钩藤汤加减辅助治疗小儿抽动障碍脾虚肝旺证31例临床观察

Clinical observation on 31 cases of tic disorders in children with spleen deficiency and liver exuberance syndrome treated by modified Gouteng Tang(钩藤汤)as adjuvant therapy

目的观察钩藤汤加减辅助治疗小儿抽动障碍(TD)脾虚肝旺证的临床疗效。方法选取2018年1月至2019年12月郸城县人民医院儿科就诊的TD脾虚肝旺证患儿62例,采用随机数字表法分为对照组和治疗组,各31例。2组均接受心理治疗,对照组在此基础上予以氟哌啶醇治疗,治疗组在对照组治疗方法的基础上联合钩藤汤治疗,均治疗6周。比较2组的临床疗效,并于治疗前、后采用耶鲁综合抽动严重程度量表(YGTSS)评分评价患儿的疾病严重程度。结果治疗组总有效率为90.32%(28/31),显著高于对照组的67.74%(21/31),2组比较,差异有统计学意义(P<0.05)。治疗前,2组抽动类型、抽动频度、抽动强度、复杂程度及干扰程度评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述评分较同组治疗前均显著下降(P<0.05),且治疗组下降更显著,差异有统计学意义(P<0.05)。结论钩藤汤加减辅助治疗小儿TD脾虚肝旺证临床疗效满意,可有效改善患儿抽动症状,值得临床推广应用。

Objective To observe the clinical efficacy of modified Gouteng Tang(钩藤汤)in adjuvant treatment of tic disorders(TD)in children with spleen deficiency and liver exuberance syndrome.Methods From January 2018 to December 2019,62 cases of TD with spleen deficiency and liver exuberance syndrome consulted in pediatrics department in The People’s Hospital in Dancheng County were divided into control group and treatment group according to random number table method,with 31 cases in each group.Both groups received psychotherapy,on this basis,the control group was given holoperidol,while the treatment group was combined with Gouteng Tang based on the therapeutic method of the control group,both were treated for 6 weeks.The clinical efficacy of the two groups was compared.Before and after treatment,the disease severity was assessed by the Yale global tic severity scale(YGTSS)score.Results The total effective rate of the treatment group was 90.32%(28/31),which was significantly higher than 67.74%(21/31)of the control group,and the difference between the 2 groups was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in tic type,tic frequency,tic intensity,complexity and disturbance degree between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned scores in both groups significantly decreased compared with those in the same group before treatment(P<0.05),moreover,the decrease in the treatment group was more significant,and the difference was statistically significant(P<0.05).Conclusion It has satisfactory clinical effect,and can effectively improve the tic symptoms of children to use modified Gouteng Tang in adjuvant treatment of TD in children with spleen deficiency and liver exuberance syndrome,which is worthy of clinical promotion and application.