小儿抽动症证候分布及用药规律文献研究

A study on syndrome distribution and medication rules of Tourette’s syndrome in children

目的:总结小儿抽动症的临床证型、中医证候分布特点及用药情况,为中医药治疗小儿抽动症提供临床思路,进一步提高中医的临床疗效。方法:通过检索2000年1月-2020年11月中国四大全文期刊数据库:中国知网、万方数据资源核心期刊、重庆维普全文期刊数据库、中国生物医学文献服务系统中关于小儿抽动症的数字化全文期刊,筛选出符合纳入要求的文献,建立小儿抽动症的文献数据库,对其不同证型间的用药、中医证候分布进行频数统计分析。结果:小儿抽动症的常用药有白芍、钩藤、僵蚕、茯苓、天麻、全蝎等,四气以平、温、寒为主,五味以甘、苦、辛、咸、酸为要,主要归肝、肺、脾经,中医证候分布在前五位的是脾虚肝旺、肝风内动、阴虚动风、气郁化火、痰热扰神。结论:小儿抽动症用药组方明显核心化,以息风止痉、平抑肝阳为主,兼以清热解毒,尤以天麻钩藤饮为主;中医证候分布以虚证为主。

Objective:To summarize the clinical syndrome type,syndrome distribution characteristics and medication rules of Tourette’s syndrome in children,so as to provide more clinical ideas for treating Tourette’s syndrome in children in TCM and further improve clinical efficacy of TCM.Methods:The literature that met the inclusion criteria from January 2000 to November 2020 in four major full-text journal databases in China,namely CNKI,Wanfang database,VIP,and SinoMed,was retrieved and selected to built a database of Tourette’s syndrome in children.The medication frequency of different syndrome types,and TCM syndrome distribution were statistically analyzed.Results:The commonly used medicines for Tourette’s syndrome in children included Baishao(paeonia lactiflora),Gouteng(uncaria),Jiangchan(silkworm),Fuling(poria cocos),Tianma(gastrodia elata)and Quanxie(scorpion),etc..The medicinal properties were mainly mild,warm,and coldness.The medicinal flavors were mainly sweet,bitter,spicy,salty,and sour.The active ingredient of the medicines mainly flowed into the liver meridian,lung meridian and spleen meridian.The top five TCM syndromes were the spleen deficiency and liver flourishing type,the liver wind movement type,the Yin(阴)deficiency and wind movement type,the Qi(气)stasis and fire type,and the phlegm-heat disturbance type.Conclusion:There are obviously core medicines in the prescriptions for Tourette’s syndrome in children,which mainly focus on calming wind and relieving spasms,and calming liver Yang(阳),supplemented by medicines for clearing heat and detoxifying,especially the Tianma Gouteng Yin(天麻钩藤饮).The distribution of TCM syndromes is mainly deficiency syndrome.