静心止动方治疗抽动障碍及其对血清IgE的影响分析

发布时间：2018-03-10 12:52

本文选题：抽动障碍　切入点：血清总IgE　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:抽动障碍(tic disorders,TD),是一种在儿童期发病、慢性的精神心理疾病,目前本病的病因病机尚不明确,临床诊断缺乏特异性指标,治疗方面也缺乏相关统一明确的方案。在免疫相关的研究中还缺乏统一性,需要进一步的研究。TD患儿中有50.8%的在抽动发病、反复或加重前有反复上呼吸道感染、慢性鼻炎、咽炎等病史,这与血清总IgE介导的Ⅰ型变态反应类似。目前对于血清IgE的研究较少,而且血清IgE与TD的相关性的结论也各不相同。因此我们在本次研究中,希望通过测定血清总IgE的水平及其用药前后的变化来研究TD与过敏反应的相关性,同时也通过静心止动方治疗TD患儿前后的对照研究,探讨此方治疗TD中可能存在的变态反应的相关机理。方法:通过对2015年10月-2016年10月期间前来广安门医院就诊的患儿严格按照纳排标准入组要求筛选、剔除,在经家长患儿同意并签署知情同意后,分别纳入TD组和阳性对照组。TD组经过静心止动方治疗3个月,并采用YGTSS评分对其治疗前后进行病情严重程度评估,同时运用减分率评价治疗的疗效;实验室指标通过测定TD组治疗前、后与阳性对照组进行比较分析。结果:本次研究TD组一共纳入142例,其中男性115人,女性27人,男女比例4.26:1,年龄最小3岁,最大15岁,平均年龄(8.04±2.69)岁。TD患儿经治疗后根据减分率结果显示:显效46例(32.39%),有效63例(44.37%),效果不明显33例(23.24%),总有效109例(76.76%)。TD患儿的血清总IgE总阳性率为35.21%,TD患儿的血清总IgE水平与阳性对照组相比差异较大。治疗后的TD患儿血清总IgE水平较治疗前略有降低,具有显著差异,其中男性患儿治疗前后血清总IgE水平变化具有显著差异。TD的严重程度与血清总IgE的水平无关。实验组春季、夏季、秋季血清总IgE水平均有显著差异,对照组无明显差异。本次入组TD患儿治疗前后部分患儿尿常规轻微异常,肝肾功能均未见异常。结论:(1)静心止动方治疗TD的疗效显著。(2)不能完全否定TD与过敏反应的相关性。(3)TD可能与血清总IgE水平的变化相关。(4)TD的严重程度与血清总IgE的水平不具有相关性。(5)TD患儿的血清总IgE水平变化可能受季节影响。
[Abstract]:Objective: TDs is a chronic mental and psychological disorder in childhood. At present, the etiology and pathogenesis of TDs are not clear, and the clinical diagnosis is lack of specific indexes. There is also a lack of unified and definite treatment programs. In immune-related studies, there is still a lack of uniformity. 50.8% of children with TD need further study. 50.8% of children with TD have recurrent upper respiratory tract infections, chronic rhinitis before recurrence or aggravation. The history of pharyngitis is similar to the type I allergy mediated by total serum IgE. There are few studies on serum IgE and different conclusions on the correlation between serum IgE and TD. We hope to study the correlation between TD and allergic reaction by measuring the level of serum total IgE and the changes before and after treatment. At the same time, we also hope to study the control study before and after the treatment of children with TD by Jing Xin Zhi Fang. To explore the mechanism of this prescription in the treatment of possible allergy in TD. Methods: by screening and eliminating the children who came to Guanganmen Hospital from October 2015 to October 2016 according to the standard of Nanodrainage strictly. After the parents agreed and signed the informed consent, they were included in the TD group and the positive control group. The TD group was treated with Jing Xin Zhi Fang for 3 months, and the severity of the disease was evaluated by YGTSS score before and after treatment. At the same time, the efficacy of the treatment was evaluated by using the score reduction rate, and the laboratory indexes were compared with the positive control group before and after the treatment. Results: 142 cases were included in the TD group, including 115 males and 27 females. The ratio of men to women is 4.26: 1, aged as young as 3 and up to 15, The average age of children was 8.04 卤2.69 years old. According to the score reduction rate after treatment, the results showed that 46 cases had marked effect (32.39%), 63 cases had significant effect (44.37%), 33 cases had no obvious effect and 33 cases had no significant effect. The total positive rate of serum total IgE in patients with total effective 109 cases was 35.21 T and the total IgE positive rate was 35.21%. The serum total IgE level of children with TD after treatment was slightly lower than that before treatment. There were significant differences in serum total IgE level before and after treatment. The severity of TD was not related to the serum total IgE level. There were significant differences in the serum total IgE levels in the experimental group in spring, summer and autumn. There was no significant difference in the control group. Before and after treatment, some of the children with TD had slight abnormal urine routine. Conclusion the therapeutic effect of Jingxinzhuo recipe on TD is significant. 2) it can not completely deny the correlation between TD and allergic reaction. Td may be related to the change of serum total IgE level. The severity of TCD is related to the total IgE in serum. The level of serum total IgE may be affected by seasons.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

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