静心制动方治疗抽动障碍疗效观察及与神经递质的相关研究

发布时间：2018-03-14 14:27

本文选题：抽动障碍　切入点：静心制动方　出处：《北京中医药大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究目的本课题通过静心制动随症加减治疗抽动障碍的临床观察,比较治疗前后症状变化,并通过对抽动障碍患儿血清神经递质多巴胺(DA)、5-羟色胺(5-HT)、P物质(SP)及一氧化氮(N0)检测,比较中医治疗前后浓度变化,探讨抽动障碍与神经递质的关系,静心制动方治疗抽动障碍疗效,以及静心制动方对于神经递质的作用。研究方法及内容本课题采用病例前后对照研究方法,临床采用静心制动结合随证加减方法,疗程为半年,观察中药治疗前后患儿抽动症状变化,用耶鲁综合抽动严重程度量表进行症状评分及严重程度评定,使用评分减分率评定疗效；使用酶联ELISA化学发光法,对抽动障碍患者血清多巴胺(DA)、5-羟色胺(5-HT)P物质(SP)及一氧化氮(N0)进行检测,观察治疗前后的变化。研究结果最终入选病例18例,男孩15例,女孩3例,男孩明显多于女孩；患儿年龄为6～18岁,平均年龄(11.34-3.1)岁,病程1～7年,平均病程为(3.0+1.9)年,患儿年龄,病程差异无统计学意义(P0.05)。疗效评定,显效9例,好转9例,无效0例,有效率100%；疗前轻度病例0例,中度病例13例,重度病例5例,治疗后轻度病例13例,中度病例5例,重度病例0例,而且治疗后耶鲁评分较疗前显著减少,具有统计学意义(P0.01)；中药治疗后血清多巴胺与疗前相比明显下降,其差异具有统计学意义(P0.05)；疗后血清5-HT、SP、NO与疗前相比,其差异无统计学意义(P0.05) 结论静心制动方治疗前后血清DA浓度有明显差异,抽动患儿可能存在神经递质失衡,但5-HT、NO及SP与抽动障碍的相关性需进一步研究。静心制动方治疗抽动障碍总有效率为100%,疗效显著。静心制动方治疗抽动障碍的作用机制可能与调节血清神经递质浓度有关。
[Abstract]:Research purpose. In this study, we compared the changes of symptoms before and after the treatment of dysphoria by the clinical observation of the addition and subtraction of cardiac immobilization with syndrome, and detected the serum neurotransmitter dopamine (dopamine), 5-hydroxytryptamine (5-HT), substance P (SPN) and nitric oxide (N _ 0) in children with dysphoria, and compared the changes of symptoms before and after treatment. To compare the change of concentration before and after TCM treatment, to explore the relationship between twitch disorder and neurotransmitter, the curative effect of Jingxinjiaofang on tic disorder, and the effect of Jingxinshuifang on neurotransmitter. Research methods and contents. In this paper, we used the method of case control study, the clinical use of static braking combined with syndrome plus or minus method, the course of treatment is half a year, observe the changes of children's tic symptoms before and after treatment with traditional Chinese medicine. The symptoms and severity were evaluated with the Yale Comprehensive tic severity scale, the efficacy was evaluated by the score reduction rate, and the enzyme linked ELISA chemiluminescence method was used. In order to observe the changes before and after treatment, the serum levels of serotonin 5 HT P (SP) and nitric oxide (N 0) were measured in patients with tic disorder. Research results. 18 cases were selected, 15 boys and 3 girls, the age of the children was 6 years old, mean age was 11.34-3.1) years, the course of disease was 1 ~ 7 years, the average course of disease was 3.01.9 years, the age of the children was 3.01.9 years. There was no significant difference in course of disease (P 0.05). There were 9 cases of marked effect, 9 cases of improvement, 0 cases of ineffective, 100 cases of effective rate, 0 cases of mild, 13 cases of moderate, 5 cases of severe, 13 cases of mild and 5 cases of moderate before treatment. There were 0 severe cases, and the Yale score after treatment was significantly lower than that before treatment, which had statistical significance (P 0.01), the serum dopamine level was significantly decreased after treatment with Chinese medicine, the difference was statistically significant (P 0.05), and the serum 5-HTP SPN no after treatment was significantly lower than that before treatment. The difference was not statistically significant (P0.05). Conclusion. There was significant difference in serum DA concentration before and after treatment with Jingxinjiaofang, and there might be neurotransmitter imbalance in children with twitch, but the correlation between 5-HTN no and SP and tic disorder needed to be further studied. The total effective rate of Jingxinjiaofang in the treatment of tic disorders is 100 and the curative effect is remarkable. The mechanism of Jingxinjiaofang in treating tic disorders may be related to regulating the concentration of serum neurotransmitters.
【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】：2013
【分类号】：R272

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