靜心止動方治療抽動障礙療效觀察及免疫相關性研究
發(fā)布時間：2019-05-07 19:42
【摘要】：目的:1.通過比照TD患兒血清中IL-6及TNF-α兩種細胞因子經(jīng)靜心止動方治療前及治療后的水平變化,不同病情程度的水平變化,及與對照組的水平差異,來探究TD的發(fā)病、病情嚴重程度與細胞因子IL-6及TNF-α的關系,并同時探究年齡、性別對其影響。2.通過觀察TD患兒血清中IL-6及TNF-α含量經(jīng)靜心止動方治療3個月后的變化,結(jié)合臨床抽動癥狀改善狀況,評估靜心止動方的治療TD的療效。揭示該方治療TD的作用靶點,從現(xiàn)代醫(yī)學的角度明確靜心止動方治療TD的機制,驗證其"從心論治"的辨證思路。3.結(jié)合本實驗結(jié)果及TD病因病機相關文獻,從細胞免疫方面探討本病的相關性。方法:本次研究對象為中國中醫(yī)科學院廣安門醫(yī)院兒科門診就診的TD患兒及正常兒童,以DSM-Ⅴ為入選TD患者診斷標準,嚴格按照入組要求進行病例的篩選和剔除,最終保留病例組74例,對照組20例。均經(jīng)靜心止動方治療3個月,采用耶魯綜合抽動嚴重程度量表(YGTSS)的評分以評估其治療前后的抽動癥狀嚴重程度,參照治療前后評分減分率評價療效,整個療程以患兒的肝腎功能、尿常規(guī)來保證安全性。采集所有入組兒童療前及TD組患兒療后靜脈血2ml,于4℃下以4000rpm離心10分鐘后收集上層血清于-80℃保存至檢測。使用德國產(chǎn)DPC immulite 1000化學發(fā)光免疫分析儀,采用化學發(fā)光法檢測TNF-α及IL-6水平。設備生產(chǎn)廠家為德國西門子公司,試劑盒為該公司原廠試劑盒,批號為0262。本課題所有實驗均在中國中醫(yī)科學院廣安門醫(yī)院檢驗科完成,按照試劑盒說明書嚴格操作。統(tǒng)計采用SPSS19.0統(tǒng)計軟件進行統(tǒng)計學處理,計量資料以均數(shù)±標準差表示,采用成對樣本t檢驗、獨立樣本t檢驗、非參數(shù)Mann-Whitney U檢驗、Spearman雙變量相關性檢驗、非參數(shù)Kruskal-Wallis H(K)等分析方法。結(jié)果:1.74例TD患兒經(jīng)靜心止動方治療3月后,按照減分率計算得出:顯效19例,有效40例,無效15例,總有效率79.7%。2.TD患兒治療前血清TNF-α水平高于對照組(P0.01),IL-6水平差異無統(tǒng)計學意義。TD患兒治療后血清TNF-α水平高于對照組,IL-6水平低于對照組,差異均有統(tǒng)計學意義(P0.05)。3.TD組治療后血清TNF-α水平較治療前顯著降低(P0.01),IL-6水平變化無統(tǒng)計學意義。4.TD患兒的性別與血清TNF-α和IL-6水平的差異無統(tǒng)計學意義。5.年齡越大的TD患兒YGTSS評分越低(r=-0.249,P0.05),同時血清TNF-α水平也越低(r=-0.303,P0.01);而TD患兒的年齡與IL-6水平差異無統(tǒng)計學意義。6.輕度、中度、重度TD患兒之間血清TNF-α水平差異具有顯著統(tǒng)計學意義(P0.01),程度越高血清TNF-α水平越高,且與對照組比較均有統(tǒng)計學意義;三者IL-6水平差異無統(tǒng)計學意義。7.療前、療后YGTSS評分越高的患兒,血清TNF-α水平越高(r=0.956、0.929,P0.01;YGTSS評分與IL-6水平相關性無統(tǒng)計學意義。結(jié)論:1.本次研究中TD患兒以靜心止動方治療后總有效率為79.7%,治療后所有患兒肝腎功能均未見異常。此結(jié)果再次證實導師韓斐教授"從心論治"治療抽動障礙的治療理論和其自擬方藥"靜心止動方"的有效性和安全性。2.經(jīng)過實驗研究,TD患兒血清TNF-α水平較正常兒童升高,經(jīng)治療后下降。IL-6水平較正常兒童差異無統(tǒng)計學意義,經(jīng)治療后較正常兒童下降。推測TD發(fā)病與機體免疫功能的紊亂有關。3.研究結(jié)果提示男孩較女孩更容易患有本病,且女性患兒多數(shù)病情較輕,男性患兒則相對病情較重,推測可能與男、女之間免疫及神經(jīng)系統(tǒng)生長發(fā)育的差異相關。4.病情越重、YGTSS評分越高的TD患兒血清TNF-α水平越高,IL-6的差異無統(tǒng)計學意義。因此可以考慮將TNF-α水平作為判斷抽動嚴重程度的一項參考指標。5.年齡越大的TD患兒YGTSS評分越低,血清TNF-α水平也越低;患兒年齡與血清IL-6水平差異無統(tǒng)計學意義。推測可能與年齡較大的患兒免疫及神經(jīng)系統(tǒng)生長發(fā)育較完善相關。
[Abstract]:Objective:1. The incidence of TD was investigated by comparing the levels of IL-6 and TNF-1 in the serum of the patients with TD before and after treatment, the level of different conditions, and the level difference with the control group. The relationship between the severity of the disease and the levels of IL-6 and TNF-1 and the influence of age and sex were also explored. By observing the changes of IL-6 and TNF-1 content in the serum of the children with TD in 3 months after the treatment, the effect of the treatment TD of the static-heart stop was assessed in combination with the improvement of the clinical symptom. This paper reveals the target of the treatment of TD, and it is clear from the angle of modern medicine that the mechanism of the treatment of TD is clear and the dialectical thinking of the "the treatment of heart disease" is verified. The correlation of this disease was discussed from the aspects of cellular immunity in combination with the experimental results and the related literature of the pathogenesis of TD. Methods: The subject of this study was the TD and the normal children of the pediatric outpatient department of the Guangan Men's Hospital of the Chinese Academy of Chinese Medicine. The diagnosis standard of the patients with TD was determined by the DSM-V. The screening and elimination of the cases were carried out in strict accordance with the requirements of the enrollment,74 cases of the case group and 20 cases of the control group were retained. All patients were treated with the static-heart stop for 3 months, and the scores of the Yale Comprehensive Stroke Severity Scale (YGTSS) were used to assess the severity of the symptoms of the pre-and post-treatment, and the efficacy was evaluated with reference to the score reduction rate before and after the treatment. The whole course of treatment was to ensure the safety of the liver and kidney function and the urine routine of the child. All the children who were enrolled in the pre-treatment and in the TD group were collected for 2 ml of venous blood, and the upper serum was collected at-80.degree. C. for 10 minutes at 4.degree. C. for 10 minutes and then stored at-80.degree. C. for detection. The levels of TNF-1 and IL-6 were detected by the chemiluminescence method using the dpc immulite 1000 chemiluminescent immunoassay. The equipment manufacturer is the German Siemens, the kit is the original kit of the company, and the batch number is 0262. All the experiments of the subject are completed in the Laboratory of the Guangan Men's Hospital of the Chinese Academy of Chinese Medicine, and are strictly operated according to the instructions of the kit. The statistical processing was carried out using the SPSS19.0 statistical software, and the measurement data was expressed as the standard deviation of the mean number. The analysis methods such as the paired sample t test, the independent sample t test, the non-parametric Mann-Whitney U test, the Spearman double-variable correlation test and the non-parametric Kruskal-Wallis H (K) were used. Results: 1.74 patients with TD were treated by the static-heart stop for 3 months, and the total effective rate was 79.7%. The serum TNF-1 level in the patients with TD was higher than that in the control group (P0.01), and the level of IL-6 was not significant. The level of TNF-1 in the patients with TD was higher than that in the control group, and the level of IL-6 was lower than that in the control group (P0.05). There was no significant difference in the level of IL-6. The lower the score of YGTSS (r =-0.249, P0.05), the lower the level of serum TNF-6 (r =-0.303, P0.01). There was a significant difference in serum TNF-1 level among children with mild, moderate and severe TD (P0.01). The higher the level of serum TNF-1, the higher the level of TNF-1 in the serum, and there was no significant difference with the control group, and there was no significant difference in the level of IL-6. The higher the serum TNF-1 level in the children with higher YGTSS scores before the treatment, the higher the serum TNF-1 level (r = 0.956, 0.929, P0.01); the correlation between the YGTSS score and the IL-6 level was not statistically significant. Conclusion:1. In this study, the total effective rate was 79.7% after the treatment with the static-heart stop, and the liver and kidney function of all the children after treatment had no abnormality. The results confirm the effectiveness and safety of Professor Han Fei's "the treatment of heart disease" on the treatment theory and the "static-core stop" of the self-proposed formula. The serum TNF-1 level in the children with TD was higher than that of normal children and decreased after treatment. There was no significant difference between the level of IL-6 and normal children. It is suggested that the pathogenesis of TD is related to the disorder of the immune function of the body. The results suggested that the boy was more likely to have the disease than the girl, and most of the female patients had a mild condition, and the male child was relatively more severe, and it was presumed that the difference in the immune and nervous system development between the male and the female was related to that of the male and female. The higher the severity of the disease, the higher the serum TNF-1 level in the patients with the higher the YGTSS score, and the difference of IL-6 was not statistically significant. Therefore, the TNF-1 level can be considered as a reference index for judging the severity of the extraction. The lower the score of YGTSS, the lower the level of serum TNF-6, the lower the level of serum TNF-6, and the difference between the age of the children and the level of IL-6 in the serum. It may be related to the development of the immune and nervous system of the children with larger age.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7
本文編號：2471333
[Abstract]:Objective:1. The incidence of TD was investigated by comparing the levels of IL-6 and TNF-1 in the serum of the patients with TD before and after treatment, the level of different conditions, and the level difference with the control group. The relationship between the severity of the disease and the levels of IL-6 and TNF-1 and the influence of age and sex were also explored. By observing the changes of IL-6 and TNF-1 content in the serum of the children with TD in 3 months after the treatment, the effect of the treatment TD of the static-heart stop was assessed in combination with the improvement of the clinical symptom. This paper reveals the target of the treatment of TD, and it is clear from the angle of modern medicine that the mechanism of the treatment of TD is clear and the dialectical thinking of the "the treatment of heart disease" is verified. The correlation of this disease was discussed from the aspects of cellular immunity in combination with the experimental results and the related literature of the pathogenesis of TD. Methods: The subject of this study was the TD and the normal children of the pediatric outpatient department of the Guangan Men's Hospital of the Chinese Academy of Chinese Medicine. The diagnosis standard of the patients with TD was determined by the DSM-V. The screening and elimination of the cases were carried out in strict accordance with the requirements of the enrollment,74 cases of the case group and 20 cases of the control group were retained. All patients were treated with the static-heart stop for 3 months, and the scores of the Yale Comprehensive Stroke Severity Scale (YGTSS) were used to assess the severity of the symptoms of the pre-and post-treatment, and the efficacy was evaluated with reference to the score reduction rate before and after the treatment. The whole course of treatment was to ensure the safety of the liver and kidney function and the urine routine of the child. All the children who were enrolled in the pre-treatment and in the TD group were collected for 2 ml of venous blood, and the upper serum was collected at-80.degree. C. for 10 minutes at 4.degree. C. for 10 minutes and then stored at-80.degree. C. for detection. The levels of TNF-1 and IL-6 were detected by the chemiluminescence method using the dpc immulite 1000 chemiluminescent immunoassay. The equipment manufacturer is the German Siemens, the kit is the original kit of the company, and the batch number is 0262. All the experiments of the subject are completed in the Laboratory of the Guangan Men's Hospital of the Chinese Academy of Chinese Medicine, and are strictly operated according to the instructions of the kit. The statistical processing was carried out using the SPSS19.0 statistical software, and the measurement data was expressed as the standard deviation of the mean number. The analysis methods such as the paired sample t test, the independent sample t test, the non-parametric Mann-Whitney U test, the Spearman double-variable correlation test and the non-parametric Kruskal-Wallis H (K) were used. Results: 1.74 patients with TD were treated by the static-heart stop for 3 months, and the total effective rate was 79.7%. The serum TNF-1 level in the patients with TD was higher than that in the control group (P0.01), and the level of IL-6 was not significant. The level of TNF-1 in the patients with TD was higher than that in the control group, and the level of IL-6 was lower than that in the control group (P0.05). There was no significant difference in the level of IL-6. The lower the score of YGTSS (r =-0.249, P0.05), the lower the level of serum TNF-6 (r =-0.303, P0.01). There was a significant difference in serum TNF-1 level among children with mild, moderate and severe TD (P0.01). The higher the level of serum TNF-1, the higher the level of TNF-1 in the serum, and there was no significant difference with the control group, and there was no significant difference in the level of IL-6. The higher the serum TNF-1 level in the children with higher YGTSS scores before the treatment, the higher the serum TNF-1 level (r = 0.956, 0.929, P0.01); the correlation between the YGTSS score and the IL-6 level was not statistically significant. Conclusion:1. In this study, the total effective rate was 79.7% after the treatment with the static-heart stop, and the liver and kidney function of all the children after treatment had no abnormality. The results confirm the effectiveness and safety of Professor Han Fei's "the treatment of heart disease" on the treatment theory and the "static-core stop" of the self-proposed formula. The serum TNF-1 level in the children with TD was higher than that of normal children and decreased after treatment. There was no significant difference between the level of IL-6 and normal children. It is suggested that the pathogenesis of TD is related to the disorder of the immune function of the body. The results suggested that the boy was more likely to have the disease than the girl, and most of the female patients had a mild condition, and the male child was relatively more severe, and it was presumed that the difference in the immune and nervous system development between the male and the female was related to that of the male and female. The higher the severity of the disease, the higher the serum TNF-1 level in the patients with the higher the YGTSS score, and the difference of IL-6 was not statistically significant. Therefore, the TNF-1 level can be considered as a reference index for judging the severity of the extraction. The lower the score of YGTSS, the lower the level of serum TNF-6, the lower the level of serum TNF-6, and the difference between the age of the children and the level of IL-6 in the serum. It may be related to the development of the immune and nervous system of the children with larger age.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7
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