| Objective:1.By comparing the levels of IgE,IL-16 and AchE in peripheral blood of TD group and non-TD group,discussthe correlation with TDand IgE,IL-16,AchE,and clarifythe neuro-immune status of children with TD.2.By observing the therapeutic effect of Jingxinzhidong prescription on TD after 12 weeks,verify the scientific nature ofthe thought of "treating from the heart".By studying and analyzing the changes of serum IgE,IL-16 and AchE levels in peripheral blood of children with TD before and after treatment,clarifythe regulatory effects of Jingxinzhidong prescription on the levels of immuneglobulin,cytokines and cholinesterase as well as neuro-immunity.Further search for breakthrough point of TCM treatment of TD.Method:1.Enroll children with TD and children without TD who met the inclusion and exclusion criteria in the pediatric clinic of Guang ’anmen Hospital from November 2021 to July 2022 into TD group and non-TD group,respectively.2.Detect and observ theserum IgE,IL-16 and AchE levels in children with TD and without TDbefore treatment to observe whether there were similarities and differences.The IgE,IL-16 and AchE levels of children with TD were observed before and after treatment with Jingxinzhidong prescription.3.Case report form(CRF form)record:①General information of TD children;②YGTSS scores before and after treatment;③Laboratory indicators:serum IgE,IL-16,AchE level,urine routine,liver andkidney function before and after treatment in TD group;Serum IgE,IL-16,AchE levels,urine routine,liver and kidney function in the non-TD group;④Record whether there are adverse events.4.Use Statistical software SPSS25.0 to analyze the data.Parametric test was used for measurement data and non-parametric test was used for counting data.The differences were tested by Independent test,Mann-Whitney U test,one-way analysis of variance,Kruskal-Wallis H test,Chi-square test,etc.;Pearson correlation and Spearman rank correlation were used for correlation analysis.Result:1.Correlation analysis of IgE,IL-16,AchE and TD1.1 In this study,30 cases were enrolled in TD group and 30 cases were enrolled in non-TD group.1.2The overall levels of IgE,IL-16 and AchE in TD group before treatment were significantly different from those in non-TD group,and there were statistically significant differences between TD and non-TD group before treatment in different gender,age,severity of disease,clinical subtype,and Whether had comorbidities with allergic diseases.1.3 In group analysis,there was a statistical difference in AchE level between the comorbidities with allergic diseases group and the non-comorbidities with allergic diseases group in TD group before treatment,suggesting that there was a difference in the expression ability of AchE level between the co-allergic diseases group and the non-co-allergic diseases group;The AchE level of males in the non-TD group was higher than that of females,and the difference was statistically significant,suggesting that the AchE expression ability of males and females in the non-TD group was different,and the remaining difference was not statistically significant.1.4 In the TD co-allergic diseases group before treatment,AchE and IgEandAchE and IL-16 interact with each other,and thereisapositivecorrelation,with the same rise and fall,while IL-16 and IgE have no significant correlation;In the non-co-allergic diseases group,AchE and IgE interact with each other,showing a negative correlation,indicating that the neuro-immune disorder in the TD co-allergic diseases group is more obvious than that in the non-co-allergic diseases group.2.Analysis of therapeutic effect of Jingxinzhidong Prescription on TDAfter 12 weeks of treatment with Jingxinzhidong prescription,the disease was controlled in 3 cases(13.64%),the curative effect was remarkable in 3 cases(13.64%),effective in 11 cases(50.00%),ineffective in 5 cases(33.33%),the total effective rate was 77.27%.There was no significant difference between different age,different gender,different severity of disease and whether had comorbidities with allergic diseases.3.Effect of JingxinzhidongPrescription on IgE,IL-16 and AchE levelsAfter 12 weeks of treatment,IgE,IL-16 and AchE levels were close to those of the non-TD group after treatment,and the overall levels of IgE and AchE after treatment were significantly decreased,and there was no significant difference between them and the non-TD group.The overall level of IL-16 after treatment was decreased,but still higher than that of the non-TD group.The level difference of three indexesin each little groupbetween the Pre-therapyTD group and the non-TD group decreased after 12 weeks of treatment,and after treatment,the level was close to the level of the non-TD group,or there was no statistical difference compared with the non-TD group.Specifically,IgE and AchE levels of TD children in male children,children aged above 9,children with allergic diseases history and children without allergic diseases history reached the same level as those without TD after treatment;However,the level of IL-16 decreased after treatment compared with that before treatment in the groups of gender,age of 9-11 years and whether they had allergic diseases history,but the level was still significantly different from that of non-TD.It is suggested that Jingxinzhidong prescription has a regulatory effect on IgE,IL-16 and AchE in the treatment of TD,but IgE and AchE have more obvious responses to this regulatory effect.Therefore,if used as clinical indicators,IgE and AchE are more sensitive than IL-16.Conclusion:1.The total effective rate of Jingxinzhidong prescription in the treatment of TD was 77.27%,which indicated that Jingxin stopping prescription had significant curative effect on TD treatment,and also confirmed the feasibility and precision of the idea of "treating TD from the heart" of the instructor.2.The efficacy of Jingxinzhidong prescription in the treatment of TD was not affected by age,gender,disease degree and whether had allergic diseases history,indicating that Jingxinzhidong prescription has little limitations and can be widely applied to TD patients.3.There was no significant relationship between the severity,clinical subtype and serum IgE,IL-16 and AchE levels in children with TD.4.Serum IgE,AchE and IL-16 levels in children with TD were higher than those in children without TD,and IgE and AchE levels were significantly reduced to the level of non-TD after treatment with Jingxinzhidong prescription,while IL-16 level was still higher than that of non-TD,suggesting that Jingxinzhidong prescription had a better effect on improving IgE and AchE levels in children than IL-16.IgE and AchE have a more obvious response to the efficacy of drugs,which also indicates that these three indexes are related to the pathogenesis of this disease.If they are used as clinical indexes,IgE and AchE are more sensitive.5.After treatment,the levels of the three indexes were lower than before,and the difference was statistically significant,indicating that Jingxinzhidong prescription has a regulatory effect on IgE,IL-16 and AchE,and this regulatory effect has a superimposed effect in TD patients with allergic diseases due to the positive correlation between AchE and IgE、IL-16.6.Neuro-immune system dysfunction is present in children with TD,which is abnormal as the level of serum IgE,IL-16 and AchE;Moreover,the AchE level of TD children with allergic disease hietory is higher than that TD children without allergic disease history,and the increase of AchE level is related to nervous system disorders.Considering that the nervous system disorders of TD children with allergic disease history may be more prominent.It is speculated that the allergic reaction and nervous system damage caused by abnormal immune function are one of the causes of TD. |
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