目的 探讨芍麻止痉颗粒联合硫必利治疗儿童抽动症的临床疗效。方法 选取2021年5月-2021年9月驻马店市精神病医院儿科接诊的70例儿童抽动症患儿,按照随机数字表法分为对照组和治疗组,每组各35例。对照组患儿口服盐酸硫必利片,从50 mg/次开始,2次/d,根据抽动发作情况可加量至150 mg/次,2次/d,症状控制后改维持剂量50~150 mg/d,分成2次服用。治疗组患儿在对照组治疗基础上口服芍麻止痉颗粒,5 g/次,3次/d。两组患儿连续用药8周。观察两组的临床疗效,比较两组临床症状好转时间、耶鲁综合抽动严重程度量表(YGTSS)评分和血清炎症因子指标。结果 治疗后,治疗组总有效率是97.14%,显著高于对照组74.29%(P<0.05)。治疗后,治疗组患儿出现耸肩、伸脖子、咧嘴、挤眼等症状好转时间均明显短于对照组(P<0.05)。治疗后,两组运动性抽动评分、发声性抽动评分均较治疗前显著降低(P<0.05);治疗后,治疗组YGTSS评分显著低于对照组(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、5-羟色胺(5-HT)、神经元特异性醇化酶(NSE)、谷氨酸(GLU)水平均较治疗前显著降低(P<0.05);且治疗后治疗组IL-6、5-HT、NSE、GLU水平均低于对照组(P<0.05)。结论 芍麻止痉颗粒联合硫必利治疗儿童抽动症具有较好的临床疗效,可明显改善患儿症状,并能有效降低炎症反应因子和神经递质水平,值得临床推广应用。

Objective To investigate the therapeutic effect of Shaomazhijing Granules combined with tiapride in treatment of tourette syndrome in children. Methods A total of 70 children with tourette syndrome treated in the department of Pediatrics of Zhumadian Psychiatric Hospital from May 2021 to September 2021 were selected and divided into control group and treatment group according to random number table method, with 35 cases in each group. Patients in the control group were po administered with Tiapride Hydrochloride Tablets, started from 50 mg/time, twice daily, according to the tic attack, and the dosage could be increased to 150 mg/time, twice daily. The maintenance dosage was changed to 50-150 mg/d, and took in 2 doses, when the symptoms were under control. Patients in the treatment group were po administered with Shaomazhijing Granules on the basis of the control group, 5 g/time, three times daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups were observed, and the improvement time of clinical symptoms, YGTSS score and serum factors were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 97.14%, significantly higher than that in the control group (74.29%, P < 0.05). After treatment, the improvement time of shoulder shrug, neck extension, mouth and eye squeezing in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, motor tic score and vocal tic score in two groups were significantly lower than those before treatment (P < 0.05). After treatment, the YGTSS score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the levels of interleukin-6 (IL-6), 5-hydroxytryptamine (5-HT), neuron specific alcoholase (NSE) and glutamate (GLU) in two groups were significantly decreased compared with before treatment (P < 0.05). The levels of IL-6, 5-HT, NSE and GLU in the treatment group were lower than those in the control group (P < 0.05). Conclusion Shaomazhijing Granules combined with tiapride has good clinical effect in treatment of tourette syndrome in children, and can significantly improve the symptoms of children and effectively reduce inflammatory response factors and neurotransmitters, which is worthy of clinical application.

R971

河南省医学科技攻关计划项目（2018020174）