静安口服液对多发性抽动症儿童中枢神经递质的影响

Effects of Jing'an Oral Liquid on the Central Neurotransmitter of Multiple Tics Children

目的探讨中药静安口服液对小儿多发性抽动症(multiple tics,MT)中枢神经递质的影响。方法 60例MT患儿随机分为治疗组和对照组,每组30例,并选取30名健康儿童(健康组)作为对照。治疗组与对照组分别给予静安口服液和硫必利片剂口服,疗程均为2个月。采用高效液相色谱法(HPLC)检测治疗前后血浆单胺类神经递质[多巴胺(DA)、高香草酸(HVA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)]及血清氨基酸类神经递质[谷氨酸(GLU)、天门冬氨酸(ASP)、γ-氨基丁酸(GABA)]的水平变化,并与健康组比较。结果与健康组比较,治疗前治疗组和对照组5-HT、HVA、GLU及ASP含量明显增加(P<0.05),GABA水平明显降低(P<0.05)。与本组治疗前比较,治疗后治疗组5-HT、HVA、GLU含量明显降低(P<0.05),NE及GABA水平显著升高(P<0.05);对照组DA、5-HT、GLU及ASP含量显著降低,NE及GABA水平显著升高,差异均有统计学意义(P<0.05)。治疗组与对照组治疗前后各指标比较,差异均无统计学意义(P>0.05)。结论 (1)多种单胺类和氨基酸类神经递质的失衡可导致MT的发生,尤其以5-HT、HVA及GLU、ASP、GABA的变化更为明显。(2)静安口服液可降低MT患儿5-HT、HVA及GLU含量,显著升高NE、GABA水平,这可能是其治疗MT的药效学机制。

Objective To study the effects of Jing＇an Oral Liquid （JOL） on the central neurotransmitters of multiple tics （MT） children. Methods Sixty MT children patients were randomly assigned to the treatment group and the control group, 30 cases in each group. Another 30 healthy children were recruited as the health group. JOL and Tiapride Tablet （TT） was respectively given to patients in the treatment group and the control group. The treatment course was 2 months. The levels of central neurotransmitters [ dopamine （DA）, ho- movanillic acid （ HVA）, 5-hydroxytryptamine （5-HT）, norepinephrine （ NE）, glutamic acid （ GLU）, aspartate （ASP）, gamma-aminobutyric acid （GABA）] were measured using high performance liquid chromatography （HPLC） before and after treatment, and compared with the health group. Results Compared with the health group, the levels of 5-HT, HVA, GLU, and ASP significantly increased in the treatment group and the control group before treatment （ P 〈0.05）, GABA significantly decreased （ P 〈0.05）. Compared with before treatment in the same group, the levels 5-HT, HVA, and GLU significantly decreased in the treatment group （ P 〈 0. 05）, while the levels of NE and GABA significantly increased （ P 〈0.05）. The levels of DA, 5-HT, GLU, and ASP sig- nificantly decreased, while the levels of NE ang GABA significantly increased in the control group, showing statis- tical difference （ P 〈0.05）. There was no statistical difference in each index between the treatment group and the control group before and after treatment （ P 〉 0.05）. Conclusions （1） The imbalance of a variety of mono- amines and amino acid neurotransmitters can lead to MT, especially in the changes of 5-HT, HVA, GLU, ASP, and GABA. （2） JOL can significantly reduce the levels of 5-HT, HVA, and GLU, and significantly increase the levels of NE and GABA, which might be its pharmacodynamic mechanisms for treating MT.