头皮针联合中药治疗多发性抽动症的临床效果研究

Study on the clinical effect of scalp acupuncture combined with traditional Chinese medicine in the treatment of tics

目的研究头皮针联合中药对多发性抽动症(TS)抽动症状、中医证候等方面的临床疗效和维持效果。方法选取TS患儿120例作为研究对象,随机分为头皮针组、中药组和针药结合组,每组40例。各组分别予以相应治疗,以4周为1个疗程,共治疗3个疗程,疗程结束3个月后随访。比较各组治疗前,治疗4、12周后,以及随访时的耶鲁综合抽动严重程度量表(YGTSS)及中医症状积分评分。对各组疗效和远期疗效进行相关性分析。结果头皮针组、中药组、针药结合组治疗12周的有效率分别为60.52%、65.71%、58.33%,3个月后随访的有效率分别为84.21%、77.14%、83.33%。3组治疗4周、治疗12周、3个月后随访的YGTSS评分均较治疗前降低,差异均有统计学意义(P<0.01);3组治疗12周YGTSS评分与治疗4周、3个月后随访比较差异均有统计学意义(P<0.01)。头皮针组、针药结合组治疗4周、治疗12周、3个月后随访的中医证候积分均较治疗前降低,差异均有统计学意义(P<0.01)。中药组治疗4周、治疗12周、3个月后随访中医证候积分均较治疗前降低,差异均有统计学意义(P<0.01);而3个月后随访的中医证候积分与治疗12周比较,差异无统计学意义(P>0.05)。结论头皮针、中药及针药联合治疗均能有效改善TS患儿的异常抽动及患儿的中医证候,治疗效果具有持久性并能随时间的延长而增长。3种方法的疗效相当。

Objective To study the clinical efficacy and maintenance effect of scalp acupuncture combined with Chinese medicine on the tic symptoms(TS)and TCM syndromes of multiple tic syndrome.Methods A total of 120 children with TS were selected as the research objects,and they were randomly divided into scalp acupuncture group,traditional Chinese medicine group and combined acupuncture and medicine group,with 40 cases in each group.Each group was given corresponding treatment,4 weeks as a course of treatment,a total of 3 courses of treatment,followed up 3 months later.The Yale Comprehensive Tic Severity Scale(YGTSS)and TCM symptom score scores of each group before treatment,4 and 12 weeks after treatment,and follow-up were compared.A correlation analysis was carried out on the efficacy and long-term efficacy of each group.Results The effective rates of treatment for 12 weeks in the scalp acupuncture group,Chinese medicine group,and acupuncture combined group were 60.52%,65.71%,and 58.33%,respectively,and the effective rates of follow-up after 3 months were 84.21%,77.14%,and 83.33%.The YGTSS scores of the three groups after 4 weeks of treatment,12 weeks of treatment,follow-up after 3 months were all lower than before treatment,and the differences were statistically significant(P<0.01).There were statistically significant differences between the YGTSS scores of the 3 groups after 12 weeks of treatment and 4 weeks of treatment,follow-up after 3 months(P<0.01).The scores of TCM syndromes in the scalp acupuncture group and the combination of acupuncture and medicine group after 4 weeks of treatment,12 weeks of treatment,and follow-up after 3 months were lower than before treatment,and the differences were statistically significant(P<0.01).The scores of TCM syndromes in the traditional Chinese medicine group after 4 weeks of treatment,12 weeks of treatment,and follow-up after 3 months were lower than before treatment and the differences were statistically significant(P<0.01).There was no statistically significant difference between the TCM syndrome scores of the TCM group after follow-up after 3 months and 12 weeks of treatment(P>0.05).Conclusion Scalp acupuncture,traditional Chinese medicine and acupuncture combined treatment can effectively improve the abnormal tics and TCM syndromes children with TS.The treatment effect is durable and can grow over time.The effects of the three methods are equivalent.