Abstract:

Objective　To explore the clinical efficacy and safety of Tongdu Yisui acupuncture combined with Ningshen Zhichou decoction in treating pediatric Tourette syndrome characterized by internal stirring of liver wind. Methods　This study was a randomized controlled trial. A total of 102 children with Tourette syndrome with internal stirring of liver wind admitted to Yulin Traditional Chinese Medicine Hospital from December 2021 to April 2024 were enrolled and were randomly divided into a treatment group and a control group, with 51 cases in each group. In the treatment group, 29 boys and 22 girls were (8.03±2.21) years old, and the course of disease was (3.86±0.62) months. In the control group, 27 boys and 24 girls were (7.89±2.15) years old, and the course of disease was (3.80±0.59) months. The control group was given tiapride hydrochloride tablets orally, the initial dose was 0.05 g/time, twice a day, and the dose was increased to 0.10 g/time, twice a day after the 3rd week, continuous treatment for 1 month. On the basis of the control group, the treatment group was given Tongdu Yisui acupuncture (3 times a week, with an interval of 1-2 days, a total of 1 month) combined with Ningshen Zhichou decoction (1 dose a day, 3 to 10 years old, 100 ml each time, twice a day; 11-12 years old, 200 ml each time, twice a day, taken warmly in the morning and evening, a total of 1 month). After treatment, the traditional Chinese medicine (TCM) syndrome score, Yale Global Tic Severity Scale (YGTSS) score, frequency and interval of tic occurrence, neurotransmitter balance, and humoral immunity level in the two groups were observed, and the safety was recorded. Independent sample t test and χ² test were used for statistical analysis. Results　After treatment, the TCM syndrome score of the treatment group was lower than that of the control group [(2.08±0.53) points vs. (3.31±0.88) points], and the scores of motor tics, vocal tics, and overall impairment and total YGTSS score of the treatment group were lower than those of the control group, with statistically significant differences (all P<0.05). After treatment, the daily frequency of the treatment group was lower than that of the control group (1.80±0.24 vs. 4.16±0.66), and the interval duration was longer than that of the control group [(10.48±1.53) h vs. (4.48±1.48) h] (both P<0.05). After treatment, the levels of neurotransmitters in the treatment group were higher than those in the control group, and the immune function was better than that in the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　The use of Tongdu Yisui acupuncture combined with Ningshen Zhichou decoction in treating pediatric Tourette syndrome with internal stirring of liver wind significantly outperforms conventional drug treatment in terms of improving TCM syndromes, YGTSS score, tic frequency and interval, neurotransmitter balance, and humoral immune level, while maintaining a high level of safety.

Key words:

Pediatric Tourette syndrome, Internal stirring of liver wind, Tongdu Yisui , acupuncture, Ningshen Zhichou , decoction, Clinical efficacy

摘要：

目的　探讨通督益髓针法联合凝神止抽汤治疗肝风内动型小儿抽动症的临床疗效及安全性。方法　本研究为随机对照试验。纳入2021年12月至2024年4月榆林市中医医院收治的102例肝风内动型小儿抽动症患者，按随机数字表法分为治疗组和对照组各51例。治疗组男29例，女22例，年龄（8.03±2.21）岁，病程（3.86±0.62）个月；对照组男27例，女24例，年龄（7.89±2.15）岁，病程（3.80±0.59）个月。对照组给予盐酸硫必利片口服，起始剂量0.05 g/次，2次/d，给药至第3周后，增加至0.10 g/次，2次/d，连续治疗1个月。治疗组在对照组基础上给予通督益髓针法（每周3次，中间间隔1～2 d）联合凝神止抽汤（1剂/d，3～10岁，每次100 ml，每日2次；11～12岁，每次200 ml，每日2次，早晚温服），共治疗1个月。治疗结束后，观察两组患儿中医证候评分、耶鲁综合抽动严重程度量表（Yale Global Tic Severity Scale，YGTSS）评分、发病频率及间歇时长、神经递质平衡及体液免疫水平，并记录安全性。统计学方法采用独立样本t检验、χ²检验。结果　治疗后，治疗组中医证候评分低于对照组［（2.08±0.53）分比（3.31±0.88）分］，且治疗组运动抽动、发声抽动、综合损害评分及YGTSS总分均低于对照组，差异均有统计学意义（均P<0.05）。治疗后，治疗组的日发病频率低于对照组（1.80±0.24比4.16±0.66），间歇时长长于对照组［（10.48±1.53）h比（4.48±1.48）h］（均P<0.05）。治疗后，治疗组的神经递质水平高于对照组，免疫功能优于对照组，差异均有统计学意义（均P<0.05）。两组不良反应总发生率差异无统计学意义（P>0.05）。结论　运用通督益髓针法联合凝神止抽汤治疗肝风内动型小儿抽动症在改善中医证候、YGTSS评分、发病频率及间歇时长、神经递质平衡及体液免疫水平等方面均优于常规药物治疗，并有较高的安全性。

关键词:

小儿抽动症, 肝风内动型, 通督益髓针法, 凝神止抽汤, 临床效果