On the treatment of Tourette's syndrome in children from the perspective of "reconciling Shaoyang"

Tourette's syndrome is a syndrome characterized by involuntary,recurrent and aimless muscle motor twitching or vocal twitching in one or more locations,which seriously affects the learning and life of children and their families.Professor The author believes that the key to the pathogenesis of children with tourette's syndrome is"the disadvantageous of cardinal Shaoyang,viscera imbalance of Yin and Yang",proposed from the"reconciling Shaoyang"to treat the disease,and use of radix bupleuri class formula add and subtract cleaning the Shaoyang heat,harmonize the Yin and Yang of the viscera,and dredge the Qi mechanism,so as to achieve the effect of"equilibrium between Yin and yang,spirit is the treatment".With daily care,the clinical effect is better.

Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.

Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children

BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology of TS remains incompletely understood.Recent studies suggest that inflammation may play a role in the severity and progression of TS,pointing to the potential influence of dietary and lifestyle factors on the condition.Currently,research on the specific connection between dietary inflammatory index(DII)and TS is still in its early stages,requir-ing additional clinical and epidemiological studies to validate the strength and specific mechanisms of this connection.METHODS A total of 207 children diagnosed with TS in the pediatric department of Qingdao Chengyang People’s Hospital from January 2022 to January 2023 were selected.They were divided into stable and unstable groups based on follow-up condi-tions.Before enrollment,general information of the children[age,gender,body mass index(BMI),guardian’s education level,DII score,medical history,family history,academic stress,electronic device usage,medication,and disease progression]was assessed,and serum inflammatory levels were measured during follow-up visits.DII scores and Yale Global Tic Severity Scale(YGTSS)scores were calculated.Furthermore,based on YGTSS scores,the children were classified into mild,moderate,and severe groups.The DII,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)levels in each group were compared.RESULTS Follow-up surveys were completed by 207 children and their guardians.Among them,117 children were in the stable group,and 90 were in the recurrent group.We found no statistically significant differences in age,gender,comorbidities,BMI,and disease duration between the two groups(P>0.05).However,academic stress,electronic device usage,medication,guardian’s education level,and DII scores showed statistically significant differences between the groups(P<0.05).Multifactorial regression analysis revealed that guardian’s anxiety level,DII score,medication,academic stress,and family history were statistically significant factors(P<0.05)affecting the recurrence of TS in children.Therefore,anxiety level,DII score,medication status,electronic device usage,and academic stress were identified as factors influencing the recurrence of TS in children.Among them,DII score,academic stress,and family history had odds ratios(OR)greater than 1,indicating risk factors,whereas medication status and guardian’s education level had OR values less than 1,indicating protective factors.According to the YGTSS scores,children were categorized into mild,moderate,and severe groups.Comparative analysis of DII and inflammatory levels in children with different degrees of tic disorders revealed that the severe group had the highest DII and inflammatory levels,followed by the moderate group,and the mild group had the lowest levels.The trend of TS progression was consistent with the DII results.Receiver operating characteristic curves were plotted to predict disease progression in patients with TS via inflammatory markers.The areas under the curve for IL-6,CRP,and TNF-αwere 0.894(95%CI:0.817-0.969),0.793(95%CI:0.694-0.893),and 0.728(95%CI:0.614-0.843)respectively,with statistically significant differences(P<0.05).According to the Youden index,the optimal cutoff values were IL-6=3.775 ng/L(sensitivity 68.1%and specificity 68.4%),CRP=6.650 mg/L(sensitivity 60.6%and specificity 68.4%),and TNF-α=0.666(sensitivity 60.6%and specificity 71.1%).CONCLUSION We found a certain correlation between DII and the severity,recurrence,and inflammatory levels of TS in children.Reasonable reduction in the intake of pro-inflammatory foods may be beneficial in reducing the risk of disease progression in children with TS.

利培酮治疗抽动秽语综合征25例

目的 了解利培酮治疗抽动秽语综合征 (Tourettesyndrome,TS)的临床疗效 .方法 对 2 5例 TS患者应用利培酮治疗 ,其中 2 0例完成了该项试验 ,在治疗前及治疗 4wk后进行耶鲁综合抽动严重程度量表 (YGTSS)评分 ,用减分率来评估治疗效果 .结果 治疗后 YGTSS的总的运动抽动分数 ,总的发声抽动分数 ,全部损伤率及总的严重程度分数均小于治疗前 ,经检验有统计学意义 ,将资料进行相关回归分析发现减分率同总的运动抽动分数及总的严重程度分数的变化相关更大 ,标准回归系数分别为 0 .5 39,0 .5 13(P<0 .0 1) ,而与总的发声抽动分数及全部损伤率的变化关系不明显 (P >0 .0 5 ) .结论 利培酮治疗 TS症状明显改善 ,疗效肯定 。

利培酮治疗Tourette综合征临床研究

目的 :探讨利培酮治疗 Tourette综合征 ( TS)的疗效及安全范围。 方法 :采用耶鲁TS症状严重程度量表和不良反应症状量表进行评定 ,并作实验室监测 ,对 3 7例 TS患者进行 8周的利培酮治疗研究。 结果 :64 .9%的病人疗效显著 ,86.5%症状改善。平均显效时间 ( 2 8.0± 1 1 .7)天 ,有效日剂量为 ( 2 .5± 0 .8) mg,副反应少而轻微。 结论 :利培酮有望成为治疗 TS的良好药物。

Review of the effects of SARS-CoV2 infection and COVID-19 on common pediatric psychiatric illnesses

Severe acute respiratory syndrome coronavirus-2 is a novel coronavirus strain that causes pneumonia and acute respiratory distress syndrome along with other morbidities,collectively known as coronavirus disease 2019(COVID-19)disease.There has been widespread discussion about the psychological impact of COVID-19 particularly on children and adolescents.There have been overarching negative effects with regards to decreased physical activity,more screen time,increasingly unhealthy diets,and irregularities in sleep/wake schedules.This,coupled with disruptions in ongoing mental health treatment and associated support structures,has caused unprecedented declines in the emotional and psychosocial wellbeing of children and adolescents.This review aims to systematically review the literature to provide a general overview of the ways in which COVID-19 has affected common psychiatric illnesses in children and adolescents.The included articles in all subsections concluded that symptoms of these common childhood psychiatric disorders have generally been exacerbated by the COVID-19 pandemic.This review indicates that quarantine and the consequent isolation have had multiple significant and consistent negative implications on the mental health of children and adolescents.Our study indicates that there should be increased vigilance among providers and families to mitigate the negative psychological effects that the COVID-19 pandemic has on children with common childhood psychiatric disorders.