针刺联合安神止抽颗粒治疗心肝火旺型小儿多发性抽动障碍的疗效观察及对神经递质和神经功能的影响

Efficacy observation of acupuncture plus An Shen Zhi Chou Ke Li for multiple tic disorders of fire hyperactivity of the heart and liver pattern in children and its effects on neurotransmitters and nerve function

目的观察针刺联合安神止抽颗粒治疗心肝火旺型小儿多发性抽动障碍的临床疗效及对患者神经递质和神经功能的影响。方法将118例心肝火旺型小儿多发性抽动障碍患者随机分为A组(59例)和B组(59例)。A组予针刺联合安神止抽颗粒治疗,B组予口服盐酸硫必利片治疗。比较两组临床疗效,观察两组治疗前后耶鲁综合抽动严重程度量表(Yale global tic severity scale,YGTSS)评分和美国脊髓损伤协会(American Spinal Injury Association,ASIA)神经功能评分的变化,比较两组治疗前后外周血中神经递质含量的变化。比较两组不良反应发生情况。采用随机行走模型评价两组患者的神经递质以及神经功能。结果A组总有效率高于B组(P<0.05)。A组治疗后YGTSS中运动性抽动评分、发声性抽动评分、病情严重程度评分以及中医次症评分均低于B组(P<0.05),ASIA神经功能评分中的感觉评分和运动评分均高于B组(P<0.05)。A组治疗后外周血多巴胺和去甲肾上腺素水平均高于B组(P<0.05),5-羟色胺、高香草酸、谷氨酸和天冬氨酸水平均低于B组(P<0.05)。随机行走模型评价,A组神经递质和神经功能改善情况优于B组。A组不良反应发生率低于B组(P<0.05)。结论针刺联合安神止抽颗粒能有效缓解心肝火旺型小儿多发性抽动障碍患者的运动性抽动和发声性抽动症状,改善神经递质含量和神经功能,疗效优于口服盐酸硫必利片且不良反应发生率更低。

Objective To observe the clinical efficacy of acupuncture plus An Shen Zhi Chou Ke Li for multiple tic disorders of fire hyperactivity of the heart and liver pattern in children and its effect on neurotransmitters and nerve function.Method One hundred and eighteen children with multiple tic disorders of fire hyperactivity of the heart and liver pattern were randomized to group A(59 cases)and group B(59 cases).Group A received acupuncture plus oral administration of An Shen Zhi Chou Ke Li and group B received oral administration of Tiapride hydrochloride tablets.The Yale global tic severity scale(YGTSS)scores and the American Spinal Injury Association(ASIA)nerve function scores were recorded in the two groups before and after treatment.The incidences of adverse events were compared between the two groups.Neurotransmitters and nerve function were assessed using the random walk model in the two groups of patients.Result The total efficacy rate was higher in group A than in group B(P<0.05).After treatment,the YGTSS motor tic score,vocal tic score and severity score,and the TCM secondary symptom score were lower(P<0.05)and the ASIA motor score and sensory score were higher(P<0.05)in group A than in group B.After treatment,peripheral blood dopamine and noradrenaline levels were higher(P<0.05)and 5-hydroxytryptamine,homovanillic acid,glutamic acid and aspartic acid levels were lower(P<0.05)in group A than in group B.Assessment using the random walk model showed that neurotransmitters and nerve function improved more in group A than in group B.The incidence of adverse events was lower in group A than in group B(P<0.05).Conclusion Acupuncture plus An Shen Zhi Chou Ke Li can effectively relieve motor tics and vocal tics and improve a neurotransmitter content and nerve function in children with multiple tic disorders of fire hyperactivity of the heart and liver pattern.It has a better therapeutic effect than oral Tiapride hydrochloride tablets with a lower incidence of adverse events.