自拟滋阴潜阳、调肝熄风方治疗阴虚风动型小儿多发性抽动症的临床研究

发布时间：2017-12-28 19:30

本文关键词：自拟滋阴潜阳、调肝熄风方治疗阴虚风动型小儿多发性抽动症的临床研究　出处：《南京中医药大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨滋阴潜阳、调肝熄风方治疗阴虚风动型小儿多发性抽动症的临床疗效及对免疫功能的影响。方法选取2013年10月-2016年10月我院收治的小儿多发性抽动症患者80例,且中医辨证分型为阴虚风动型,将其按照随机数字法随机分为观察组和对照组,每组40例,对照组给予肌苷合并维生素B6治疗,观察组给予自拟滋阴益肺、调肝熄风方治疗,2组均以1月为1个疗程,均治疗3个疗程。观察治疗前后临床症状及体征的变化,采用美国儿童精神病研究院的耶鲁抽动程度综合量表(YGTSS),对治疗前后2组的YGTSS分值进行测定,依据YGTSS量表的减分率,对临床疗效评定。并对2组的细胞免疫(CD3+、CD4+、CD8+、CD4+/CD8+)及体液免疫(血清IgG、IgA、IgM)水平进行检测,随访3月统计2组复发情况。结果治疗后2组中医证候总积分均显著下降(P0.01),但观察组下降更为明显(P0.01)。治疗后2组运动抽动、发生抽动、综合损害、总评分的YGTSS评分均显著下降(P0.01),但观察组下降更为明显(P0.01)。观察组的总有效率为97.5%显著高于对照组的85.0%(P0.05);观察组复发率(5%)显著低于对照组(20.00%,P0.05)。治疗后2组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+均显著改善(P0.01),但观察组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+改善更为明显(P0.01)。治疗后2组IgA、IgG、IgM均显著升高(P0.01),但观察组升高更为明显(P0.01)。结论滋阴潜阳、调肝熄风方可显著改善小儿多发性抽动症患儿的临床症状,减少患儿的发生抽动、运动抽动及综合损害,临床疗效显著,安全性高,其作用机制可能与提高免疫能力有关。
[Abstract]:Objective to investigate the effect of nourishing yin and Yang and regulating the liver and extinguishing the wind in the treatment of multiple Tourette syndrome of yin deficiency and wind movement and its influence on the immune function. Methods from October 2013 -2016 year in October in our hospital 80 cases of children with Tourette syndrome patients, and TCM syndrome of yin deficiency, which were randomly divided into observation group and control group, 40 cases in each group, the control group was given inosine combined with vitamin B6 treatment, observation group were treated with nourishing yin and tonifying lung, regulating liver Xifeng decoction, 2 groups were in January for 1 courses, 3 courses of treatment were. The changes of clinical symptoms and signs before and after treatment were observed. The YGTSS scores of the 2 groups were measured by the Yale spasm comprehensive scale (YGTSS) of the American Academy of child psychiatry, and the clinical efficacy was evaluated according to the reduction rate of YGTSS scale. The 2 groups of cellular immunity (CD3+, CD4+, CD8+, CD4+/CD8+) and humoral immunity (serum IgG, IgA, IgM) were detected, and the recurrence of 2 groups was followed up in March. Results after treatment, the total scores of the 2 groups of TCM syndromes were significantly decreased (P0.01), but the decrease in the observation group was more obvious (P0.01). After the treatment, the YGTSS scores of the 2 groups of movement, twitch, comprehensive damage and total score were significantly decreased (P0.01), but the decrease in the observation group was more obvious (P0.01). The total effective rate of the observation group was 97.5% significantly higher than that of the control group (85% (P0.05)), and the recurrence rate of the observation group (5%) was significantly lower than that of the control group (20%, P0.05). After treatment, 2 groups of CD3~+, CD4~+, CD8~+, CD4~+/CD8~+ were significantly improved (P0.01), but the improvement of CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+ in the observation group was more obvious (P0.01). After treatment, the 2 groups of IgA, IgG and IgM increased significantly (P0.01), but the increase in the observation group was more obvious (P0.01). Conclusion Ziyin Qianyang and regulating liver and expelling wind prescription can significantly improve the clinical symptoms of children with Tourette syndrome and reduce the incidence of tic disorder, motor tic disorder and general impairment. The clinical efficacy is significant, and the safety is high. Its mechanism may be related to the improvement of immunity.
【作者单位】：苏州大学附属第一医院;苏州大学附属儿童医院;苏州卫生职业技术学院附属口腔医院;
【基金】：山东省中医药科技发展计划项目(2013ZDZK-126)
【分类号】：R277.7
【正文快照】： 小儿多发性抽动症(TS)又称抽动-秽语综合征,是以多发性不自主运动和(或)伴有异常发音为特征的慢性神经精神疾病,临床主要表现为面部、躯干四肢肌肉不自主抽动,伴喉部发音或不文明语言为特点[1]。发病年龄段多在儿童及青少年时期,通常在年龄段4~11岁多见,男孩发病率相较女孩而

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