缓肝理脾汤加减方联合刺四缝穴治疗儿童抽动障碍的临床观察  

Clinical Observation on the Modified Huangan Lipi Decoction Combinedwith Acupuncture at Sifeng Points in the Treatment of Childrenwith Tic Disorders

作　　者：梁妙珍 李雪娇 陈丽军 林晓洁[2] LIANG Miao-Zhen;LI Xue-Jiao;CHEN Li-Jun;LIN Xiao-Jie(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2024年第1期105-109,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20181036)。

摘　　要：【目的】观察缓肝理脾汤加减方(由茯神、白芍、白术、制远志、石菖蒲、郁金等中药组成)联合刺四缝穴治疗儿童抽动障碍的临床疗效。【方法】将70例脾虚肝旺型抽动障碍患儿随机分为治疗组和对照组,每组各35例。对照组给予盐酸硫必利片的常规西药治疗,治疗组给予缓肝理脾汤加减方联合刺四缝穴治疗,疗程为8周。观察2组患儿治疗前后耶鲁综合抽动严重程度量表(YGTSS)的抽动肌群、抽动频度、抽动强度、复杂程度及干扰程度等各项抽动症状评分及其总分的变化情况,并评价2组患儿的临床疗效和安全性。【结果】(1)疗效方面,治疗8周后,治疗组的总有效率为88.57%(31/35),对照组为68.57%(24/35),组间比较,治疗组的总有效率(卡方检验)和总体疗效(秩和检验)均明显优于对照组,差异均有统计学意义(P<0.05)。(2)症状评分方面,治疗后,2组患儿YGTSS的抽动肌群、抽动频度、抽动强度、复杂程度及干扰程度等各项抽动症状评分及其总分均较治疗前明显降低(P<0.01),且治疗组的降低作用均明显优于对照组,差异均有统计学意义(P<0.01)。(3)安全性方面,治疗过程中,治疗组的不良反应发生率为2.86%(1/35),对照组为8.57%(3/35),组间比较,治疗组的不良反应发生率有低于对照组趋势,但差异无统计学意义(P>0.05)。【结论】缓肝理脾汤加减方联合刺四缝穴治疗脾虚肝旺型抽动障碍患儿临床疗效确切,其疗效优于西药盐酸硫必利片。Objective To observe the clinical efficacy of the modified Huangan Lipi Decoction(mainly composed of Sclerotium Poriae Pararadicis,Paeoniae Radix Alba,Atractylodis Macrocephalae Rhizoma,Polygalae Radix,Acori Tatarinowii Rhizoma,and Curcumae Radix)combined with acupuncture at Sifeng(EX-UE10)points in the treatment of children with tic disorders(TD).Methods Seventy cases of TD children with spleen deficiency and liver hyperactivity syndrome were randomly divided into the treatment group and the control group,with 35 cases in each group.The control group was treated with conventional western medicine of Tiapride Hydrochloride Tablets,while the treatment group was treated with the combination of the modified Huangan Lipi Decoction and acupuncture at Sifeng points.Both groups were treated for 8 weeks.The changes of the Yale Global Tic Severity Scale(YGTSS)item scores of tic muscle group,tic frequency,tic intensity,complexity and interference degree as well as their total scores in the two groups were observed before and after treatment.Moreover,the clinical efficacy and safety in the two groups were evaluated.Results(1)After 8 weeks of treatment,the total effective rate of the treatment group was 88.57%(31/35),and that of the control group was 68.57%(24/35).The intergroup comparison showed that the total effective rate(tested by chi-square test)and the overall therapeutic efficacy (tested by rank-sum test)of the treatment group were significantly superior to those of the control group,and thedifferences were statistically significant(P<0.05).(2)After treatment, the YGTSS item scores of tic musclegroup, tic frequency, tic intensity, complexity and interference degree as well as their total scores in the twogroups were significantly lower than those before treatment(P<0.01),and the effect on lowering the above scoresof the treatment group was significantly superior to that of the control group,the differences being all statisticallysignificant(P<0.01).(3)During the treatment, the incidence of adverse reactions in the tr

关 键 词：儿童抽动障碍 脾虚肝旺型 缓肝理脾汤加减方 四缝穴 临床疗效 安全性 

分 类 号：R246.4[医药卫生—针灸推拿学]