家庭沙盘游戏联合托吡酯治疗儿童难治性多发性抽动症的临床分析
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摘要
目的分析家庭沙盘游戏联合托吡酯治疗儿童难治性多发性抽动症的临床价值。方法选取2017年1-12月汕头市妇幼保健院收治的100例规律应用氟哌啶醇治疗后效果不明显的难治性多发性抽动症患儿为研究对象,随机分为观察组和对照组,每组各50例。观察组采用家庭沙盘游戏联合托吡酯联合治疗,托吡酯剂量0. 5～1. 0 mg/kg开始,每周递增0. 5 mg/kg,最大剂量4 mg·kg-1·d-1;对照组采用托吡酯单独治疗。观察比较治疗前后两组难治性多发性抽动症患儿YGTSS评分变化情况,并分析对氟哌啶醇的依赖情况。结果治疗前,两组患儿运动抽动分数、发声抽动分数比较,差异均无统计学意义(均P>0. 05);治疗后,观察组患儿运动抽动分数、发声抽动分数及下降幅度均明显优于对照组,差异均有统计意义(均P<0. 05)。观察组患儿对药物的依赖情况显著低于对照组,差异有统计意义(P<0. 05)。结论家庭沙盘游戏联合托吡酯可有效治疗难治性多发性抽动症,不良反应较轻。
Objective To analyze the clinical value of family Sandplay combined with topiramate in the treatment of intractable tic disorder in children. Methods From January 2017 to December 2017,100 children with intractable Tourette's disease who were treated with haloperidol regularly in Shantou Maternal and Child Health Hospital were randomly divided into observation group and control group,50 cases in each group. The observation group was treated with family Sandplay combined with topiramate. The dosage of topiramate was 0. 5 ～1. 0 mg/kg,increasing by 0. 5 mg/kg per week,and the maximum dosage was 4 mg·kg~(-1)·d~(-1). The control group was treated with topiramate alone. The changes of YGTSS score in two groups of children with refractory Tourette syndrome before and after treatment were observed,and the situation of haloperidol was analyzed. Results Before treatment,there was no significant difference in motor and vocal tic scores between the two groups( P>0. 05); after treatment,the motor and vocal tic scores of the observation group were significantly better than those of the control group,with statistical significance( P< 0. 05). The dependence of the observation group on the drug was significantly lower than that of the control group,and the difference was statistically significant( P<0. 05). Conclusion Family Sandplay combined with topiramate can effectively treat refractory Tourette's disease with mild adverse reactions.
Objective To analyze the clinical value of family Sandplay combined with topiramate in the treatment of intractable tic disorder in children. Methods From January 2017 to December 2017,100 children with intractable Tourette's disease who were treated with haloperidol regularly in Shantou Maternal and Child Health Hospital were randomly divided into observation group and control group,50 cases in each group. The observation group was treated with family Sandplay combined with topiramate. The dosage of topiramate was 0. 5 ～1. 0 mg/kg,increasing by 0. 5 mg/kg per week,and the maximum dosage was 4 mg·kg~(-1)·d~(-1). The control group was treated with topiramate alone. The changes of YGTSS score in two groups of children with refractory Tourette syndrome before and after treatment were observed,and the situation of haloperidol was analyzed. Results Before treatment,there was no significant difference in motor and vocal tic scores between the two groups( P>0. 05); after treatment,the motor and vocal tic scores of the observation group were significantly better than those of the control group,with statistical significance( P< 0. 05). The dependence of the observation group on the drug was significantly lower than that of the control group,and the difference was statistically significant( P<0. 05). Conclusion Family Sandplay combined with topiramate can effectively treat refractory Tourette's disease with mild adverse reactions.
引文
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[16]侯海,罗超,陈中豪.谷氨酸脱氢酶与几种肿瘤的关系[J].生物工程学报,2019,35(3):389-395.
[2]吴开力,李坤珂.重视过敏性结膜炎的诊断与治疗[J].中华实验眼科杂志,2018,36(9):661-665.
[3]王叶新,成媛媛,董继承.阿立哌唑致锥体外系症状[J].药物不良反应杂志,2018,20(3):235-236.
[4]廖海蓉,黄钢,章小雷.家庭沙盘游戏疗法的应用及展望[J].心理医生,2017,23(3):275-276.
[5]李雯,魏东.托吡酯对酸敏感离子通道1a调控作用的研究[J].中风与神经疾病杂志,2018,35(2):107-110.
[6]左启华.小儿神经系统疾病[M].第2版,北京:人民卫生出版社,2005:936-941.
[7]赵欢欢.风湿性舞蹈病的中西医治疗进展[J].风湿病与关节炎,2015,4(4):72-73.
[8]张静,张月华.进行性肌阵挛癫痫研究进展[J].广东医学,2018,56(4):316-319.
[9]李皓平.对小儿习惯性抽搐的临床治疗体会[J].广东医学杂志,1985,6(9):35-36.
[10]安平,鲁伯埙.亨廷顿舞蹈症研究现状[J].中国细胞生物学学报,2018,40(10):1621-1632.
[11]汪丽静,汪群,龚庆辉,等.小舞蹈症临床40例治疗体会[J].中国现代药物应用,2013,7(4):47-48.
[12]荣晓婷,何璇,李树茂,等.肝豆状核变性案[J].中国针灸,2019,26(1):39-43.
[13]雷蕾,张真真,夏江燕,等.中枢神经递质紊乱与术后认知功能损伤[J].临床麻醉学杂志,2017,33(2):199-201.
[14]王欣,张璞,张勋.嘌呤代谢异常与听力损失[J].中华耳科学杂志,2015,13(4):754-756.
[15]沙从波,喻绪恩,张亮亮.抗γ-氨基丁酸B型受体脑炎1例报告[J].第二军医大学学报,2019,40(1):115-116.
[16]侯海,罗超,陈中豪.谷氨酸脱氢酶与几种肿瘤的关系[J].生物工程学报,2019,35(3):389-395.