针刺联合参赭镇气汤治疗小儿抽动障碍脾虚痰聚证40例临床观察  

Clinical observation on 40 cases of tic disorders in children with phlegm accumulation due to spleen deficiency syndrome treated by acupuncture combined with Shenzhe Zhenqi Tang (参赭镇气汤)

作　　者：李灵浙 陆月仙 宋丰军[1] 黄海琼 叶必宏[1] 方芳[1] 周英[1] LI Lingzhe;LU Yuexian;SONG Fengjun;HUANG Haiqiong;YE Bihong;FANG Fang;ZHOU Ying(Department of Acupuncture and Tuina Physiotherapy,Wenzhou Hospital of TCM,Wenzhou,Zhejiang,325000,China)

机构地区：[1]温州市中医院针推理疗科,浙江温州325000

出　　处：《中医儿科杂志》2021年第4期73-78,共6页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察针刺联合参赭镇气汤治疗小儿抽动障碍的临床疗效。方法选取2017年9月至2019年9月温州市中医院针推理疗科收治的80例抽动障碍脾虚痰聚证患儿,按照随机数字表法分为对照组和治疗组,各40例。对照组予氟哌啶醇口服,治疗组予针刺联合中药参赭镇气汤口服,2组均连续治疗8周后统计疗效。结果对照组总有效率为82.5%(33/40),治疗组为95.0%(38/40),2组比较,差异有统计学意义(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组中医证候积分均明显降低,与同组治疗前比较,差异有统计学意义(P<0.01),且治疗组降低更显著,与对照组治疗后比较,差异有统计学意义(P<0.05)。治疗前2组耶鲁综合抽动严重程度量表(YGTSS)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YGTSS积分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05或P<0.01),且治疗组下降更显著,与对照组治疗后比较,差异有统计学意义(P<0.05)。治疗前2组血清γ-氨基丁酸(GABA)、谷氨酸(GLU)、去甲肾上腺素(NE)、多巴胺(DA)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组血清GABA水平明显升高,GLU、NE、DA水平明显降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组改善更显著,与对照组治疗后比较,差异有统计学意义(P<0.05)。对照组总不良反应发生率为20.0%(8/40),治疗组为5.0%(2/40),2组比较,差异有统计学意义(P<0.05)。治疗后2组均随访6个月,对照组复发4例(12.12%),治疗组未出现复发病例,经Fisher检验,治疗组复发率明显低于对照组(P<0.05)。结论针刺联合参赭镇气汤治疗小儿抽动障碍脾虚痰聚证,能有效缓解临床症状,改善血清GABA、GLU、NE、DA水平,不良反应小,复发率低,值得临床推广应用。Objective To observe the clinical efficacy of acupuncture combined with Shenzhe Zhenqi Tang(参赭镇气汤)in the treatment of tic disorders(TD)in children.Methods From September 2017 to September 2019,80 cases of TD in children with phlegm accumulation due to spleen deficiency syndrome admitted into department of acupuncture and tuina physiotherapy of Wenzhou Hospital of TCM were chosen and divided into control group and treatment group according to random number table method,with 40 cases in each group.The control group was given oral administration of haloperidol,while the treatment group was given acupuncture combined with oral administration of Shenzhe Zhenqi Tang.We kept statistics about the efficacy after the 2 groups were both continuously treated for 8 weeks.Results The total effective rate of the control group was 82.5%(33/40),that of the treatment group was 95.0%(38/40),and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the difference was not statistically significant in TCM symptom score between the 2 groups(P>0.05),and they were comparable.After treatment,TCM symptom score in the 2 groups all significantly decreased,and the difference was statistically significant compared with that in the same group before treatment(P<0.01),moreover,the treatment group decreased more significantly,and the difference was statistically significant compared with the control group after treatment(P<0.05).Before treatment,the difference was not statistically significant in the Yale global tic severity scale(YGTSS)score between the 2 groups(P>0.05),and they were comparable.After treatment,YGTSS score in the 2 groups significantly decreased,and the difference was statistically significant compared with that in the same group before treatment(P<0.05 or P<0.01),moreover,the treatment group decreased more significantly,and the difference was statistically significant compared with the control group after treatment(P<0.05).Before treatment,the difference was not statistically signif

关 键 词：小儿 抽动障碍 针刺 参赭镇气汤 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]