丙戊酸钠和氟哌啶醇治疗小儿多发性抽动症的临床研究  

Clinical trial of sodium valproate and haloperidol in the treatment of children with Tourette's syndrome

作　　者：武星光 白丽霞 崔俊强 胡先明 WU Xing-guang;BAI Li-xia;CUI Jun-qiang;HU Xian-ming(Department of Pediatric Medicine,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Department of Medical,Shanxi Children's Hospital,Shanxi Maternal and Child Health Hospital,Taiyuan 030001,Shanxi Province,China;Mental Health Department,Shanxi Children's Hospital,Shanxi Maternal and Child Health Hospital,Taiyuan 030001,Shanxi Province,China;Developmental Behavior Department,Shanxi Children's Hospital,Shanxi Maternal and Child Health Hospital,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学儿科医学系,山西太原030001 [2]山西省儿童医院,山西省妇幼保健院医务科,山西太原030001 [3]山西省儿童医院,山西省妇幼保健院精神卫生科,山西太原030001 [4]山西省儿童医院,山西省妇幼保健院儿童发育行为科,山西太原030001

出　　处：《中国临床药理学杂志》2023年第24期3608-3612,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 观察丙戊酸钠和氟哌啶醇治疗小儿多发性抽动症疗效及对血清胰岛素样生长因子-1(IGF-1)、神经元特异性烯醇化酶(NSE)、S100β水平的影响。方法 将多发性抽动症患儿分为对照组和试验组。对照组给予氟哌啶醇,每次2 mg,每天2~3次,口服,共治疗3个月;试验组给予丙戊酸钠20 mg·kg^(-1)·d^(-1),每12 h给药1次,口服,共治疗3个月。比较2组患者的临床疗效、耶鲁综合抽动严重程度量表(YGTSS)、血清IGF-1、NSE、S100β水平和神经递质水平、细胞因子水平,以及药物不良反应的发生情况。结果 本研究共纳入150例患者,试验过程中共脱落5例,试验组和对照组分别纳入73例、72例。试验组、对照组治疗总有效率分别为91.78%(67例/73例)和79.17%(57例/72例),差异有统计学意义(P<0.05)。试验组和对照组治疗后YGTSS评分运动性抽动得分分别为(9.79±1.73)和(11.05±2.18)分,发声性抽动得分分别为(10.52±2.06)和(11.37±2.24)分,YGTSS评分总分分别为(20.31±2.57)和(22.42±2.57)分,血清IGF-1水平分别为(60.37±3.29)和(58.04±3.16)μg·L^(-1),NSE水平分别为(95.26±10.19)和(101.81±10.54)ng·L^(-1),S100β水平分别为(83.69±10.33)和(87.05±9.76)ng·L^(-1),血清5-HT水平分别为(59.05±5.69)和(61.37±5.52)ng·mL^(-1),GABA水平分别为(2.37±0.32)和(2.04±0.39)ng·mL^(-1),NE水平分别为(32.85±4.63)和(29.24±4.02)ng·mL^(-1),IL-6水平分别为(19.05±2.97)和(21.31±4.01)ng·mL^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组的复发率分别为16.44%(12例/73例)和23.61%(17例/72例),差异无统计学意义(P>0.05)。2组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论 相比于氟哌啶醇,丙戊酸钠治疗小儿多发性抽动症的有效率较高,更能减轻患者临床症状,改善神经功能,并有助于降低机体血清IGF-1、NSE、S100β水平及炎症因子水平。Objective To explore the efficacy of sodium valproate and haloperidol in the treatment of Tourette's syndrome in children and the effects on serum levels of insulin-like growth factor 1(IGF-1),neuron specific enolase(NSE) and S100β.Methods Children with Tourette's syndrome were divided into treatment group and control group.Control group was given oral administration of haloperidol 2 mg every time,twice or three times a day for 3 months,treatment group was given oral administration of 20 mg·kg^(-1)·d^(-1) sodium valproate for every 12 hours,totally treatment for 3 months.The clinical efficacy,Yale Global Tourette Severity Scale(YGTSS),levels of serum IGF-1,NSE and S100β,neurotransmitters,cytokines,and occurrence of adverse drug reactions were compared between the two groups of patients.Results A total of 150 patients were included in this study,including 5cases of shedding during the trial,thus 73 cases in treatment group and 72 cases in control group were finally enrolled.The total effective rates of treatment in treatment group and control group were 91.78%(67 cases/73 cases) and79.17%(57 cases/72 cases),with significant difference(P<0.05).The scores of motor tic of YGTSS in treatment group and control group after treatment were(9.79±1.73) and(11.05±2.18) points;the vocal tic scores were(10.52±2.06) and(11.37±2.24) points;the total scores of YGTSS were(20.31±2.57) and(22.42±2.57)points;serum levels of IGF-1 were(60.37±3.29) and(58.04±3.16) μg·L^(-1);levels of NSE were(95.26±10.19) and(101.81±10.54) ng·L^(-1),S100β levels were(83.69±10.33) and(87.05±9.76)ng·L^(-1);levels of 5-HT were(59.05±5.69) and(61.37±5.52) ng·mL^(-1);levels of GABA were(2.37±0.32) and(2.04±0.39) ng·mL^(-1);levels of NE were(32.85±4.63) and(29.24±4.02) ng·mL^(-1)levels of IL-6 in were(19.05±2.97) and(21.31±4.01) ng·mL^(-1),all with significant difference(all P<0.05).The recurrence rate in treatment group and control group were 16.44%(12 cases/73 cases) and 23.61%(17 cases/72 cases),with no significant differe

关 键 词：丙戊酸钠 氟哌啶醇 小儿多发性抽动症 胰岛素样生长因子-1 神经元特异性烯醇化酶 

分 类 号：R97[医药卫生—药品]