桑叶钩藤汤配合耳穴贴压治疗儿童抽动障碍的疗效观察

Observation on Therapeutic Effect of Sangye Gouteng Decoction Combined with Auricular Point Seed-pressing Therapy on Tic Disorder in Children

【目的】观察桑叶钩藤汤配合耳穴贴压治疗抽动障碍(TD)患儿的临床疗效。【方法】将60例TD患儿随机分为观察组和对照组,每组各30例。观察组给予桑叶钩藤汤配合耳穴贴压治疗,对照组给予盐酸硫必利片治疗,4周为1个疗程,共治疗3个疗程。观察2组患儿治疗前后中医症候评分、耶鲁综合抽动严重程度量表(YGTSS)评分和各项抽动症状评分(包括抽动的次数、频率、强度、复杂性及对正常行为的干扰等)的变化情况,并评价2组临床疗效和安全性。【结果】(1)治疗3个疗程后,观察组的总有效率为96.7%(29/30),对照组为83.3%(25/30),观察组的疗效明显优于对照组,差异有统计学意义(P <0.05)。(2)治疗后各观察时点,2组患儿的中医主症评分和次症评分均较治疗前降低(P<0.05),且观察组的降低幅度均大于对照组(P<0.05)。(3)治疗后各观察时点,2组患儿的YGTSS评分均较治疗前明显降低(P<0.05),其中观察组表现为逐渐降低趋势,而对照组表现为先降低后升高趋势;组间比较,治疗1个疗程后,观察组的YGTSS评分高于对照组(P<0.05),但治疗2~3个疗程后,观察组的YGTSS评分均低于对照组(P<0.05)。(4)治疗3个疗程后,2组患儿的抽动次数、频率、强度、复杂性和对正常行为的干扰等各项抽动症状评分均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.05)。(5)治疗过程中,对照组有3例患儿出现嗜睡、头晕等不适,观察组均未见不良反应情况发生。【结论】桑叶钩藤汤配合耳穴贴压治疗TD患儿疗效确切,其疗效优于盐酸硫必利片。

Objective To observe the curative effect of Sangye Gouteng Decoction combined with auricular point seed-pressing therapy on tic disorder(TD)in children. Methods Sixty TD children were randomly divided into observation group(n = 30)and control group(n = 30). The observation group was treated with Sangye Gouteng Decoction combined with auricular point seed-pressing therapy,and the control group was treated with Tiapride Hydrochloride Tablets. Four weeks constituted one course of treatment, and the two groups were treated for 3 courses. Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,the scores of the Yale global tic severity scale(YGTSS),and the scores of tic symptoms such as the times of tic,the frequency of tic,the intensity of tic,the complexity of the tic,and the influence of tic on the normal behavior in the two groups were observed. After treatment, the clinical efficacy and safety of the two groups were also evaluated.Results(1)After treatment for 3 courses,the total effective rate in the observation group was 96.7%(29/30),and that in the control group was 83.3%(25/30). The intergroup comparison showed that the difference between the two groups was statistically significant(P < 0.05).(2)The scores of primary and secondary TCM symptoms in the two groups at various time points after treatment were lower than those before treatment(P<0.05), and the decrease degree in the observation group was superior to that in the control group(P < 0.05).(3)At various time points after treatment,the YGTSS scores in the two groups were lower than those before treatment(P<0.05),and the scores showed a gradually decreasing trend in the observation group and showed a decreasing trend firstly and then an increasing trend in the control group. The intergroup comparison showed that the YGTSS scores of the observation group after treatment for one course were higher than those of the control group(P < 0.05),while after treatment for 2-3 courses,the YGTSS scores of the observation group were lower than those of the control group(P < 0.05).(4)After treatment for 3 courses, the scores of the tic symptoms such as the times of tic, the frequency of tic,the intensity of tic,the complexity of the tic,and the influence of tic on the normal behavior in the two groups were much improved in comparison with those before treatment(P<0.05),and the improvement in the observation group was superior to that in the control group(P < 0.05).(5)During the period of treatment,3 cases from the control group had the discomforts of somnolence and vertigo,while there was no adverse reaction occurring in the observation group. Conclusion Sangye Gouteng Decoction combined with auricular point seedpressing therapy exerts certain therapeutic effect for the treatment of tic disorder(TD)in children,and its effect is stronger than that of Tiapride Hydrochloride Tablets.