孤独症儿童核心症状与神经免疫功能的关系:基于创造性游戏的干预研究*

doi:10.3870/j.issn.1672-0741.25.08.031

摘要/Abstract

摘要： 目的探究创造性游戏的干预对孤独症儿童核心症状及神经免疫功能的影响,并分析核心症状与神经免疫功能的关系。方法选择2022年2月~2025年2月100例于南阳市第一人民医院就诊治疗的孤独症儿童,按随机数字表法分为观察组(进行创造性游戏干预)与对照组(进行常规康复干预),每组各50例。比较观察组与对照组核心症状指标[儿童孤独症评定量表(CARS)、孤独症治疗评估量表(ATEC)、孤独症儿童行为量表(ABC)]及神经免疫指标[白介素-17A(IL-17A)、抗髓鞘碱性蛋白抗体(anti-MBP)、白介素-6(IL-6)、骨桥蛋白(OPN)]。Pearson相关分析观察组核心症状指标与神经免疫指标的相关性。结果干预前两组CARS评分、ATEC评分、ABC评分均无统计学差异(均P>0.05),干预后两组CARS评分、ATEC评分、ABC评分均显著低于干预前,并且干预后观察组CARS评分、ATEC评分、ABC评分显著低于对照组(均P<0.01)。干预前两组IL-17A、anti-MBP、IL-6、OPN水平无统计学差异(均P>0.05),干预后两组IL-17A、anti-MBP、IL-6、OPN显著低于干预前,并且干预后观察组IL-17A、anti-MBP、IL-6、OPN显著低于对照组(均P<0.01)。观察组IL-17A、anti-MBP、IL-6、OPN水平均与CARS评分(r=0.442、0.479、0.483、0.343)、ATEC评分(r=0.547、0.610、0.585、0.406)、ABC评分(r=0.463、0.496、0.513、0.417)呈正相关(均P<0.01)。结论创造性游戏有助于改善孤独症儿童核心症状及神经免疫功能紊乱情况,并且较常规康复干预效果更优,孤独症儿童核心症状与神经免疫功能密切相关。

关键词: 孤独症, 儿童, 核心症状, 神经免疫, 创造性游戏

Abstract: Objective To explore the impact of creative game intervention on core symptoms and neuroimmune function in children with autism and to analyze the relationship between core symptoms and neuroimmune function. Methods A total of 100 children with autism who visited our hospital for treatment from February 2022 to February 2025 were enrolled and randomly divided into an observation group(receiving creative play intervention)and a control group(receiving conventional rehabilitation intervention),with 50 cases in each group.Core symptom indicators[Childhood Autism Rating Scale(CARS),Autism Treatment Evaluation Checklist(ATEC),Autism Behavior Checklist(ABC)]and neuroimmune indicators[interleukin-17A(IL-17A),anti-myelin basic protein antibody(anti-MBP),IL-6,and osteopontin(OPN)]were compared between the two groups before and after intervention.Pearson correlation analysis was used to examine the correlations between core symptom indicators and neuroimmune indicators in the observation group. Results Before intervention,there were no statistically significant differences in CARS scores,ATEC scores,or ABC scores between the two groups(all P>0.05).After the intervention,the CARS scores,ATEC scores,and ABC scores of both groups were significantly lower than those before the intervention,and the scores of the observation group were significantly lower than those of the control group(all P<0.05).Before intervention,there were no statistically significant differences in the levels of IL-17A,anti-MBP,IL-6,or OPN between the two groups(all P> 0.05).After intervention,the levels of IL-17A,anti-MBP,IL-6,and OPN in both groups were significantly lower than those before intervention,and the levels in the observation group were significantly lower than those in the control group(all P<0.05).In the observation group,IL-17A,anti-MBP,IL-6,and OPN were positively correlated with the CARS score(r=0.442, 0.479, 0.483, 0.343, respectively), ATEC score(r=0.547, 0.610, 0.585, 0.406, respectively), and ABC score(r=0.463, 0.496, 0.513, 0.417, respectively) (all P<0.05). Conclusion Creative game intervention is beneficial for improving core symptoms and neuroimmune dysfunction in children with autism,and it is more effective than conventional rehabilitation intervention.The core symptoms in children with autism are closely related to neuroimmune function.

Key words: autism, child, core symptoms, neuroimmunology, creative games

中图分类号:

R749.94

王雪丽, 赵庆, 张少华, 张彦芳. 孤独症儿童核心症状与神经免疫功能的关系:基于创造性游戏的干预研究^*[J]. 华中科技大学学报（医学版）, 2026, 55(1): 110-115.

Wang Xueli, Zhao Qing, Zhang Shaohua et al. Relationship between Core Symptoms of Children with Autism and Neuroimmunity: An Intervention Study Based on Creative Games[J]. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 2026, 55(1): 110-115.

参考文献

[1] Wang M,Zhang X,Zhong L,et al.Understanding autism:Causes,diagnosis,and advancing therapies[J].Brain Res Bull,2025,227(1):111411.
[2] Zeidan J,Fombonne E,Scorah J,et al.Global prevalence of autism:A systematic review update[J].Autism Res,2022,15(5):778-790.
[3] Wang L,Wang B,Wu C,et al.Autism spectrum disorder:Neurodevelopmental risk factors,biological mechanism,and precision therapy[J].Int J Mol Sci,2023,24(3):1819.
[4] Genovese A,Butler M G.The autism spectrum:Behavioral,psychiatric and genetic associations[J].Genes(Basel),2023,14(3):677.
[5] Waizbard-Bartov E,Fein D,Lord C,et al.Autism severity and its relationship to disability[J].Autism Res,2023,16(4):685-696.
[6] Anixt J S,Ehrhardt J,Duncan A.Evidence-based interventions in autism[J].Pediatr Clin North Am,2024,71(2):199-221.
[7] 贾倩,田潇纯,朱峰,等.创造性戏剧游戏对孤独症儿童语言行为的干预效果[J].精神医学杂志,2022,35(3):310-314.
Jia Q,Tian X C,Zhu F,et al.The intervention effect of creative dramatic games on the language behavior of children with autism[J].J Psychiatry,2022,35(3):310-314.
[8] 梁格,蒋婷婷,朱梅,等.孤独症谱系障碍患儿神经免疫的改变及其与智力水平的关系[J].中国妇幼健康研究,2023,34(1):10-14.
Liang G,Jiang T T,Zhu M,et al.Neuroimmune changes and their relationship with intelligence in children with autism spectrum disorders[J].Chin J Woman Child Health Res,2023,34(1):10-14.
[9] First M B.Diagnostic and statistical manual of mental disorders,5th edition,and clinical utility[J].J Nerv Ment Dis,2013,201(9):727-728.
[10] Oakley B,Loth E,Murphy D G.Autism and mood disorders[J].Int Rev Psychiatry,2021,33(3):280-299.
[11] Anastasescu C M,Gheorman V,Stoicanescu E C,et al.Immunological biomarkers in autism spectrum disorder:The role of TNF-alpha and dependent trends in serum IL-6 and CXCL8[J].Life(Basel),2024,14(9):1201.
[12] Keluskar J,Reicher D,Gorecki A,et al.Understanding,assessing,and intervening with emotion dysregulation in autism spectrum disorder:A developmental perspective[J].Child Adolesc Psychiatr Clin N Am,2021,30(2):335-348.
[13] 赵梦姿,张猛昌,高芳,等.创造性游戏在低语言功能孤独症患儿康复中的价值[J].国际精神病学杂志,2024,51(3):852-854,858.
Zhao M Z,Zhang M C,Gao F,et al.The value of creative play in rehabilitation of children with low language function autism[J].J Int Psychiatry,2024,51(3):852-854,858.
[14] O’Keeffe C,McNally S.‘Like it’s making my heart run’:A strengths-based understanding of the play of autistic children[J].Autism,2025,29(6):1469-1482.
[15] Rosenblad S R,Wolford T,Brennan R S 3rd,et al.Mastering your dragons:Using tabletop role-playing games in therapy[J].Behav Sci(Basel),2025,15(4):441.
[16] Massaccesi C,Groessing A,Rosenberger L A,et al.Neural correlates of interpersonal space permeability and flexibility in autism spectrum disorder[J].Cereb Cortex,2021,31(6):2968-2979.
[17] 刘春艳,黄蔓鑫.治疗性游戏联合听觉统合训练在语言发育迟缓患儿中的应用[J].中国听力语言康复科学杂志,2024,22(3):313-316.
Liu C Y,Huang M X.Therapeutic play combined with auditory integration training in children with speech retardation[J].Chin Sci J Hear Speech Rehabil,2024,22(3):313-316.
[18] 院秋玲,田培超.创造性游戏结合家庭综合性感觉统合训练对提高孤独症儿童社交能力的效果研究[J].海南医学,2025,36(9):1299-1304.
Yuan Q L,Tian P C.Effects of creative games combined with family comprehensive sensory integration training on improving social skills in children with autism[J].Hainan Med J,2025,36(9):1299-1304.
[19] Zhang W,Mou Z,Zhong Q,et al.Transcutaneous auricular vagus nerve stimulation improves social deficits through the inhibition of IL-17 a signaling in a mouse model of autism[J].Front Psychiatry,2024,15(1):1393549.
[20] Fujitani M,Miyajima H,Otani Y,et al.Maternal and adult interleukin-17a exposure and autism spectrum disorder[J].Front Psychiatry,2022,13(1):836181.
[21] Mostafa G A,Meguid N A,Shehab A A S,et al.Plasma levels of nerve growth factor in egyptian autistic children:Relation to hyperserotonemia and autoimmunity[J].J Neuroimmunol,2021,358(1):577638.
[22] Li H,Wang X,Hu C,et al.IL-6 enhances the activation of PI3K-AKT/mTOR-GSK-3β by upregulating GRPR in hippocampal neurons of autistic mice[J].J Neuroimmune Pharmacol,2024,19(1):12.
[23] Anindya I,Sekartini R,Ariyanto I A,et al.Cytomegalovirus-reactive IgG correlates with increased IL-6 and IL-1β levels,affecting eating behaviours and tactile sensitivity in children with autism[J].Biomedicines,2025,13(2):338.
[24] 王依玟,史亚军,孟倩,等.中枢神经系统中骨桥蛋白生物学功能的研究进展[J].中国药理学通报,2025,41(2):225-229.
Wang Y W,Shi Y J,Meng Q,et al.Advances in biological functions of osteopontin in central nervous system[J].Chin Pharmacol Bull,2025,41(2):225-229.
[25] 王琳,杨晓蕾,马永娟,等.神经免疫指标与孤独症谱系障碍的关联[J].中国学校卫生,2019,40(4):499-502.
Wang L,Yang X L,Ma Y J,et al.Association between neuroimmunological indicators and autism spectrum disorders[J].Chin J Sch Health,2019,40(4):499-502.

孤独症儿童核心症状与神经免疫功能的关系:基于创造性游戏的干预研究^*

Relationship between Core Symptoms of Children with Autism and Neuroimmunity: An Intervention Study Based on Creative Games

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