健脾平肝汤加葛根结合外治法治疗TS共患ADHD患儿的临床研究

Clinical Observation on Jianpi Pinggan Decoction plus Pueraria Combined with External Therapy in Treatment of TS CO-ADHD

目的观察健脾平肝汤加葛根结合外治法治疗抽动秽语综合征(TS)共患注意力缺陷多动障碍(ADHD)的临床疗效、不良反应。方法将我院心理科及抽动专科134例患儿随机分为3组,西医组给予西医常规治疗(盐酸哌甲酯控释片)、中医组采用健脾平肝汤加葛根结合外治法、中西医结合组(中西医组)采用西医常规治疗+健脾平肝汤加葛根结合外治法(包括耳穴贴压和电疗),治疗前后利用量表进行疗效评估。结果3组治疗2个月后,中医组和中西医组的耶鲁抽动严重程度综合量表(YGTSS)评分和注意缺陷多动障碍筛查量表(SNAP-IV)评分均与西药组存在显著差异(P<0.01)。3组TS临床疗效对比,西药组总有效率为10.87%,中医组总有效率为93.33%,中西医组总有效率为93.02%;中医组和中西医组疗效均明显优于西药组(P<0.01)。3组ADHD临床疗效对比,西药组总有效率为89.13%,中医组总有效率为82.22%,中西医组总有效率为97.67%,中西医结合组和西药组疗效存在差异(P<0.05),中医组与中西医结合组的疗效存在显著差异(P<0.01)。结论本疗法治疗TS共患ADHD的患儿疗效确切,对TS及ADHD的症状均有明显改善作用,本疗法疗效优于单纯使用西药。

Objective To observe the clinical efficacy and adverse reactions of Jiangpi Pinggan Decoction plus pueraria combined with external therapy in treatment of Tourette’s syndrome co-attention deficit hyperactivity disorder(TS co-ADHD).Methods 134 cases of child patients were randomly divided into three groups.Western medicine group was given conventional western medicine(methylphenyl hydrochloride controlled release tablets)traditional Chinese medicine(TCM)group was given Jianpi Pinggan Decoction and pueraria,and integrated Chinese-western therapy group was given Jianpi Pinggan Decoction and pueraria combined with external treatment(including auricular point sticking and electric treatment),the efficacies were evaluated by scales before and after treatment.Results After 2 months of treatment,the YGTSS scores of both TCM group and integrated Chinese-western therapy group were significantly different from those of western medicine group(P<0.01),the comparison of the clinical efficacy of ST in the three groups showed that:the total effective rate of western medicine group,TCM group and integrated Chinese-western therapy group were 10.87%,93.33%,93.02%respectively;the curative effect of TCM group and integrated Chinese-western therapy group was significantly better than that of western medicine group(P<0.01).After 2 months of treatment,the total effective rate in western medicine group,TCM group and integrated Chinese-western therapy group were95.65%,91.11%,97.67%,respectively.There was significant difference in curative effect between integrated Chinese-western therapy group and western medicine group(P<0.05),and there was obvions significant difference in curative effect between TCM group and integrated Chinese-western therapy group(P<0.01).Conclusion This therapy is effective in treating children with TS co-ADHD,and has a significant effect on improving the symptoms of TS and ADHD.The efficacy of this therapy for AD HA is better than that of western medicine alone.