中医辨证治疗儿童抽动障碍的临床研究

发布时间：2018-04-19 10:46

本文选题：儿童抽动障碍 + 中医辨证治疗　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:抽动障碍为儿童常见的神经精神发育障碍,近年来,其发病率不断上升,得到了家庭和社会越来越多的关注,但现代医学尚未找到安全有效的治疗方法。目前,许多文献报道,使用中医辨证治疗儿童抽动障碍获得了满意的效果,且副作用较少。本研究旨在通过临床病例的收集与观察,在治疗前后,分别使用耶鲁综合抽动严重程度量表(YGTSS)及中医症候评分量表来评价中医辨证治疗儿童抽动障碍的临床效果。方法:使用自身治疗前后对照的研究方法,收集符合诊断标准和纳入标准的抽动障碍患儿共40例,在治疗前、治疗4周后及治疗8周后,使用耶鲁综合抽动严重程度量表(YGTSS)对患儿的抽动症状的严重程度进行评定,而其他伴随症状的严重程度则使用中医症候评分量表进行评价,记录每次的得分情况,采用尼莫地平计算法得出治疗前后的减分率及总有效率,从而判断中医辨证治疗能否有效改善患儿的抽动症状及其他伴随症状。结果:纳入研究的40例临床病例中,治疗前与治疗4周后、治疗前与治疗8周后、治疗4周后与治疗8周后的耶鲁综合抽动严重程度量表及中医症候量表的得分均具有显著性差异(P0.01)。在疗效评价方面,通过耶鲁综合抽动严重程度量表的减分率来评价患儿抽动症状的改善情况以及对日常生活的影响情况,研究结果显示:治疗4周后的总有效率为55%,治疗8周后的总有效率为77.5%,经统计学分析,治疗8周后的总有效率与治疗4周后的总有效率相比,二者具有显著性差异(P0.05)。同时通过中医症候量表的减分率来评价患儿伴随症状的改善情况,结果显示:治疗4周后的总有效率为60%,治疗8周后的总有效率为85%,经统计学分析,二者也具有显著性差异(P0.01)。而且在治疗的整个过程中,没有出现一例药物不良反应。结论:中医辨证治疗儿童抽动障碍,无论在是改善患儿的抽动症状方面,还是在改善其他伴随症状方面,疗效肯定,治疗8周的临床效果较治疗4周更为显著,而且安全性好,副作用少。
[Abstract]:Objective: tic disorder is a common neuropsychiatric disorder in children. In recent years, the incidence of twitching disorder has been increasing, which has been paid more and more attention by family and society. However, modern medicine has not found a safe and effective treatment method.At present, it is reported in many literatures that the treatment of children with tic disorder with TCM syndrome differentiation has achieved satisfactory results and fewer side effects.The purpose of this study was to evaluate the clinical effect of TCM syndrome differentiation in children with tic disorder by using YGTSS and TCM symptom scale before and after treatment.Methods: a total of 40 children with tic disorders who met the diagnostic criteria and the inclusion criteria were collected before, 4 weeks and 8 weeks after treatment.Yale comprehensive tic severity scale (YGTSS) was used to assess the severity of the children's tic symptoms, while the severity of other accompanying symptoms was evaluated by the TCM symptom scale to record the scores of each time.The reduction rate and total effective rate before and after treatment were obtained by using Nimodipine calculation method, so as to judge whether TCM syndrome differentiation treatment can effectively improve the tic symptoms and other associated symptoms of children.Results: of the 40 clinical cases included in the study, before and after 4 weeks of treatment, before and after 8 weeks of treatment,The scores of Yale comprehensive tic severity scale and TCM symptom scale after 4 weeks and 8 weeks of treatment were significantly different (P 0.01).In the evaluation of curative effect, the improvement of tic symptoms and the influence on daily life of children were evaluated by the reduction rate of Yale comprehensive tic severity scale.The results showed that the total effective rate was 55 after 4 weeks treatment and 77.5 after 8 weeks treatment. By statistical analysis, there was significant difference between the total effective rate after 8 weeks treatment and the total effective rate after 4 weeks treatment (P 0.05).The results showed that the total effective rate was 60 after 4 weeks treatment and the total effective rate after 8 weeks treatment was 85. The statistical analysis showed that there was also a significant difference between the two groups (P 0.01).And there was no adverse drug reaction during the course of treatment.Conclusion: in the treatment of children's tic disorder with TCM syndrome differentiation, the clinical effect of 8 weeks treatment is more significant than that of 4 weeks, and the safety is good, whether in improving the symptoms of children with tic symptoms or in improving other accompanying symptoms.Less side effects.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

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