加味泻黄散治疗儿童多发性抽动症脾胃积热证60例临床观察  

Clinical observation on 60 cases of Tourette syndrome in children with heat accumulation in spleen and stomach syndrome treated by Jiawei Xiehuang San(加味泻黄散)

作　　者：杨翠玲 张肖瑾 赵琼[1] 周江[1] 贾雪 李珊珊[1] YANG Cuiling;ZHANG Xiaojin;ZHAO Qiong;ZHOU Jiang;JIA Xue;LI Shanshan(Department of Pediatrics,Affiliated Hospital of Chengdu University of Chinese Medicine,Chengdu,Sichuan,610000,China;Clinical Medical College,Chengdu University of Chinese Medicine,Chengdu,Sichuan,610000,China)

机构地区：[1]成都中医药大学附属医院儿科,四川成都610000 [2]成都中医药大学临床医学院,四川成都610000

出　　处：《中医儿科杂志》2020年第5期71-75,共5页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：国家重点研发计划资助项目(2018YFC1704104);四川省教育厅科研项目(17ZB0157)。

摘　　要：目的观察加味泻黄散治疗儿童多发性抽动症脾胃积热证的临床疗效。方法选取2018年8月至2019年8月在成都中医药大学附属医院儿科门诊就诊的多发性抽动症脾胃积热证患儿120例,按随机数字表法分为治疗组和对照组,各60例。治疗组给予加味泻黄散,对照组给予泰必利(盐酸硫必利片),2组均以4周为1个疗程,3个疗程后比较2组的临床疗效和中医证候疗效,治疗前及治疗4周、8周、12周的耶鲁抽动症整体严重程度量表(YGTSS)积分,中医证候积分和用药安全性分析。结果治疗组总有效率为91.67%(55/60),对照组为86.67%(52/60),2组比较,差异有统计学意义(P<0.05)。治疗组中医证候疗效总有效率为100.00%(60/60),对照组为13.33%(8/60),2组比较,差异有统计学意义(P<0.05)。治疗前,2组YGTSS积分比较,差异无统计学意义(P>0.05),具有可比性。治疗4周、8周,2组YGTSS积分与同组治疗前比较,差异无统计学意义(P>0.05);治疗12周,2组YGTSS积分较同组治疗前明显下降,差异有统计学意义(P<0.05)。2组治疗后同期YGTSS积分比较,差异均无统计学意义(P>0.05)。治疗前,2组中医证候积分比较,差异均无统计学意义(P>0.05),具有可比性。治疗12周,与同组治疗前比较,2组抽动证候积分均显著下降(P<0.05),对照组其余证候积分无统计学意义(P>0.05),治疗组其余中医证候积分均显著下降(P<0.05),且治疗组中医证候积分显著优于对照组,差异均有统计学意义(P<0.05)。治疗期间,2组患儿治疗前、后进行血、尿、大便常规、肝肾功能、心电图检查,结果均未见明显异常。结论加味泻黄散治疗儿童多发性抽动症脾胃积热证疗效满意,不仅可以较好地改善抽动、口干口臭、烦躁易怒、食欲不振等中医证候,而且用药安全性良好,值得临床推广应用。Objective To observe the clinical efficacy of Jiawei Xiehuang San(加味泻黄散)in the treatment of Tourette syndrome(TS)in children with heat accumulation in spleen and stomach syndrome.Methods From August 2018 to August 2019,120 cases of TS in children with heat accumulation in spleen and stomach syndrome consulted in outpatient service of pediatrics department in Affiliated Hospital of Chengdu University of Chinese Medicine were divided into treatment group and control group according to random number table method,with 60 cases in each.The treatment group was given Jiawei Xiehuang San,while the control group was given Taibili(tiapride hydrochloride tablets).Four weeks constituted 1 course of treatment for both groups.After 3 courses of treatment,the clinical efficacy and TCM symptom efficacy of the 2 groups,the scores of Yale Global Tic Severity Scale(YGTSS),TCM syndrome scores and medication safety were compared before treatment and at week 4,week 8 and week 12 after treatment.Results The total effective rate of the treatment group was 91.67%(55/60),that of the control group was 86.67%(52/60),and the difference between the 2 groups was statistically significant(P<0.05).The total effective rate of TCM symptom in the treatment group was 100.00%(60/60),that of the control group was 13.33%(8/60),and the difference between the 2 groups was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in YGTSS scores between the 2 groups(P>0.05),and they were comparable.At week 4 and week 8 after treatment,the difference was not statistically significant in YGTSS scores of the 2 groups compared with the same group before treatment(P>0.05).At week 12 after treatment,YGTSS scores of the 2 groups significantly decreased compared with the same group before treatment,and the difference was statistically significant(P<0.05).The difference was not statistically significant in YGTSS scores between the 2 groups at the same period after treatment(P>0.05).Before treatment,the difference

关 键 词：多发性抽动症 儿童 脾胃积热证 加味泻黄散 临床观察 

分 类 号：R749.94[医药卫生—神经病学与精神病学]