宁动颗粒对儿童抽动-秽语综合征伴睡眠障碍的影响

摘要

目的 观察宁动颗粒治疗儿童抽动-秽语综合征伴睡眠障碍的疗效.方法 采用美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)中的抽动-秽语综合征(TS)的西医诊断标准和相关中医诊断标准纳入患儿83例,分成硫必利组25例,宁动颗粒组30例,宁动颗粒+硫必利组28例,治疗3个月前后应用耶鲁综合抽动严重程度量表(YGTSS)和阿森斯失眠量表(Athens)进行评分,并评价临床疗效.结果 硫必利组、宁动颗粒组和宁动颗粒+硫必利组治疗TS疗效的有效率分别为92.0％,90.0％和96.4％;治疗睡眠障碍疗效的有效率分别为84.0％,93.3％和96.4％;3组间TS与睡眠障碍疗效、治疗前后YGTSS与Athens比较,差异有统计学意义(P＜0.05);宁动颗粒+硫必利组与硫必利组在治疗后Athens比较,差异有统计学意义(P＜0.05);治疗期间,3组不良反应分别为16,1和8例.结论 宁动颗粒组在治疗TS方面的疗效与硫必利组的疗效接近,但在治疗TS的同时改善患儿睡眠障碍的疗效优于硫必利组,且不良反应发生率低;宁动颗粒联合硫必利治疗TS伴睡眠障碍的临床疗效较佳,并能在一定程度上降低单纯应用硫必利而导致的不良反应发生率.%Objective To observe curative effect of Ningdong granules on tourette syndrome (TS) concomitant with sleep disorder in children.Methods Eighty-three cases were diagnosed by diagnosis and statistics of mental-disorder (DSMIV) TS criterion and diagnostic standard of traditional Chinese medicine,and then were divided into 3 groups:tiapride hydrochloride group (n =25),Ningdong granules group (n =30) and tiapride hydrochloride plus Ningdong granules group (n =28).Yale global tic severity scale (YGTSS) and Athens insomnia scale (Athens) were used for rating the clinical efficacy before and after treatment.The enrolled children were treated for a period of three months.Results The therapeutic effective rate of TS in tiapride hydrochloride group,Ningdong granules group and tiapride hydrochloride plus Ningdong granules group was 92.0％,90.0％ and 96.4％,respectively.The therapeutic effective rate of sleep disorder was 84.0％,93.3％ and 96.4％,respectively.Mter treatment,YGTSS and Athens scores were significantly changed in all three groups (P ＜ 0.05).Athens score was significantly different between tiapride hydrochloride plus Ningdong granules group and tiapride hydrochloride group (P ＜ 0.05).The total number of adverse reactions was 16,1 and 8,with significant difference (P ＜ 0.01).Conclusion Curative effect of Ningdong granules is similar to that of tiapride hydrochloride on treating TS,but Ningdong granules is more effective than tiapride hydrochloride on treating sleep disorder with less adverse reactions.Combination therapy of Ningdong granules with tiapride hydrochloride is the better choice for treating TS with sleep disorder,and it can also reduce the incidence of adverse reactions of tiapride hydrochloride.