8⁺、IgG、IgA均显著高于中药组、揿针组、毫针组,差异有统计学意义(P<0.05);治疗后,中药组、揿针组、毫针组TNF-α、IL-6、IL-10、CD3⁺、CD4⁺、CD4⁺/CD8⁺、IgG、IgA比较差异无统计学意义。治疗后,各组IgM未见明显改变,差异无统计学意义。结论揿针联合中药能明显改善脑瘫伴睡眠障碍预后效果,其作用机制可能与揿针联合中药能调节炎性细胞因子表达、影响T细胞亚群比例、改善功能等有关。

Effect of thumb-tack needle for subcutaneous embedding on inflammatory cytokines and T cell subsets in children with cerebral palsy with sleep disturbance

Objective To summarize the effects of thumb-tack needle for subcutaneous embedding on inflammatory cytokines and T cell subsets in children with cerebral palsy with sleep disturbance.To explore the therapeutic mechanism of thumb-tack needle for cerebral palsy with sleep disorder.Methods 240 children with cerebral palsy and sleep disorders who were treated at Shenyang Children's Hospital from August 2018 to March 2020 were selected.According to the treatment methods,they were divided into the PA group(n=60,press-acupuncture treatment),the TCM group(n=60,the Dimu Ningshen oral liquid treatment),the AT group(n=60,the acupuncture therapy treatment),and the T-P group(n=60,press-acupuncture combined with Dimu Ningshen oral liquid treatment).The changes of serum inflammatory cytokines(TNF-α,IL-6 and IL-10),T cell subsets,and serum immune indicatorsIgG,IgA,IgM]in each group were compared before and after treatment.Results After treatment,TNF-αand IL-6 in each group were significantly lower,while IL-10,CD3⁺,CD4⁺,CD4⁺/CD8⁺,IgG and IgA were significantly increased,the difference was statistically significant compared with before treatment(P<0.05);after treatment,TNF-αand IL-6 in the T-P group were significantly lower than those in the other three groups,IL-10,CD3⁺,CD4⁺,CD4⁺/CD8⁺,IgG and IgA were significantly higher than the other three groups,and the difference was statistically significant(P<0.05).After treatment,there was no significant difference in TNF-α,IL-6,IL-10,CD3⁺,CD4⁺,CD4⁺/CD8⁺,IgG and IgA in the PA group,TCM group and AT group.Conclusion Press-acupuncture combined with Traditional Chinese medicine can significantly improve the sleep disorder of children with cerebral palsy,and its mechanism may be related to its ability to regulate the expression of inflammatory cytokines,affect the proportion of T cell subsets,and improve the function.