局部推拿联合脏腑点穴法治疗多发性抽动症患儿的疗效观察  

Clinical Value of Local Massage Combined with VisceralAcupoint Massage Therapy in the Treatment of Children with Tourette Syndrome

作　　者：杨蕾 田苗[1] 张瑶 马澜 张占玲[1] YANG Lei;TIAN Miao;ZHANG Yao;MA Lan;ZHANG Zhan-ling(Baoding No.1 Hospital of Traditional Chinese Medicine,Baoding Hebei 071000)

机构地区：[1]河北省保定市第一中医院,河北保定071000

出　　处：《世界中西医结合杂志》2022年第5期1030-1033,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：保定市科技计划项目(2041ZF127)。

摘　　要：目的探讨局部推拿联合脏腑点穴法治疗多发性抽动症(Tourette syndrome,TS)患儿的临床疗效。方法选取2017年3月—2020年3月期间河北省保定市第一中医院收治的TS患儿132例作为研究对象,采用随机数字表法将其分为A、B、C三组,每组各44例。3组患儿均给予西医治疗,B组行西医+局部常规推拿治疗,C组行西医+局部推拿+脏腑点穴法干预。治疗12周后,观察比较3组患儿治疗后临床疗效、中医证候评分;采用酶联免疫吸附法检测3组患儿治疗前后血清因子指标[血清γ-氨基丁酸(Gamma-aminobutyric acid,GABA)、谷氨酸(Glutamic Acid,GLU)及脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)]。结果治疗后3组患儿总有效率比较,差异无统计学意义(P>0.05);C组显效率50%(22/44)明显高于A组23.81%(10/42),差异有统计学意义(P<0.05)。3组患儿治疗后中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且B组中医证候评分明显低于A组,C组明显低于A、B组,差异有统计学意义(P<0.05)。3组患儿治疗后血清GABA、BDNF水平均较治疗前升高,GLU均较治疗前降低,差异有统计学意义(P<0.05);且C组患儿血清GABA、BDNF水平明显高于A、B组,GLU水平明显低于A、B组,B组患儿血清GABA、BDNF水平明显高于A组,GLU水平明显低于A组,差异均有统计学意义(P<0.05)。结论局部推拿联合脏腑点穴法治疗TS患儿疗效显著,与其调整神经递质和神经营养因子水平有关。Objective To study the clinical value of local massage combined with visceral acupoint massage therapy in the treatment of children with Tourette syndrome(TS).Methods A total of 132 children with TS treated in Baoding No.1 Hospital of Traditional Chinese Medicine from March 2017 to March 2020 were enrolled in this studyand assigned into groups A,B,and C according to the random number table method,with 44 children in each group.The children ingroups A,B,and C received western medicine,western medicine+local massage,and western medicine+local massage+visceral acupoint massage,respectively.The treatment lasted for 12 weeks and then therapeutic effect was compared among the three groups.The TCM syndrome scores were recorded before and after treatment.The enzyme-linked immunosorbent assay was employed to determine the levels of serum factors[γ-aminobutyric acid(GABA),glutamate(GLU),and brain-derived neurotrophic factor(BDNF)]before and after treatment.Results During the treatment,2 patients in group A voluntarily asked to quit,and 1 patient in group B lost to follow-up.The total effective rate showed no significant difference among the three groups(P>0.05).Group C had higher marked response rate[50%(22/44)vs.23.81%(10/42),P<0.05]than group A.After treatment,the TCM syndrome scores declined in all the three groups compared with those before treatment and showed a trend of group C<group B<group A(P<0.05).The treatments in all the three groups increased theserum levels of GABA and BDNF and decreased that of GLU(P<0.05).Moreover,theserum levels of GABA and BDNF showed a trend of group C>group B>group A,and that of GLU presented a trend ofgroup C<group B<group A(P<0.05).Conclusion Local massage combined with visceral acupoint massage therapy may regulate the levels of neurotransmitters and neurotrophic factors to treat TS in children.

关 键 词：局部推拿 脏腑点穴法 多发性抽动症 

分 类 号：R582.2[医药卫生—内分泌]