健脾止动汤对多发性抽动症血清脑源性神经营养因子含量的影响及疗效观察
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摘要
目的:观察中药健脾止动汤治疗多发性抽动症(TS)脾虚肝亢证的临床疗效,及其对TS患儿血清脑源性神经营养因子(BDNF)含量的影响。方法:选取56例符合TS中西医诊断标准的患儿作为观察组,同期就诊的30例健康儿童作为对照组,采用酶联免疫吸附法(ELISA)分别检测其血清BDNF水平。观察组予健脾止动汤配方颗粒口服治疗12周,对其中临床数据完整的48例TS患儿,于疗后再次检测其血清BDNF含量。结果:观察组TS患儿临床疗效达91.7%,运动性及发声性抽动积分均显著下降。观察组患儿血清BDNF水平明显低于对照组,差异具有显著统计学意义(P<0.01),经治疗后观察组血清BDNF水平较治疗前升高,差异具有统计学意义(P<0.01)。结论:健脾止动汤可改善TS患儿的抽动症状,其抗抽动作用可能与提高患儿血清BDNF含量相关。
Objective:To investigate the clinical efficacy of JianpiZhidong Decoction(JPZDD) and its influence on the expression of brain-derived neurotrophic factor(BDNF). Methods:Fifty-six cases of TS children with spleen deficiency and liver excessive syndrome were given JPZDD for treatment(treatment group) and thirty healthy children were randomly recruited as control group.ELISA was used to measure the serum BDNF level in all the cases.After 12 weeks
Objective:To investigate the clinical efficacy of JianpiZhidong Decoction(JPZDD) and its influence on the expression of brain-derived neurotrophic factor(BDNF). Methods:Fifty-six cases of TS children with spleen deficiency and liver excessive syndrome were given JPZDD for treatment(treatment group) and thirty healthy children were randomly recruited as control group.ELISA was used to measure the serum BDNF level in all the cases.After 12 weeks
引文
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[6] Dickel DE, Veenstra-Vanderweele J, Bivens NC, et al. Association studies of serotonin system candidate genes in early-onset obsessive-compulsive disorder [J]. Biological psychiatry, 2007, 61(3): 322-329.
[7] 程宇航, 何凡, 江红卫, 等. Tourette’s综合征患者血清脑源性神经营养因子表达水平对照研究 [J]. 精神医学杂志, 2010, 23(4): 248-249.
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[9] 张爱启, 田执梁, 计玲玲, 等. 抽动障碍患儿血清脑源性神经营养因子及微量元素锌水平检测及临床意义 [J]. 现代生物医学进展, 2009, 9(17): 3275-3276,3284.
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[17] Liu Y, Tao L, Fu X, et al. BDNF protects retinal neurons from hyperglycemia through the TrkB/ERK/MAPK pathway [J]. Molecular medicine reports, 2013, 7(6): 1773-1778.
[18] Numakawa T, Adachi N, Richards M, et al. Brain-derived neurotrophic factor and glucocorticoids: reciprocal influence on the central nervous system [J]. Neuroscience, 2013, 239:157-172.
[19] Freeman RD, Fast DK, Burd L, et al. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries [J]. Developmental medicine and child neurology, 2000, 42(7): 436-447.
[20] 刘智胜. Tourette综合征共患病的诊治进展 [J]. 中国儿童保健杂志, 2010, 18(2): 94-95,99.
[21] 陈自佳, 王素梅. 健脾止动汤治疗儿童脾虚肝亢型多发性抽动症的安全性评价 [J]. 北京中医药, 2016, 35(7): 681-683.
[22] 韦芳芳, 曾常青, 赵宇红, 等. 钩藤神经保护机制的研究进展 [J]. 中国中药杂志, 2014, 39(14): 2603-2607.
[23] 于文静, 白雪, 张雯, 等. 健脾止动汤对多发性抽动症患儿神经递质的影响 [J]. 中华中医药杂志, 2015, 30(5): 1757-1761.
[24] 张雯, 于文静, 王道涵, 等. 健脾止动汤对TS模型大鼠抗抽动效应及脑内兴奋性氨基酸递质的影响[J]. 中华中医药杂志, 2014, 29(5): 1653-1656.
[25] 张雯, 崔霞, 于文静, 等. “阴阳平衡”与多发性抽动症氨基酸类神经递质调控的相关性 [J]. 中华中医药学刊, 2015, 33(2): 275-277.
[2] Hallett M. Tourette Syndrome: Update [J]. Brain & development, 2015, 37(7): 651-655.
[3] Hirschtritt ME, Lee PC, Pauls DL, et al. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome [J]. JAMA psychiatry, 2015, 72(4): 325-333.
[4] Zheng W, Li XB, Xiang YQ, et al. Aripiprazole for Tourette’s syndrome: a systematic review and meta-analysis [J]. Human psychopharmacology, 2016, 31(1): 11-18.
[5] Nijs J, Meeus M, Versijpt J, et al. Brain-derived neurotrophic factor as a driving force behind neuroplasticity in neuropathic and central sensitization pain: a new therapeutic target? [J]. Expert opinion on therapeutic targets, 2015, 19(4): 565-576.
[6] Dickel DE, Veenstra-Vanderweele J, Bivens NC, et al. Association studies of serotonin system candidate genes in early-onset obsessive-compulsive disorder [J]. Biological psychiatry, 2007, 61(3): 322-329.
[7] 程宇航, 何凡, 江红卫, 等. Tourette’s综合征患者血清脑源性神经营养因子表达水平对照研究 [J]. 精神医学杂志, 2010, 23(4): 248-249.
[8] 何凡, 郑毅, 程宇航, 等. Tourette综合征疗效与血清脑源性神经营养因子表达水平相关性对照研究 [J]. 精神医学杂志, 2014, 27(4): 248-250.
[9] 张爱启, 田执梁, 计玲玲, 等. 抽动障碍患儿血清脑源性神经营养因子及微量元素锌水平检测及临床意义 [J]. 现代生物医学进展, 2009, 9(17): 3275-3276,3284.
[10] Association AP. DSM-V [M]. St. Louis, 2013.
[11] Du Y-s, Li H-f, Vance A, et al. Randomized double-blind multicentre placebo-controlled clinical trial of the clonidine adhesive patch for the treatment of tic disorders [J]. Australian & New Zealand Journal of Psychiatry, 2008, 42(9): 807-813.
[12] Nomura Y. Tourette Syndrome: Clinical Features and Pathophysiology[J]. Brain and nerve, 2017, 69(12): 1373-1385.
[13] Robertson MM. A personal 35 year perspective on Gilles de la Tourette syndrome: prevalence, phenomenology, comorbidities, and coexistent psychopathologies [J]. The lancet Psychiatry, 2015, 2(1): 68-87.
[14] Yang C, Zhang L, Zhu P, et al. The prevalence of tic disorders for children in China: A systematic review and meta-analysis [J]. Medicine, 2016, 95(30): e4354.
[15] Ribases M, Gratacos M, Armengol L, et al. Met66 in the brain-derived neurotrophic factor (BDNF) precursor is associated with anorexia nervosa restrictive type [J]. Molecular psychiatry, 2003, 8(8): 745-751.
[16] Karege F, Schwald M, Cisse M. Postnatal developmental profile of brain-derived neurotrophic factor in rat brain and platelets [J]. Neuroscience letters, 2002, 328(3): 261-264.
[17] Liu Y, Tao L, Fu X, et al. BDNF protects retinal neurons from hyperglycemia through the TrkB/ERK/MAPK pathway [J]. Molecular medicine reports, 2013, 7(6): 1773-1778.
[18] Numakawa T, Adachi N, Richards M, et al. Brain-derived neurotrophic factor and glucocorticoids: reciprocal influence on the central nervous system [J]. Neuroscience, 2013, 239:157-172.
[19] Freeman RD, Fast DK, Burd L, et al. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries [J]. Developmental medicine and child neurology, 2000, 42(7): 436-447.
[20] 刘智胜. Tourette综合征共患病的诊治进展 [J]. 中国儿童保健杂志, 2010, 18(2): 94-95,99.
[21] 陈自佳, 王素梅. 健脾止动汤治疗儿童脾虚肝亢型多发性抽动症的安全性评价 [J]. 北京中医药, 2016, 35(7): 681-683.
[22] 韦芳芳, 曾常青, 赵宇红, 等. 钩藤神经保护机制的研究进展 [J]. 中国中药杂志, 2014, 39(14): 2603-2607.
[23] 于文静, 白雪, 张雯, 等. 健脾止动汤对多发性抽动症患儿神经递质的影响 [J]. 中华中医药杂志, 2015, 30(5): 1757-1761.
[24] 张雯, 于文静, 王道涵, 等. 健脾止动汤对TS模型大鼠抗抽动效应及脑内兴奋性氨基酸递质的影响[J]. 中华中医药杂志, 2014, 29(5): 1653-1656.
[25] 张雯, 崔霞, 于文静, 等. “阴阳平衡”与多发性抽动症氨基酸类神经递质调控的相关性 [J]. 中华中医药学刊, 2015, 33(2): 275-277.