CBIT联合泰必利治疗儿童抽动障碍的临床疗效研究
发布时间：2018-10-23 20:46
【摘要】：目的:抽动障碍(Tic Disorder,TD)常伴发心理和行为问题,药物治疗有其自身的局限性。综合行为干预疗法(Comprehensive Behavioral Interventions for Tics,CBIT)作为一种心理治疗方法有其独特的优势,在国际专业领域已经被认可,而在国内还没有临床应用的研究报道。本研究旨在探索CBIT联合泰必利治疗TD的有效性,找到一种更优化的治疗方案。方法:以符合美国《精神疾病诊断与统计手册》第5版(Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V)中TD诊断标准的31例8~13岁的TD儿童为研究对象,随机分为研究组(CBIT联合泰必利治疗)10例,对照组(单独使用泰必利治疗)21例。观察治疗效果共4个月,在治疗开始前、治疗1月、2月和4月4个时间点应用“耶鲁综合抽动严重程度量表(Yale Global Tic Severity Scale,YGTSS)”和“临床疗效总评量表(Clinical Global Impression,CGI)”分别进行评分和疗效比较。使用SPSS17.0软件包建立数据库并进行统计分析。数据处理计数资料采用X~2检验,计量资料采用t检验,等级资料的比较采用秩和检验。两组整体比较时采用两因素重复测量数据方差分析,组间比较时采用成组t检验,组内比较时采用重复测量数据多重比较配对的t检验,即Bonferroni法,以α=0.05为检验水准。结果:治疗1月后,两组运动抽动得分的差异有统计学意义(P0.05),治疗2月和4月后功能受损得分的差异有统计学意义(P0.05),其中治疗2月后的差异有显著的统计学意义(P0.01)。其余各时间点各因子得分的组间比较,差异均无统计学意义(P0.05)。两组内部3个因子得分在治疗4个月后与治疗前相比,除研究组发声抽动得分外,差异均有统计学意义(P0.008),在治疗2月后与治疗1月后相比,差异均无统计学意义(P0.008)。两组间治疗前与治疗后各个时间点CGI-S、CGI-I的比较,差异均无统计学意义(P0.05)。两组内治疗前与治疗后各时间点CGI-S的比较,差异均有统计学意义(P0.05)。两组均未出现严重的不良反应。结论:CBIT联合泰必利治疗TD与单独使用泰必利比较,不仅能更好地减少运动抽动和发声抽动症状,而且可以更有效地缓解患儿的功能受损。
[Abstract]:Objective: tic disorder (Tic Disorder,TD) is often associated with psychological and behavioral problems. Drug therapy has its own limitations. Comprehensive behavioral intervention therapy (Comprehensive Behavioral Interventions for Tics,CBIT) as a psychotherapy has its unique advantages, has been recognized in the international professional field, but there is no clinical application in China. The purpose of this study was to explore the efficacy of CBIT combined with tiapride in the treatment of TD and to find a more optimal treatment scheme. Methods: a total of 31 813 year old TD children who met the diagnostic criteria of TD in the fifth edition of (Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V were randomly divided into study group (CBIT combined with tiapride). There were 21 cases in the control group (treated with tiapride alone). The therapeutic effect was observed for 4 months. In the first month, two months and four months after treatment, the Yale Comprehensive tic severity scale (Yale Global Tic Severity Scale,YGTSS) and the Clinical curative effect scale (Clinical Global Impression,CGI) were used to evaluate and compare the efficacy. Use SPSS17.0 software package to build database and make statistical analysis. X2 test is used for data processing, t test is used for measurement data, and rank sum test is used for the comparison of grade data. Two factors repeated measurement data analysis of variance (ANOVA) was used in the whole comparison of the two groups, the group t test was used in the comparison between groups, and the t test of multiple comparisons of repeated measurement data in the group was used in the intra-group comparison, that is, the Bonferroni method was used to test the level of 伪 = 0. 05. Results: after 1 month treatment, there was significant difference between the two groups (P0.05), and the difference between the two groups after 2 months and 4 months was statistically significant (P0.05), and there was significant difference after 2 months of treatment (P0.01). There was no significant difference in the scores of each factor between the other time points (P0.05). The scores of three factors in the two groups were significantly different after 4 months of treatment compared with those before treatment except for the phonation twitching score of the study group (P0.008). There was no significant difference between the two groups after 2 months of treatment and 1 month after treatment (P0.008). There was no significant difference in CGI-S,CGI-I between the two groups before and after treatment (P0.05). There were significant differences in CGI-S between the two groups before and after treatment (P0.05). There were no serious adverse reactions in both groups. Conclusion: compared with tiapride alone, CBIT combined with tiapride can not only reduce the symptoms of motor twitch and phonation, but also relieve the impairment of function more effectively.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.94
本文编号：2290422
[Abstract]:Objective: tic disorder (Tic Disorder,TD) is often associated with psychological and behavioral problems. Drug therapy has its own limitations. Comprehensive behavioral intervention therapy (Comprehensive Behavioral Interventions for Tics,CBIT) as a psychotherapy has its unique advantages, has been recognized in the international professional field, but there is no clinical application in China. The purpose of this study was to explore the efficacy of CBIT combined with tiapride in the treatment of TD and to find a more optimal treatment scheme. Methods: a total of 31 813 year old TD children who met the diagnostic criteria of TD in the fifth edition of (Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V were randomly divided into study group (CBIT combined with tiapride). There were 21 cases in the control group (treated with tiapride alone). The therapeutic effect was observed for 4 months. In the first month, two months and four months after treatment, the Yale Comprehensive tic severity scale (Yale Global Tic Severity Scale,YGTSS) and the Clinical curative effect scale (Clinical Global Impression,CGI) were used to evaluate and compare the efficacy. Use SPSS17.0 software package to build database and make statistical analysis. X2 test is used for data processing, t test is used for measurement data, and rank sum test is used for the comparison of grade data. Two factors repeated measurement data analysis of variance (ANOVA) was used in the whole comparison of the two groups, the group t test was used in the comparison between groups, and the t test of multiple comparisons of repeated measurement data in the group was used in the intra-group comparison, that is, the Bonferroni method was used to test the level of 伪 = 0. 05. Results: after 1 month treatment, there was significant difference between the two groups (P0.05), and the difference between the two groups after 2 months and 4 months was statistically significant (P0.05), and there was significant difference after 2 months of treatment (P0.01). There was no significant difference in the scores of each factor between the other time points (P0.05). The scores of three factors in the two groups were significantly different after 4 months of treatment compared with those before treatment except for the phonation twitching score of the study group (P0.008). There was no significant difference between the two groups after 2 months of treatment and 1 month after treatment (P0.008). There was no significant difference in CGI-S,CGI-I between the two groups before and after treatment (P0.05). There were significant differences in CGI-S between the two groups before and after treatment (P0.05). There were no serious adverse reactions in both groups. Conclusion: compared with tiapride alone, CBIT combined with tiapride can not only reduce the symptoms of motor twitch and phonation, but also relieve the impairment of function more effectively.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.94
【参考文献】
相关期刊论文 前4条
1 陈青广;;盐酸硫必利片对多发性抽动症患儿血清兴奋性氨基酸水平的影响[J];中国乡村医药;2014年01期
2 朱秋暹;;利培酮与泰必利治疗小儿多发性抽动症的效果比较[J];吉林医学;2012年30期
3 郑清芬;赵德运;张古英;李现力;孔祥武;;硫必利和肌苷及赖氨肌醇维生素B_(12)治疗儿童抽动症疗效观察[J];河北医药;2012年17期
4 钟佑泉;吴惧;谢晓丽;胡文广;周文智;;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年03期
，本文编号：2290422
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2290422.html
最近更新
教材专著
