张氏头针治疗儿童多发性抽动症的随机对照临床研究

Randomized Controlled Clinical Study of Zhang’s Scalp Acupuncture in the Treatment of Children with Multiple Tics

目的观察张氏头针治疗儿童多发性抽动症的临床疗效。方法2019年3月至2020年12月共招募多发性抽动症儿童60例,随机分为头针组和硫必利组,每组各30例。头针组采用毫针针刺双侧运动区、舞蹈震颤控制区及百会、印堂,每周治疗3次,1个月为1个疗程,共治疗4个疗程;硫必利组给予盐酸硫必利片50-100 mg/次,2次/天,1个月为1个疗程,共治疗4个疗程。比较两组患者治疗前后耶鲁综合抽动严重程度量表(Yale global Tic severity scale,YGTSS)、中医证候积分、SF-36健康调查简表(the MOS item short from health survey,SF-36)及临床疗效评价结果。结果头针组合硫必利组组内比较:二组的YGTSS评分、中医证候积分与治疗前相比具有显著统计学差异(P<0.05),SF-36评分中头针组在生理功能、生理职能、总体健康、情感职能、心理健康等5个维度的评分高于治疗前,差异有统计学意义(P<0.05);硫必利组在生理功能、生理职能、总体健康、心理健康等5个维度的评分高于治疗前,差异有统计学意义(P<0.05);头针组合硫必利组组间比较:头针组治疗后YGTSS评分、中医证候积分均低于硫必利组,差异有统计学意义(P<0.05),头针组在SF-36量表中总体健康和心理健康2个维度照优于硫必利组,差异有统计学意义(P<0.05);治疗结束3个月随访,头针组YGTSS评分、中医证候积分均低于硫必利组,差异有统计学意义(P<0.05)。结论张氏头针能够很好的改善多发性抽动症的临床症状,提高其生活质量。

Objective To observe the clinical effect of Zhang’s scalp acupuncture in the treatment of children with Multiple Tics.Method A total of 60 children with Multiple Tics were recruited from March 2019 to December 2020 and divided into scalp acupuncture group and tiapride hydrochloride group by RCT, with 30 cases in each group. The scalp acupuncture group received acupuncture in bilateral motor area, dance tremor control area, Baihui(DU20) and Yintang(EX-HN3), three times a week, one month as a course of treatment, and a total of 4 courses of treatment. Tiapride hydrochloride group was given tiapride hydrochloride tablets 50 – 100 mg/time, twice a day, 1 month as a course of treatment, a total of 4 courses of treatment. The YGTSS, TCM syndrome scores, SF-36 and clinical efficacy evaluation results were used to compare the two groups before and after treatment.Results Comparison of scalp acupuncture and tiapride hydrochloride group: Compared with before treatment, the YGTSS scores and TCM syndrome scores of the two groups showed significant differences(P<0.05). In SF-36 score, the scores of physiological function, physiological function, general health, emotional function and mental health of the scalp acupuncture group were higher than those of before treatment, and the differences were significant(P<0.05). The scores of physiological function, physiological function, general health and mental health in tiapride hydrochloride group were higher than those before treatment, and the difference were significant(P<0.05). Comparison between the them: after treatment, the YGTSS scores and TCM syndrome scores of the scalp acupuncture were lower than those of the tiapride hydrochloride, and the differences were significant(P<0.05). The overall health and mental health of the SF-36 scale in the scalp acupuncture group were better than those of the tiapride hydrochloride group, and the differences were significant(P<0.05). After 3 months of followup, the YGTSS scores and TCM syndrome scores of the scalp acupuncture group were lower than those of the tiapride hydrochloride group, with significance differences(P<0.05).Conclusion Zhang’s scalp acupuncture can improve the clinical symptoms of T Multiple Tics and improve the quality of life.