针刺联合氟哌啶醇治疗小儿抽动秽语综合征35例临床观察
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摘要
目的观察针刺联合氟哌啶醇治疗小儿抽动秽语综合征的临床疗效。方法选取2015年9月至2017年9月我院儿科收治的70例抽动秽语综合征患儿,采用随机数字表法分为对照组和治疗组,各35例。对照组口服氟哌啶醇治疗,治疗组在对照组治疗方法的基础上采用穴位针刺治疗,8周后统计2组的临床疗效。结果治疗前2组运动性抽动和发声性抽动耶鲁综合抽动严重程度量表(YGTSS)评分比较,差异无统计学意义(P>0.05),具有可比性。治疗8周后,2组运动性抽动和发声性抽动YGTSS评分均较同组治疗前显著下降(P<0.01),且治疗组下降更明显(P<0.05)。对照组总有效率为71.43%,治疗组为94.29%,2组比较,差异有统计学意义(P<0.05)。治疗前2组血浆多巴胺(DA)、5-羟色胺(5-HT)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组血浆DA、5-HT水平均显著下降,与同组治疗前比较,差异有统计学意义(P<0.01),且治疗组下降更明显(P<0.05)。结论针刺联合氟哌啶醇治疗小儿抽动秽语综合征临床疗效显著,可有效改善患儿运动性抽动和发声性抽动YGTSS评分以及DA、5-HT水平,值得临床推广应用。
Objective To observe the clinical efficacy of acupuncture combined with haloperidol in the treatment of children with Gilles de la Tourette syndrome.Methods Seventy cases with Gilles de la Tourette syndrome treated in pediatrics department in our hospital from September 2015 to September 2017 were chosen and randomly divided into control group and treatment group according to the random number table,with 35 cases in each.The control group was given oral haloperidol,the treatment group was given acupoint acupuncture therapy on the basis of the control group.The clinical efficacy of the 2 groups were kept by statistics after treatment for 8 weeks.Results There was no significant difference in YGTSS scores of motor tics and vocal tics between the two groups before treatment(P>0.05),and they were comparable.After treatment for 8 weeks, YGTSS scores of motor tics and vocal tics in both groups were significantly lower than those in the same group before treatment(P<0.01),moreover,the decrease in the treatment group was more significant(P<0.05).The total effective rate of the control group was 71.43%,that of the treatment group was 94.29%,the difference was statistically significant between the two groups(P<0.05).Before treatment,the difference was not statistically significant in the plasma levels of dopamine(DA) and 5-HT between the two groups(P>0.05),and they were comparable;after treatment,the plasma levels of DA and 5-HT in the two groups both significantly decreased,the difference was statistically significant compared with the same group before treatment(P<0.01),moreover,the treatment group decreased more significantly(P<0.05).Conclusion The acupuncture combined with haloperidol in the treatment of children with Gilles de la Tourette syndrome has marked clinical efficacy,and it can effectively improve the YGTSS scores of motor tics and vocal tics,the levels of DA and 5-HT,which is worthy of clinical promotion.
Objective To observe the clinical efficacy of acupuncture combined with haloperidol in the treatment of children with Gilles de la Tourette syndrome.Methods Seventy cases with Gilles de la Tourette syndrome treated in pediatrics department in our hospital from September 2015 to September 2017 were chosen and randomly divided into control group and treatment group according to the random number table,with 35 cases in each.The control group was given oral haloperidol,the treatment group was given acupoint acupuncture therapy on the basis of the control group.The clinical efficacy of the 2 groups were kept by statistics after treatment for 8 weeks.Results There was no significant difference in YGTSS scores of motor tics and vocal tics between the two groups before treatment(P>0.05),and they were comparable.After treatment for 8 weeks, YGTSS scores of motor tics and vocal tics in both groups were significantly lower than those in the same group before treatment(P<0.01),moreover,the decrease in the treatment group was more significant(P<0.05).The total effective rate of the control group was 71.43%,that of the treatment group was 94.29%,the difference was statistically significant between the two groups(P<0.05).Before treatment,the difference was not statistically significant in the plasma levels of dopamine(DA) and 5-HT between the two groups(P>0.05),and they were comparable;after treatment,the plasma levels of DA and 5-HT in the two groups both significantly decreased,the difference was statistically significant compared with the same group before treatment(P<0.01),moreover,the treatment group decreased more significantly(P<0.05).Conclusion The acupuncture combined with haloperidol in the treatment of children with Gilles de la Tourette syndrome has marked clinical efficacy,and it can effectively improve the YGTSS scores of motor tics and vocal tics,the levels of DA and 5-HT,which is worthy of clinical promotion.
引文
[1]孔莹, 徐海鹏, 高伟,等. 头针结合药物治疗抽动秽语综合征临床观察[J].针灸临床杂志,2017,33(11):20-24.
[2]陈果, 向娟, 欧阳里知,等.“聪脑通络针法”联合中药治疗小儿抽动秽语综合征36例[J]. 中国针灸,2016,36(11):1169-1170.
[3]American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. Arlington, VA: American Psychiatric Publishing,2013: 936.
[4]Storch E A, Murphy T K, Geffken G R, et al. Reliability and validity of the Yale Global Tic Severity Scale[J]. Psychological Assessment, 2005, 17(4):486-91.
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[6]李双, 孙少馨, 李媛媛,等. 埋针结合中药治疗小儿多发性抽动症30例临床观察[J]. 世界中西医结合杂志,2017,12(10):1422-1424.
[7]冯碧红,王辉杰.宁动颗粒联合氟哌啶醇对抽动秽语综合征患儿的治疗效果及细胞免疫功能的影响[J].中国生化药物杂志,2017,37(3):107-109.
[8]覃超峰,罗本华.头针为主治疗小儿脑瘫的临床研究概况[J].中医儿科杂志, 2017,12(1):79-83.
[2]陈果, 向娟, 欧阳里知,等.“聪脑通络针法”联合中药治疗小儿抽动秽语综合征36例[J]. 中国针灸,2016,36(11):1169-1170.
[3]American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. Arlington, VA: American Psychiatric Publishing,2013: 936.
[4]Storch E A, Murphy T K, Geffken G R, et al. Reliability and validity of the Yale Global Tic Severity Scale[J]. Psychological Assessment, 2005, 17(4):486-91.
[5]中华医学会儿科学分会神经学组.儿童抽动障碍诊断与治疗专家共识(2017版)[J].中华实用儿科临床杂志,2017,32(15):1137-1140.
[6]李双, 孙少馨, 李媛媛,等. 埋针结合中药治疗小儿多发性抽动症30例临床观察[J]. 世界中西医结合杂志,2017,12(10):1422-1424.
[7]冯碧红,王辉杰.宁动颗粒联合氟哌啶醇对抽动秽语综合征患儿的治疗效果及细胞免疫功能的影响[J].中国生化药物杂志,2017,37(3):107-109.
[8]覃超峰,罗本华.头针为主治疗小儿脑瘫的临床研究概况[J].中医儿科杂志, 2017,12(1):79-83.