归脾汤合四逆散联合针刺治疗脾虚肝旺型小儿多发性抽动症临床研究  

Clinical Study on Guipi Decoction and Sini Powder Combined with Acupuncture for Multiple Tics in Children of Spleen Deficiency and Liver Effulgence Type

作　　者：张哲 赵文鸽 甘琳琳 孙莹莹 ZHANG Zhe;ZHAO Wenge;GAN Linlin;SUN Yingying(Department of Pediatrics,Xuchang Hospital of Traditional Chinese Medicine,Xuchang Henan 461000,China)

机构地区：[1]许昌中医院儿科,河南许昌461000

出　　处：《新中医》2024年第15期28-32,共5页New Chinese Medicine

摘　　要：目的:观察归脾汤合四逆散联合针刺治疗脾虚肝旺型小儿多发性抽动症的临床效果。方法:选取脾虚肝旺型小儿多发性抽动症70例为研究对象,按随机数字表法分为研究组和对照组各35例。2组均给予常规对症治疗,对照组采用针刺治疗,研究组在对照组基础上给予归脾汤合四逆散治疗。2组疗程均为3个月。评价2组临床疗效,比较2组治疗前后中医证候积分、耶鲁综合抽动症严重程度量表(YGTSS)评分及血清神经递质水平,统计不良反应发生情况。结果:2组总有效率比较,差异无统计学意义(P>0.05)。治疗后,2组中医证候积分、运动性抽动、发声性抽动、YGTSS总分低于治疗前(P<0.05),且研究组各项评分低于对照组(P<0.05)。治疗后,2组γ-氨基丁酸(GABA)水平较治疗前升高,多巴胺(DA)、去甲肾上腺素(NE)水平较治疗前下降(P<0.05);治疗后研究组GABA水平高于对照组,DA、NE水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:归脾汤合四逆散联合针刺治疗脾虚肝旺型小儿多发性抽动疗效确切,能够改善患儿抽动症状,调节神经递质水平,安全性较高。Objective:To observe the clinical effect of Guipi Decoction and Sini Powder combined with acupuncture on multiple tics in children of spleen deficiency and liver effulgence type.Methods:A total of 70 cases of children with multiple tics of spleen deficiency and liver effulgence type were selected as the research objects,and were divided into the study group and the control group according to the random number table method,with 35 cases in each group.Both groups were given routine symptomatic treatment;the control group was treated with acupuncture,and the study group was additionally treated with Guipi Decoction and Sini Powder based on the treatment of the control group.Both groups were treated for three months.The clinical effects in the two groups were evaluated;traditional Chinese Medicine(TCM)syndrome scores,Yale Global Tic Severity Scale(YGTSS)scores and serum neurotransmitter levels before and after treatment were compared between the two groups;the incidence of adverse reactions were counted.Results:There was no significant difference in the comparison of the total effective rates between the two groups(P>0.05).After treatment,TCM syndrome scores,motor tic,vocal tic and total scores of YGTSS in the two groups were decreased when compared with those before treatment(P<0.05),and the scores in the study group were lower than those in the control group(P<0.05).After treatment,γ-aminobutyric acid(GABA)levels in the two groups were increased,and the levels of dopamine(DA)and norepinephrine(NE)were declined when compared with those before treatment(P<0.05).After treatment,GABA level in the study group was higher than that in the control group,and the levels of DA and NE were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Guipi Decoction and Sini Powder combined with acupuncture has a definite curative effect in the treatment of multiple tics in children of spleen deficiency and liver effulgence typ

关 键 词：小儿多发性抽动症 脾虚肝旺型 归脾汤 四逆散 针刺 耶鲁综合抽动症严重程度量表 神经递质 

分 类 号：R749.94[医药卫生—神经病学与精神病学]