针刺配合耳穴贴压辅助治疗小儿抽动障碍60例临床观察  

Clinical observation on 60 cases of children with tic disorders treated by acupuncture cooperated with auricular-plaster as adjuvant therapy

作　　者：代卫锋 韩雪[1] DAI Weifeng;HAN Xue(Department of TCM,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州大学附属儿童医院中医科,河南郑州450000

出　　处：《中医儿科杂志》2021年第4期69-73,共5页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：2019年度河南省中医药科学研究专项课题(2019ZY3012);韩雪名中医学术经验研究工作室建设项目(zsmzy201810)。

摘　　要：目的观察针刺配合耳穴贴压辅助治疗小儿抽动障碍的临床疗效。方法选取2018年5月至2019年5月郑州大学附属儿童医院中医科门诊就诊的抽动障碍患儿120例,采用随机数字表法分为对照组和治疗组,各60例。对照组采用滋肾平肝方中药口服治疗,治疗组在对照组治疗方法的基础上给予针刺配合耳穴贴压法治疗,2组均连续治疗2个月后比较临床疗效、中医证候积分以及血清多巴胺(DA)、5-羟色胺(5-HT)、γ-氨基丁酸(GABA)水平变化。结果治疗组总有效率为93.33%(56/60),显著高于对照组的80.00%(48/60),2组比较,差异有统计学意义(P<0.05)。治疗前,2组运动性抽动总分、发声性抽动总分、耶鲁综合抽动严重程度量表(YGTSS)积分比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组上述积分较同组治疗前显著降低(P<0.05),且治疗组降幅更明显(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组中医证候积分较同组治疗前显著降低(P<0.05),且治疗组降幅更明显,差异有统计学意义(P<0.05)。治疗前,2组DA、5-HT、GABA水平比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组DA、5-HT水平较同组治疗前显著降低(P<0.05),GABA水平显著升高(P<0.05),且治疗组下降/升高更显著,差异有统计学意义(P<0.05)。结论针刺配合耳穴贴压辅助治疗小儿抽动障碍不仅能够有效改善患儿YGTSS积分、中医证候积分,而且能降低体内DA、5-HT水平,升高GABA水平,疗效显著,值得临床推广应用。Objective To observe the clinical efficacy of children with tic disorders(TD)treated by acupuncture cooperated with auricular-plaster as adjuvant therapy.Methods From May 2018 to May 2019,120 cases of children with TD consulted in outpatient service of TCM department of Children’s Hospital Affiliated to Zhengzhou University were divided into control group and treatment group according to random number table method,with 60 cases in each group.The control group was given Chinese materia medica(CMM)oral administration of Zishen Pinggan Fang(滋肾平肝方),on this basis,the treatment group was given acupuncture cooperated with auricular-plaster therapy.The clinical efficacy,TCM symptom score,serum dopamine(DA),5-hydroxytryptamine(5-HT)andγ-aminobutyric acid(GABA)levels were compared between the 2 groups after 2 months of continuous treatment.Results The total effective rate of the treatment group was 93.33%(56/60),which was significantly higher than 80.00%(48/60)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,there was no significant difference in the total score of motor tic,total score of verbal tic and the Yale global tic severity scale(YGTSS)score between the 2 groups(P>0.05),and they were comparable;After treatment,the above scores of the 2 groups significantly decreased than those in the same group before treatment(P<0.05),moreover,the decreasing amplitude in the treatment group was more significant(P<0.05).Before treatment,there was no significant difference in TCM symptom score between the 2 groups(P>0.05),and they were comparable;After treatment,TCM symptom score of the 2 groups significantly decreased than that of the same group before treatment(P<0.05),moreover,the decreasing amplitude of the treatment group was more significant,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of DA,5-HT and GABA between the 2 groups(P>0.05),and they were comparable;After treat

关 键 词：儿童 抽动障碍 针刺 耳穴贴压 滋肾平肝方 神经递质 临床观察 

分 类 号：R749.94[医药卫生—神经病学与精神病学]