头针结合药物治疗抽动秽语综合征临床观察

摘要

Objective:To observe the clinical effect of scalp-acupuncture combined with medication in the treatment of Tourette's Syndrome (TS).Methods:60 TS patients were randomly divided into the scalp-acupuncture group (group A,n =20),the medication group (group B,n =20),and the combined group of scalp -acupuncture and medication (group C,n =20).Points in group A were chosen according to the international standardization program of scalp-acupuncture,group B was treated with Haloperidol,and group C was treated with scalp-acupuncture and Haloperidol.The treatment course was eight weeks.Symptom scores and clinical effect were compared with YGTSS in the groups before the treatment,four-week and eight-week after the treatment,during one-month and three-month follow-up.Results:Scores of YGTSS,levels of DA and 5-HT were all decreased significantly after the treatment in the three groups (P ＜ 0.05).In terms of YGTSS score after the treatment,the differences between group C and group A,and between group C and group B were both statistically significant(P ＜0.01,P ＜0.05);also there was significant difference between group A and group B(P＜0.05).The total effective rates were 60％ in group A,75％ in group B,and 85％ in group C.Although group A was not better than group B or group C in clinical efficacy,it had the least side effect;group B had more side effect.The curative effect was kept in both group A and group C during one-month and three-month follow-up,but it decreased in group B at the same time point.Conclusion:The combination of scalp-acupuncture and medication is effective for TS,which is superior to simple scalp-acupuncture or simple medication.It provides reference for the clinical treatment of TS.%目的:观察头针结合药物治疗抽动秽语综合征的临床疗效.方法:将入选的60例抽动秽语综合征患者随机分为头针组(A组)、药物组(B组)和头针结合药物治疗组(C组),每组各20例,其中A组参照《头针穴名国际标准化方案》,针刺舞蹈震颤控制区、顶颞前斜线、颞前线、顶中线和顶旁1线,B组给予氟哌啶醇治疗,C组在A组基础上给予氟哌啶醇治疗,连续治疗8周,分别在治疗前、治疗4周、治疗8周、随访1个月后、随访3个月后采用《耶鲁抽动症程度量表YGTSS》进行症状评分及疗效对比.结果:A、B和C组3组都能降低YGTSS评分,同时,可以使患者血浆中纹状体多巴胺(DA)和5-羟色胺(5-HT)数值降低,差异均具有统计学意义(P＜0.05).3组患者治疗后YGTSS量表总评分比较:C与A组比较有显著性差异(P＜0.01);C组与B组比较有统计学意义(P＜0.05);A组与B组比较有统计学意义(P＜0.01).A组治疗总有效率60％,B组75％,C组85％,C组疗效优于A、B两组,B组治疗效果优于A组.A组副作用最少,B组副作用较多.A组和C组在随访1个月和3个月时仍能保持疗效,B组在随访时疗效降低.结论:头针结合药物治疗抽动秽语综合征疗效肯定,优于单纯头针或单纯药物治疗,为临床治疗抽动秽语综合征提供了依据.