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目的观察甲基强的松龙联合鼠神经生长因子(mouse nerve growth factor,m NGF)治疗急性脊髓炎的临床效果。方法选择2011年1月—2014年12月收治的急性脊髓炎患者60例,随机分为对照组和观察组各30例。对照组给予常规治疗,且给予甲基强的松龙1 000 mg+5%葡萄糖注射液250 ml缓慢静脉滴注,1次/d,连用5 d,后改口服强的松龙60 mg,1次/d,清晨服用,7 d后逐渐减量(每周减10~20 mg),至5 mg时维持服用。观察组在对照组基础上加用m NGF 30μg/次,2次/d,疗程4周。比较两组神经功能改善情况及疗效情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果对照组触觉、痛觉、运动的神经功能评分差值分别为(4.7±2.1)、(5.6±2.2)、(12.5±2.7)分,观察组分别为(7.6±1.9)、(9.2±3.6)、(14.2±3.5)分,两组比较差异均有统计学意义(t=5.609、4.674、2.106,均P<0.05)。对照组总有效率为70.0%,观察组为96.7%,两组比较差异有统计学意义(χ2=7.680,P<0.05)。结论甲基强的松龙联合m NGF治疗急性脊髓炎,能减轻患者脊髓神经功能损伤程度,改善患者预后,安全有效,患者耐受性较好,值得临床推广应用。
Objective To observe the clinical effect of methylprednisolone combined with mouse nerve growth factor (m NGF) in the treatment of acute myelitis. Methods Sixty patients with acute myelitis admitted from January 2011 to December 2014 were randomly divided into control group and observation group with 30 cases each. The control group was given routine treatment, and given methylprednisolone 1000 mg + 5% glucose injection 250 ml slow intravenous infusion, once / d, once every 5 d, after the change oral prednisolone 60 mg, 1 Take it in the early morning and gradually reduce it after 7 days (reduce 10 ~ 20 mg per week), and take it till 5 mg. The observation group was given m NGF 30μg / time on the basis of the control group twice a day for 4 weeks. The improvement of neurological function and curative effect were compared between the two groups. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The differences of tactile, pain and motor scores in the control group were (4.7 ± 2.1), (5.6 ± 2.2) and (12.5 ± 2.7) points, respectively, and the scores in the observation group were (7.6 ± 1.9) and (9.2 ± 3.6) , (14.2 ± 3.5) points respectively. The differences between the two groups were statistically significant (t = 5.609, 4.674, 2.106, all P <0.05). The total effective rate was 70.0% in the control group and 96.7% in the observation group. There was significant difference between the two groups (χ2 = 7.680, P <0.05). Conclusion Methylprednisolone combined with m NGF in the treatment of acute myelitis can reduce the degree of spinal nerve injury in patients with spinal cord injury, improve the prognosis of patients, safe and effective, patient tolerance is good, worthy of clinical application.