阿立哌唑联合低频重复经颅磁刺激治疗儿童抽动障碍临床研究

Clinical Study of Aripiprazole Combined with Low-frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Tic Disorders in Children

目的探讨在儿童抽动障碍治疗中联合应用阿立哌唑和低频重复经颅磁刺激的临床治疗效果。方法随机选择2019年10月—2021年4月在国药北方医院治疗的80例患有抽动障碍儿童纳入本次研究,并将其按照治疗方案的不同分成观察组(n=40)与对照组(n=40),观察组患儿采用阿立哌唑和低频重复经颅磁刺激联合治疗,对照组患儿采用单一的阿立哌唑治疗。评估比对两组患儿治疗前后的抽动严重程度、自我意识、生活质量评分、临床治疗有效率及不良反应发生情况。结果治疗前和治疗2周两组患儿的抽动严重程度评分对比,差异无统计学意义(P>0.05),观察组治疗4周评分(30.58±14.87)分、治疗8周评分(21.35±12.45)分明显优于对照组患儿的(38.26±15.73)分、(29.06±14.32)分,差异有统计学意义(P<0.05);治疗前两组患儿自我意识及生活质量评分对比,差异无统计学意义(P>0.05),治疗后观察组患儿自我意识评分(70.21±5.73)分明显高于对照组患儿(61.46±5.25)分,生活质量评分(73.18±5.88)分则明显低于对照组患儿(84.12±6.44)分,差异有统计学意义(P<0.05);治疗2、4周两组患儿的临床治疗有效率对比,差异无统计学意义(P>0.05),治疗8周观察组患儿的临床治疗有效率82.5%明显优于对照组患儿临床治疗有效率62.5%,差异有统计学意义(χ^(2)=4.013,P<0.05);治疗2、4周两组患儿的不良反应评分对比,差异无统计学意义(P>0.05),治疗后8周观察组患儿的不良反应评分(2.02±1.60)分明显优于对照组的(2.87±1.75)分,差异有统计学意义(t=-2.267,P<0.05)。结论阿立哌唑联合低频重复经颅磁刺激治疗儿童抽动障碍较单一阿立哌唑疗效更佳,联合治疗对儿童抽动障碍症状改善效果更好,且能明显提升患儿自我意识及生活质量,治疗时的不良反应风险更低。

Objective To explore the clinical therapeutic effect of the combined application of aripiprazole and low frequency repetitive transcranial magnetic stimulation in the treatment of children with tic disorders.Methods Eighty cases of children suffering from tic disorders treated in Sinopharm North Hospital from October 2019 to April 2021 were randomly selected for inclusion in this study,and they were divided into the observation group(n=40)and the control group(n=40)according to the difference of treatment programs.Children in the observation group were treated with the combination of aripiprazole and low-frequency repetitive transcranial magnetic stimulation,while children in the control group were treated with aripiprazole alone.The severity of tics,self-consciousness,quality of life scores,clinical efficacy and adverse reactions of the two groups before and after treatment were assessed.Results There was no statistically significant difference between the tic severity scores of the two groups before treatment and at 2 weeks of treatment(P>0.05),and the scores of the observation group at 4 weeks of treatment(30.58±14.87)points and 8 weeks of treatment(21.35±12.45)points were significantly better than(38.26±15.73)points and(29.06±14.32)pointsthe of the children of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in self-awareness and quality of life scores between the two groups before treatment(P>0.05),but after treatment,the self-awareness score of the children in the observation group(70.21±5.73)points was significantly higher than(61.46±5.25)points of the children in the control group,and the quality of life score(73.18±5.88)points was significantly lower than that of the children in the control group(84.12±6.44)points,and the difference was statistically significant(P<0.05).There was no statistically significant difference in clinical treatment efficiency between the two groups at 2 weeks and 4 weeks after treatment(P>0.05).At 8 weeks after treatment,the clinical treatment efficiency rate of children in the observation group was 82.5%,which was significantly better than that of children in the control group 62.5%,and the difference was statistically significant(χ^(2)=4.013,P<0.05).There was no statistically significant difference in the adverse reaction scores of the children in the two groups at 2 weeks and 4 weeks after treatment(P<0.05),and the adverse reaction scores of the children in the observation group at 8 weeks after treatment(2.02±1.60)points were significantly better than those of the children in the control group(2.87±1.75)points,and the difference was statistically significant(t=-2.267,P<0.05).Conclusion Aripiprazole combined with low-frequency repetitive transcranial magnetic stimulation is more effective than single aripiprazole in the treatment of tic disorders in children,and the combined treatment has a better effect on the improvement of the symptoms of tic disorders in children,and it can significantly improve the children's self-awareness and quality of life,and the risk of adverse reactions is lower during the treatment.