六经辨证论治孤独症谱系障碍刻板动作的临床疗效观察

Clinical effect of six-meridian syndrome differentiation in the treatment of stereotypy of autistic spectrum disorder

目的:探讨六经辨证治疗孤独症谱系障碍刻板动作的临床疗效。方法:选取2019年6月~2020年10月期间梧州市中医医院收治的120例孤独症谱系障碍患者,根据随机数字表法将其分为观察组和对照组各60例,将观察组患儿按年龄段分为学龄前组(0~6周岁)及学龄组(6~12周岁),其中学龄前组50例,学龄组10例,将观察组患儿根据证型分别采用娇芽方类方、来复汤类方、理中汤类方及厥阴阳明同治方类方进行治疗,对照组患儿采用常规治疗方式,比较治疗后患儿临床疗效,治疗前后儿童孤独症评量表(CARS)、发育商(DQ)评分,临床症状指标改善情况及发展状况变化情况。结果:学龄前组患儿的总有效率80.00%及学龄组患儿的总有效率66.00%显著大于对照组患儿的42.86%;治疗后学龄组患儿的CARS及DQ评分显著优于学龄前组和对照组;治疗后学龄前组及学龄组患儿的眼神交流、想象游戏、刻板动作、语言常态、语言理解、认知能力、社交能力及理解能力方面的改善显著优于对照组。结论:基于六经辨证的治疗方法可有效改善孤独症谱系障碍患儿刻板动作的重复,治疗效果较显著。

Objective To explore the clinical effect of six-meridian syndrome differentiation in the treatment of stereotypy of autistic spectrum disorder(ASD).Methods A total of 120 ASD patients who were admitted to Wuzhou Hospital of Traditional Chinese Medicine from June 2019 to October 2020 were enrolled and divided into observation group and control group according to random number table method,60 cases in each group.According to different age groups,children in observation group were divided into preschool group(18 cases,0~6 years old)and school-age group(24 cases,6~12 years old).According to different syndromes,children in observation group were treated with Jiaoya associated prescription,Laifu Decoction associated prescription,Lizhong Decoction associated prescription and Jueyin Yangming associated prescription.The children in control group were treated with routine treatments.The clinical curative effect after treatment,changes in scores of child autism rating scale(CARS)and developmental quotient(DQ),improvement and development status of clinical symptoms indexes before and after treatment were compared.Results The total response rate in preschool group and school-age group was significantly higher than that in control group(80.00%,66.00%vs 42.86%).After treatment,CARS and DQ scores in school-age group were significantly better than those in control group,which were significantly better in preschool group than control group.After treatment,improvement of eye contact,imagination game,stereotyped movements,language normality,language understanding,cognitive ability,sociability and comprehension ability in preschool group and school-age group was significantly better than that in control group.Conclusion The treatment method based on six-meridian syndrome differentiation can effectively improve the repetition of stereotypy in ASD children,with very significant curative effect.