针药结合治疗儿童抽动障碍气郁化火证30例临床观察

Clinical observation on 30 cases of tourette syndrome with qi stagnation transforming into fire in children treated by combination of acupuncture and medicine

目的观察针药结合治疗儿童抽动障碍气郁化火证的临床疗效。方法将60例抽动障碍气郁化火证患儿采用随机数字表法分为对照组和治疗组,各30例。对照组给予氟哌啶醇口服;治疗组在对照组治疗方法的基础上给予针刺(主穴取神庭、四神聪、百会、风池)治疗,配穴根据临床症状加减。2组均治疗4个月后比较2组的临床疗效以及治疗前后耶鲁抽动症程度量表(YGTSS)评分,血清多巴胺(DA)、5-羟色胺(5-HT)水平。结果治疗后2组YGTSS评分,血清DA、5-HT水平均明显降低,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.05或P<0.01);治疗组总有效率为93.33%(28/30),对照组为73.33%(22/30),2组比较差异有统计学意义(P<0.05)。结论针药结合治疗儿童抽动障碍气郁化火证临床疗效显著,可明显改善临床症状,其作用机制可能与降低血清DA、5-HT水平有关。

Objective To observe the clinical effect of acupuncture combined with medicine in the treatment of tourette syndrome with qi stagnation transforming into fire in children.Methods 60 children with tourette syndrome of qi stagnation ransforming into fire were divided into control group and treatment group with 30 cases in each group by random number table method.The control group was given haloperidol orally;the treatment group,on the basis of the treatment method of the control group,was given acupuncture[taking Shenting(DU24),Sishencong(EX-HN1),Baihui(DU20),Fengchi(GB20)as the main acupoints]treatment,and the matching points were modified according to the clinical symptoms.Both groups were treated for 4 months.The clinical efficacy,Yale Toutic Severity Scale(YGTSS)score,serum dopamine(DA)and 5-hydroxytryptamine(5-HT)levels before and after treatment were compared between the two groups.Results After treatment,YGTSS score,serum DA and 5-HT le-vels were significantly decreased in 2 groups,and the difference was statistically significant compared with that before treatment(P<0.01),and the decrease was more obvious in treatment group,and the difference was statistically significant compared with control group(P<0.05 or P<0.01).The total effective rate was 93.33%(28/30)in the treatment group and 73.33%(22/30)in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion The combination of acupuncture and medicine in the treatment of qi stagnation transforming into fire syndrome in children with tourette syndrome has significant clinical effect and can significantly improve clinical symptoms,the mechanism of which may be related to the reduction of serum DA and 5-HT levels.