目的 探讨菖麻熄风片联合硫必利治疗小儿多发性抽动症的临床疗效。方法 选取2019年6月-2022年6月哈尔滨医科大学附属第六医院（江南院区）收治的102例多发性抽动症患儿，按随机数字表法分为对照组和治疗组，每组各51例。对照组口服盐酸硫必利片，起始剂量0.5片/次，1次/d；根据抽动发作情况剂量可增至0.5片/次，2次/d。治疗组在对照组基础上口服菖麻熄风片，7~12岁者2片/次，12岁者3片/次，均为3次/d。两组疗程均为12周。观察两组的临床疗效，比较治疗前后两组耶鲁抽动症整体严重程度量表（YGTSS）评分、中医症状积分、儿少心理健康量表（MHS-CA）、儿童生活质量普适性核心评定量表4.0（PedsQL4.0）评分及血浆多巴胺（DA）、5-羟色胺（5-HT）、神经元特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组总有效率是92.16%，显著高于对照组的76.47%（P<0.05）。治疗后，两组YGTSS中运动性抽动、发声性抽动评分、缺损评分及其总分均显著降低（P<0.05），以治疗组降低更显著（P<0.05）。治疗后，两组中医症状积分均显著降低，但MHS-CA、PedsQL4.0评分均显著增高（P<0.05），以治疗组改善更显著（P<0.05）。治疗后，两组血浆DA、5-HT、NSE水平均显著下降（P<0.05）；且治疗后，治疗组血浆DA、5-HT、NSE水平均显著低于对照组（P<0.05）。结论 菖麻熄风片联合硫必利治疗小儿多发性抽动症能安全有效地缓解患儿临床症状，改善患儿心理健康状况及生活质量，纠正体内神经递质失调，减轻神经损伤，整体疗效较为满意。

Objective To explore the clinical effect of Changma Xifeng Tablets combined with tiapride in treatment of children with multiple tourette syndrome. Methods A total of 102 children with multiple tourette syndrome admitted to the Sixth Affiliated Hospital of Harbin Medical University (Jiangnan Hospital) from June 2019 to June 2022 were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group. Patients in the control group were po administered with Tiapride Hydrochloride Tablets, the initial dosage was 0.5 tablets/time, once daily, and the dosage can be increased to 0.5 tablets/time, 2 times daily according to the tic attack. Patients in the treatment group were po administered with Changma Xifeng Tablets on the basis of the control group, 2 tablets/time for 7 to 12 years old, 3 tablets/time for 12 years old, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the scores of Yale Tourette Syndrome Overall Severity Scale (YGTSS), TCM symptom score, MHS-CA, PedsQL4.0, and the levels of serum dopamine (DA), 5-hydroxytryptamine (5-HT), and neuron-specific enolase (NSE) were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 92.16%, which was significantly higher than that of the control group (76.47%, P < 0.05). After treatment, the motor tic score, vocal tic score, defect score and total score of YGTSS in both groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the scores of TCM symptoms in both groups were significantly decreased, but the scores of MHS-CA and PedsQL4.0 were significantly increased (P < 0.05), and the improvement was more significant in the treatment group (P< 0.05). After treatment, the plasma levels of DA, 5-HT and NSE in 2 groups were significantly decreased (P < 0.05). After treatment, the plasma levels of DA, 5-HT and NSE in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Changma Xifeng Tablets combined with tiapride can safely and effectively relieve the clinical symptoms of children with multiple tourette syndrome, and can improve the psychological health and life quality of children, correct the imbalance of neurotransmitters in the body, and reduce nerve injury. The overall effect is satisfactory.

R971

黑龙江省自然科学基金资助项目（LH2020H065）