清心平肝法针刺治疗儿童多发性抽动障碍31例临床观察

Clinical observation on 31 cases of children with multiple tic disorders treated by acupuncture of clearing heart and soothing liver manipulation

目的观察清心平肝法针刺治疗儿童多发性抽动障碍的临床疗效。方法选取2016年1月至2020年11月舟山市妇女儿童医院中医针推科门诊治疗的多发性抽动障碍患儿62例,采用随机数字表法分为治疗组与对照组,各31例。对照组予盐酸硫必利片口服,治疗组在对照组治疗方法的基础上予清心平肝法针刺治疗,2组均以10 d为1个疗程,连续治疗3个疗程后统计临床疗效。结果治疗组总有效率为93.55%(29/31),显著优于对照组的70.97%(22/31),2组比较,差异有统计学意义(P<0.05)。治疗前2组的发声性抽动评分、运动性抽动评分及耶鲁综合抽动严重程度量表(YGTSS)总分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组的上述评分均较同组治疗前明显降低(P<0.05),且治疗组降低更显著,差异均有统计学意义(P<0.05)。治疗前2组的中医证候积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组的中医证候积分均较同组治疗前显著降低(P<0.05),且治疗组降低更显著,差异均有统计学意义(P<0.05)。治疗组的不良反应发生率为3.23%(1/31),显著低于对照组的25.81%(8/31),2组比较,差异有统计学意义(P<0.05)。结论清心平肝法针刺治疗儿童多发性抽动障碍疗效显著,可明显改善临床症状,且安全性高,值得临床推广应用。

Objective To observe the clinical efficacy of acupuncture of clearing heart and soothing liver manipulation for children with multiple tic disorders.Methods From January 2016 to November 2020,62 cases of children with multiple tic disorders treated in department of TCM acupuncture and tuina of Zhoushan Women and Children’s Hospital were divided into treatment group and control group according to random number table method,with 31 cases in each group.The control group was given oral administration of tiapride hydrochloride tablets,on this basis,the treatment group was given acupuncture of clearing heart and soothing liver manipulation.Ten days constituted 1 course of treatment for both groups and the clinical efficacy was assessed after consecutive 3 courses of treatment.Results The total effective rate of the treatment group was 93.55%(29/31),which was significantly superior to 70.97%(22/31)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the differences were not statistically significant in vocal tic score,motor tic sore and Yale Global Tic Severity Scale(YGTSS)total score between the 2 groups(P>0.05),indicating comparability.After treatment,the above-mentioned scores of the 2 groups all significantly decreased as compared with the same group before treatment(P<0.05),moreover,the decrease was more significant in the treatment group,and the difference was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in TCM symptom score between the 2 groups(P>0.05),indicating comparability.After treatment,TCM symptom score of the 2groups significantly decreased as compared with the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the treatment group was 3.23%(1/31),which was statistically significant lower than 25.81%(8/31)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Conclusion It has marked efficacy,can markedly alleviate the clinical symptoms with high safety to apply acupuncture of clearing heart and soothing liver manipulation for children with multiple tic disorders,which deserves clinical promotion and application.