安神定志汤治疗儿童多发性抽动症的疗效观察
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摘要
【目的】探析在"恢复中轴圆运动"思想指导下的安神定志汤治疗儿童多发性抽动症的临床疗效。【方法】将60例多发性抽动症患儿随机分为治疗组和对照组,每组各30例。对照组给予静灵口服液治疗,治疗组给予安神定志汤加减治疗,连续治疗6周并随访半年。观察2组患儿治疗前后耶鲁综合抽动严重程度量表评分(包括抽动频率、抽动次数和抽动强度评分)的变化情况和治疗组患儿血清微量元素的变化情况,评价2组治疗后疗效和随访疗效。【结果】(1)治疗6周后,治疗组的总有效率为96.67%,明显高于对照组的66.56%,差异有统计学意义(P<0.05)。(2)治疗后,2组患儿耶鲁综合抽动严重程度量表各维度评分均较治疗前下降(P<0.05),且治疗组对各维度评分的降低作用均优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,治疗组患儿血铅含量下降,血锌、铁含量升高,差异均有统计学意义(P<0.05或P<0.01)。(4)共有48例有效病例获得随访,治疗组的复发率为7.1%,明显低于对照组的25.0%,差异有统计学意义(P<0.05)。【结论】在"恢复中轴圆运动"思想指导下的安神定志汤治疗儿童多发性抽动症有较好的疗效。
Objective To explore the clinical effect of Anshen Dingzhi Decoction prescribed according to restoringcentral-axis Qi circular movement for the treatment of Tourette's syndrome in children. Methods A total of 60 cases of children with Tourette's syndrome were randomly divided into treatment group(30 cases)and controlgroup(30 cases). The control group was treated with Jingling Oral Liquid,and the treatment group was treatedwith Anshen Dingzhi Decoction orally. The treatment lasted for 6 continuous weeks and a follow-up for half a yearwas carried out. Before and after treatment, the scores of the frequency, times, and severity of tics wereevaluated with Yale Global Tic Severity Scale(YGTSS),and the serum contents of trace elements were detected.The clinical efficacy of the two groups was evaluated after treatment and after the follow-up. Results(1)The totaleffective rate of the treatment group(96.67%)was higher than that of the control group(66.56%),the differencebeing significant(P<0.05).(2)After treatment, the scores of the frequency, times, and severity of ticsevaluated with YGTSS in the two groups were decreased(P<0.05 compared with those before treatment),and thedecrease in the treatment group was superior to that in the control group(P<0.05).(3)After treatment, thecontents of serum lead in the treatment group were lower while the levels of zinc and ferritin were higher than thosebefore treatment, the differences being significant(P<0.05 or P<0.01).(4)The results of follow-up for 48 cases showed that the recurrence rate in the treatment group was 7.1%, lower than that in the control group(25.0%),and the difference was signficiant(P<0.05). Conclusion Anshen Dingzhi Decoction prescribed accordingto restoring central-axis Qi circular movement is effective for the treatment of Tourette's syndrome in children.
Objective To explore the clinical effect of Anshen Dingzhi Decoction prescribed according to restoringcentral-axis Qi circular movement for the treatment of Tourette's syndrome in children. Methods A total of 60 cases of children with Tourette's syndrome were randomly divided into treatment group(30 cases)and controlgroup(30 cases). The control group was treated with Jingling Oral Liquid,and the treatment group was treatedwith Anshen Dingzhi Decoction orally. The treatment lasted for 6 continuous weeks and a follow-up for half a yearwas carried out. Before and after treatment, the scores of the frequency, times, and severity of tics wereevaluated with Yale Global Tic Severity Scale(YGTSS),and the serum contents of trace elements were detected.The clinical efficacy of the two groups was evaluated after treatment and after the follow-up. Results(1)The totaleffective rate of the treatment group(96.67%)was higher than that of the control group(66.56%),the differencebeing significant(P<0.05).(2)After treatment, the scores of the frequency, times, and severity of ticsevaluated with YGTSS in the two groups were decreased(P<0.05 compared with those before treatment),and thedecrease in the treatment group was superior to that in the control group(P<0.05).(3)After treatment, thecontents of serum lead in the treatment group were lower while the levels of zinc and ferritin were higher than thosebefore treatment, the differences being significant(P<0.05 or P<0.01).(4)The results of follow-up for 48 cases showed that the recurrence rate in the treatment group was 7.1%, lower than that in the control group(25.0%),and the difference was signficiant(P<0.05). Conclusion Anshen Dingzhi Decoction prescribed accordingto restoring central-axis Qi circular movement is effective for the treatment of Tourette's syndrome in children.
引文
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[14]董崇娟,李永辉,王永强,等.抽动障碍患儿血铅及微量元素含量的变化[J].心理医生,2015,21(21):35.
[15]宋爱华,马翠荣,王英淑.微量元素与中医药的关系[J].微量元素与健康研究,2010,27(5):69.
[16]马融,魏小维,李亚萍,等.益肾填精法治疗儿童多动症及其神经生化机制研究[J].天津中医药,2007,24(4):309.
[17]綦秀贞,门忠友,刘淑芬.小儿多发性抽动症与全血微量元素的相关性研究[J].中国优生与遗传杂志,2010,18(11):129.
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[22]宋厚盼,李茹柳,王一寓,等.白术提取物对IEC-6细胞迁移过程多胺信号通路钙离子调控的影响[J].中华中医药杂志,2014,29(5):1361.
[23]刘本娟,曹宝萍,吴民耀.葛根素对中枢神经系统神经细胞保护作用的研究进展[J].生命科学,2009,21(1):131.
[24]李晓康,王泓午,于春泉,等.名医取象推论麦芽疏肝功效的思考[J].天津中医药,2013,30(1):11.
[25]唐洪梅,李锐,周莉玲.石菖蒲对中枢神经系统作用研究进展[J].广州中医药大学学报,2000,17(2):181.
[2]美国精神医学会.精神障碍诊断与统计手册[M].5版.北京:北京大学出版社,2016:253-256.
[3]中华中医药学会.中医儿科常见病诊疗指南[M].北京:中国中医药出版社,2012.
[4]江育仁,张奇文,俞景茂,等.实用中医儿科学[J].上海:上海科学技术出版社,2005.
[5]钟佑泉,吴惧,谢晓丽,等.耶鲁抽动症整体严重度量表对抽动障碍患儿的临床评估[J].中国实用儿科杂志,2006,21(3):214.
[6]钟佑泉,陶宣华,吴惧,等.耶鲁抽动症整体严重度量表在儿科临床的初步应用[J].四川医学,2000,21(2):110.
[7]刘映玲.小儿安神补脑颗粒剂治疗儿童抽动症的临床研究[D].广州:广州中医药大学,2008.
[8]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实用版)[J].中华实用儿科临床杂志,2017,32(15):1137.
[9]中华医学会儿科学分会神经学组.儿童抽动障碍的诊断与治疗建议[J].中华儿科杂志,2013,51(1):72.
[10]牟文凤,宋金莲,丁伟.注意缺陷多动障碍儿童体内铅、锌、铁含量的检测分析[J].中国儿童保健杂志,2013,21(1):106.
[11]Chimienti F,Aouffen M,Favier A,et al.Zinc Homeostasisregulating proteins:new drug targets for triggering cell fate[J].Curr Drug Targets,2003,4(4):323.
[12]Ronchetti R,Van den Hazel P,Schoeters G,et al.Lead neurotoxicity in children:is prenatal exposure more important than postnatal exposure[J].Acta Paediatr Suppl,2006,95(453):45.
[13]陈文,林广裕,吴毅.多发性抽动症患儿血清铁的变化比较分析[J].中国组织工程研究,2005,9(15):252.
[14]董崇娟,李永辉,王永强,等.抽动障碍患儿血铅及微量元素含量的变化[J].心理医生,2015,21(21):35.
[15]宋爱华,马翠荣,王英淑.微量元素与中医药的关系[J].微量元素与健康研究,2010,27(5):69.
[16]马融,魏小维,李亚萍,等.益肾填精法治疗儿童多动症及其神经生化机制研究[J].天津中医药,2007,24(4):309.
[17]綦秀贞,门忠友,刘淑芬.小儿多发性抽动症与全血微量元素的相关性研究[J].中国优生与遗传杂志,2010,18(11):129.
[18]段玲玲,张骠.小儿多发性抽动症中枢神经生化介质研究进展[J].江西中医药,2008,39(11):78.
[19]汪受传.中医儿科学[M].北京:中国中医药出版社,2004.
[20]彭子益.圆运动的古中医学[M].北京:中国中医药出版社,2007.
[21]李伟,文红梅,崔小兵,等.白术健脾有效成分研究[J].南京中医药大学学报,2006,22(6):366.
[22]宋厚盼,李茹柳,王一寓,等.白术提取物对IEC-6细胞迁移过程多胺信号通路钙离子调控的影响[J].中华中医药杂志,2014,29(5):1361.
[23]刘本娟,曹宝萍,吴民耀.葛根素对中枢神经系统神经细胞保护作用的研究进展[J].生命科学,2009,21(1):131.
[24]李晓康,王泓午,于春泉,等.名医取象推论麦芽疏肝功效的思考[J].天津中医药,2013,30(1):11.
[25]唐洪梅,李锐,周莉玲.石菖蒲对中枢神经系统作用研究进展[J].广州中医药大学学报,2000,17(2):181.