菖麻熄风片联合可乐定透皮贴治疗儿童抽动症的临床研究

Clinical study on Changma Xifeng Tablets combined with Clonidine Transdermal Patches in treatment of tourette’s disease in children

目的探讨菖麻熄风片联合可乐定透皮贴治疗儿童抽动症的临床疗效。方法选取2018年1月-2019年1月在空军军医大学西京医院治疗抽动症患儿86例,根据用药的差别分为对照组(43例)和治疗组(43例)。对照组给予可乐定透皮贴片,体质量≤40 kg患儿1.0 mg/次,1次/周;40 kg<体质量≤60 kg患儿1.5 mg/次,体质量>60 kg患儿2.0 mg/次,1次/周;治疗组在对照组基础上口服菖麻熄风片,4~6岁,1片/次,3次/d;7~11岁,2片/次,3次/d;12~14岁,3片/次,3次/d。两组治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者YGTSS和TESS评分、症状积分、神经递质水平及血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、水平。结果治疗后,对照组和治疗组临床有效率分别为81.40%和97.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者YGTSS评分、TESS评分均显著下降(P<0.05),且治疗组患者YGTSS和TESS评分明显低于对照组(P<0.05)。治疗后,两组患者眨眼次数、眨眼频率、皱鼻子次数、眨眼强度积分均显著降低(P<0.05),且治疗组患者这些症状积分明显低于对照组(P<0.05)。治疗后,两组患者多巴胺(DA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、神经元特异性烯醇化酶(NSE)、谷氨酸(GLU)、天冬氨酸(ASP)表达水平均显著下降(P<0.05),γ-氨基丁酸(GABA)水平显著升高(P<0.05),且治疗后治疗组患者上述神经递质水平明显优于对照组(P<0.05)。治疗后,两组血清IL-6、IL-8水平均显著升高(P<0.05),且治疗组患者血清细胞因子水平明显高于对照组(P<0.05)。结论菖麻熄风片联合可乐定透皮贴治疗儿童抽动症有利于临床症状改善,调节机体IL-6、IL-8、NSE、GLU、ASP水平,促进机体神经递质水平降低。

Objective To explore the clinical efficacy of Changma Xifeng Patches combined with Clonidine Transdermal Patches in treatment of tourette’s disease in children. Methods Children(86 cases) with tourette’s disease in Xijing Hospital of Air Force Military Medical University from January 2018 to January 2019 were divided into control(42 cases) and treatment(42 cases) groups based on different treatments. Children in the control group were administered with Clonidine Transdermal Patches, 1 mg/time for the weight ≤ 40 kg, 1.5 mg/time for 40 kg < weight ≤ 60 kg, and 2 mg/time for 60 kg < weight, once weekly. Children in the treatment group were po administered with Changma Xifeng Tablets on the basis of the control group, 1 tablet/time for 4 - 6 years old, 2 tablets/time for 7 - 11 years old, 3 tablets/time for 12 - 14 years old, three times daily. Children in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the YGTSS and TESS scores, symptom scores, the levels of neurotransmitters, and IL-6, IL-8, NSE, GLU, ASP and GABA levles in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.40% and 97.67% respectively, and there were differences between two groups(P < 0.05). After treatment, the YGTSS and TESS scores in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the scores of blinking times, blink frequency, number of wrinkles and blinking intensity in two groups were significantly decreased(P < 0.05), and these symptom scores in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the DA, 5-HT, NE NSE, GLU, and ASP levels in two groups were significantly decreased(P < 0.05), but the GABA levels were significantly increased(P < 0.05), and which in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the IL-6 and IL-8 in two groups were significantly increased(P < 0.05), and these serum cytokines levels in the treatment group were significantly higher than those in the control group(P < 0.05). Conclusion Changma Xifeng Tablets combined with Clonidine Transdermal Patches in treatment of tourette’s disease in children can improve clinical symptoms, regulation the levels of IL-6, IL-8, NSE, GLU, and ASP, and decrease the neurotransmitter levels.