自拟滋阴潜阳、调肝熄风方治疗阴虚风动型小儿多发性抽动症的临床研究

摘要

OBJECTIVE To study the clinical effectiveness and influence of Enriching Yin and Subduing Yang,Regulating Liver and Extinguishing Wind Formula in the treatment of Tourette syndrome caused by wind stirring due to yin deficiency.METHODS 80 patients with Tourette syndrome caused by wind stirring due to yin deficiency admitted in our hospital from Oct.2013 to Oct.2016 were selected and randomly divided into the observation group and the control group by random number,40 cases in each group.The control group was treated with inosine combined with vitamin B6,and the observation group was treated with self-made Enriching Yin and Subduing Yang,Regulating Liver and Extinguishing Wind Formula.One month for a course for both groups,and both were treated for 3 courses.Changes of clinical symptoms and signs were observed before and after treatment.YGTSS of American Infant Psychosis Study Institute was applied to test the YGTSS scores in two groups before and after treatment.The clinical effect was evaluated according to the reduction rate of YGTSS scale.Cellular immunity (CD3+,CD4+,CD8+ and CD4+/CD8+) and humoral immunity (serum IgG,IgA and IgM) levels in two groups were tested.Patients in two groups were followed up for 3 months to count the recurrence.RESULTS Total scores of TCM syndrome in two groups decreased significantly (P<0.01) after treatment,but that in the observation group decreased more significantly (P<0.01).Motor tics,incidence tics,resultant damages and YGTSS scores of total in two groups decreased significantly (P<0.01) after treatment,but that in the observation group decreased more significantly (P<0.01).Total effective rate in the observation group was 97.5%,which was significantly higher than that in the control group (85.0%,P<0.05).The recurrence rate of the observation group (5%) significantly lower than that in the control group (20.00%)(P<0.05).CD3+,CD4+,CD8+ and CD4+/CD8+ in two groups improved significantly after treatment (P<0.01),but that in the observation group improved more significantly (P<0.01).IgA,IgG and IgM levels in two groups increased significantly after treatment (P<0.01),but that in the observation group increased more significantly (P<0.01).CONCLUSION Enriching Yin and Subduing Yang,Regulating Liver and Extinguishing Wind Formula can significantly improve clinical symptoms of patients with Tourette syndrome,decrease patients,incidence tics,motor tics and resultant damages,which have significant clinical effectiveness and high safety.Its action mechanism may be related to the improvement of immunity.%目的 探讨滋阴潜阳、调肝熄风方治疗阴虚风动型小儿多发性抽动症的临床疗效及对免疫功能的影响.方法 选取2013年10月-2016年10月我院收治的小儿多发性抽动症患者80例,且中医辨证分型为阴虚风动型,将其按照随机数字法随机分为观察组和对照组,每组40例,对照组给予肌苷合并维生素B6治疗,观察组给予自拟滋阴益肺、调肝熄风方治疗,2组均以1月为1个疗程,均治疗3个疗程.观察治疗前后临床症状及体征的变化,采用美国儿童精神病研究院的耶鲁抽动程度综合量表(YGTSS),对治疗前后2组的YGTSS分值进行测定,依据YGTSS量表的减分率,对临床疗效评定.并对2组的细胞免疫(CD3+、CD4+、CD8+、CD4+/CD8+)及体液免疫(血清 IgG、IgA、IgM) 水平进行检测,随访3月统计2组复发情况.结果 治疗后2组中医证候总积分均显著下降(P<0.01),但观察组下降更为明显(P<0.01).治疗后2组运动抽动、发生抽动、综合损害、总评分的YGTSS评分均显著下降(P<0.01),但观察组下降更为明显(P<0.01).观察组的总有效率为97.5%显著高于对照组的85.0%(P<0.05);观察组复发率(5%)显著低于对照组(20.00%,P<0.05).治疗后2组CD3+、CD4+、CD8+、CD4+/CD8+均显著改善(P<0.01),但观察组CD3+、CD4+、CD8+、CD4+/CD8+改善更为明显(P<0.01).治疗后2组IgA、IgG、IgM均显著升高(P<0.01),但观察组升高更为明显(P<0.01).结论 滋阴潜阳、调肝熄风方可显著改善小儿多发性抽动症患儿的临床症状,减少患儿的发生抽动、运动抽动及综合损害,临床疗效显著,安全性高,其作用机制可能与提高免疫能力有关.