摘要
【目的】观察中西医结合阶梯法治疗小儿抽动障碍的临床疗效。【方法】将50例抽动障碍儿童按照耶鲁综合抽动严重程度量表(YGTSS量表)制定的病情分级标准分级,根据评分进行中西医结合阶梯法分级治疗,同时配合心理干预治疗,以治疗2周、4周、8周、12周后为疗效及不良反应测评时点,评估症状评分,观察不良反应,根据评分决定升降级治疗。观察治疗前后抽动障碍患儿症状评分变化、临床疗效及不良反应。【结果】治疗前按照YGTSS量表评分分级,其中一级12例,二级24例,三级12例,四级2例;治疗后,患儿的抽动症状显著改善,其中14例抽动症状完全消失,治疗前后比较差异有统计学意义(P<0.01)。治疗2周、4周、8周及12周后,患儿的抽动积分呈逐渐下降趋势,其中治疗2周、4周后与治疗前比较差异无统计学意义(P>0.05),治疗8周及12周后与治疗前比较差异有统计学意义(P<0.01)。以YGTSS减分率评定疗效,其中临床痊愈25例,显效15例,有效8例,无效2例,总有效率为96%。【结论】中西医结合阶梯法治疗小儿抽动障碍,既能最大限度发挥了中医治疗本病的优势,又能让病情严重者症状可以得到及时控制;根据量化的疗效评价标准,病情控制后采取降级治疗,能最大限度地缩短西药的使用时间,减少其副作用,改善其停药易反复等问题,患儿的依从性强。
Objective To observe the therapeutic effect of integrated traditional Chinese and western medicine stage-by-stage therapy for children tic disorder. Methods Fifty children with tic disorder were classified into various stages based on the Yale Global Tie Severity Scale （YGTSS） , and then were given stage-by-stage therapy according to the staging scores, and received psychological intervention simultaneously. At the end of week 2, 4, 8, and 12 after treatment, efficacy and adverse drug reaction were monitored, and the results were used as the reference for the updating stage-by-stage therapy. The scores of symptoms, therapeutic effect, and adverse reaction were observed before and after treatment. Results Before treatment, 10 children were classified into stage one, 24 into stage two, 12 into stage three, and 2 into stage four based on the scores of YGTSS. After treatment, tic was much relieved, and even disappeared in 14 children, the difference being significant compared with that before treatment （P 〈0. 01）. At the end of week 2, 4, 8, and 12 after treatment, the score of tie showed a decrease trend, and the difference was insignificant between week 2, 4 and before treatment （ P 〉 0. 05 ）, but the difference was significant between week 8, 12 and before treatment （ P 〈 0.01 ）. The results of therapeutic effect evaluation based on YGTSS score reduction rate showed that 25 cases were cured, 15 were markedly effective, 8 were effective, 2 were ineffective, and the total effective rate was 96%. Conclusion Integrated traditional Chinese and western medicine stage-by-stage therapy is safe and effective for the treatment of children tic disorder through relieving the symptom, shortening medication time for western medicine, and reducing recurrence after drug withdrawal.
出处
《广州中医药大学学报》
CAS
北大核心
2013年第2期157-161,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省佛山市科技局医学科研立项项目(编号:201108039)
关键词
抽动障碍
耳穴贴压法
捏脊针四缝法
疏肝健脾法
中西医结合阶梯法
儿童
Tic disorder
Auricular acupoint pressing therapy
Therapy for pinching spine and needling Sifeng point
Therapy for soothing liver and strengthening spleen
Integrated traditional Chinese and western medicine stage-by-stage therapy
Children
