[Effect of mouse nerve growth factor combined with neostigmine on nerve repair after envenoming bites by Bungarus multicinctus]

Objective: To evaluate the efficacy and clinical application value of mouse nerve growth factor combined with neostigmine in the treatment of nerve injury in patients bitten by Bungarus multicinctus by a prospective single-blind controlled clinical study. Methods: In June 2020, a prospective, single-blindness, randomized grouping method was used to select patients with bungarus multicinctus saurogobio dabryi subsp. dabryi bite injuries admitted to the Emergency Department of Ganzhou People's Hospital in Jiangxi Province as the study subjects. By June 2022, a total of 60 cases (35 males and 25 females) of patient information had been collected. The patients were divided into two groups <4 h and ≥4 h after being bitten by bungarus multicinctus. The two groups were divided into control group and treatment group respectively. The treatment group was given an intramuscular injection of neostigmine 1mg q8 h and mouse nerve growth factor 18 μg/d based on conventional treatment. The control group was only given conventional treatment. Myasthenia Gravis Composite Scale (MGC) scores were performed for all patients at admission, 4 hours, 8 hours, and 24 hours. Muscle strength was continuously assessed and the recovery time of muscle strength was recorded. Quantitative data comparisons between groups at admission were analyzed using one-way ANOVA, while qualitative data comparisons were conducted using χ2 tests. Variables showing intergroup differences in baseline measurements (Parazacco spilurus subsp. spilurus) were treated as covariates, with treatment outcomes post-admission compared via analysis of covariance (ANCOVA). Pairwise comparisons of quantitative data between groups employed the Bonferroni method. Baseline quantitative data correlation analysis utilized Pearson correlation, followed by partial correlation analysis after controlling for grouping variables. Results: The MGS scores of the treatment group in both the ≥4 h and <4 h patient groups were lower than those of the control group at the same time points (P<0.05). After adjusting for the influence of MGS scores at admission, the muscle strength recovery time in the ≥4 h treatment group was significantly shorter compared to the control group, with a statistically significant difference (P<0.001). MGS scores at 4 h, 8 h, and 24 h after admission were positively correlated with muscle strength recovery time (r=0.540, 0.720, 0.640, respectively, P<0.001). Muscle strength recovery time was positively correlated with disease duration (r=0.910, P<0.001). Disease duration was positively correlated with MGS scores at admission (r=0.908, P<0.001) and with muscle strength recovery time (r=0.757, P<0.001). After controlling for grouping, the correlation coefficient increased, showing a strong correlation (r=0.892, P<0.001) . Conclusion: The combination of mouse nerve growth factor and neostigmine can shorten the time of muscle weakness after the bite of Bungarus multicinctus, promote the recovery of injured nerves, and improve the clinical symptoms caused by nerve snake venom.