目的 探寻芍麻止痉颗粒联用阿立哌唑对抽动障碍患儿的临床疗效。方法 选取2024年8月—2025年8月南阳市中心医院收治的80例抽动障碍患儿，依据治疗方式差异分为对照组和治疗组，每组各40例。对照组口服阿立哌唑片，起始剂量2.5 mg/d，1～2周增加1次剂量，直到症状控制或达治疗剂量10 mg/d，随后减量维持。治疗组在对照组基础上口服芍麻止痉颗粒，5 g/次，3次/d。两组患者均连续治疗8周。对比两组临床疗效、抽动症状[耶鲁综合抽动严重程度量表（YGTSS）]、自我意识[儿童自我意识量表（PHCSS）]、生活质量[抽动秽语综合征儿童青少年生活质量量表（GTS-QOL）]及神经递质[多巴胺（DA）、神经递质5-羟色胺（5-HT）、γ-氨基丁酸（GABA）]。结果 治疗后，治疗组总有效率（95.00%）高于对照组（77.50%，P＜0.05）。治疗后，两组YGTSS量表各维度运动抽动、发声抽动、整体功能损害评分与同组治疗前比较均显著降低（P＜0.05）；且治疗组的YGTSS量表各维度运动抽动、发声抽动、整体功能损害评分均低于对照组（P＜0.05）。治疗后，两组PHCSS量表各维度得分与同组治疗前比较均明显提高（P＜0.05），且治疗组PHCSS量表各维度得分均高于对照组（P＜0.05）。治疗后，两组GTS-QOL量表中身体和日常生活活动影响、强迫观念与行为问题、认知功能问题、精神心理问题及GTS-QOL总分与同组治疗前比较均显著降低（P＜0.05）；且治疗后治疗组GTS-QOL量表各维度评分均低于对照组（P＜0.05）。治疗后，两组患者5-HT、DA与同组治疗前比较均显著下降，而GABA水平升高（P＜0.05），且治疗后治疗组血清5-HT、DA表达低于对照组，GABA表达高于对照组（P＜0.05）。结论 对于儿童抽动障碍，芍麻止痉颗粒与阿立哌唑的协同作用显著，不仅能有效控制抽动症状、优化神经递质表达，也有助于提升患者的自我意识与生活品质。

Objective To explore the clinical efficacy of Shaoma Zhijing Granules combined with aripiprazole in treatment of tic disorders in children. Methods A total of 80 children with tic disorders admitted to Nanyang Central Hospital from August 2024 to August 2025 were enrolled and divided into a control group and a treatment group according to different therapeutic regimens, with 40 cases in each group. The control group received oral Aripiprazole Tablets at an initial dose of 2.5 mg per day. The dose was increased once every 1 — 2 weeks until symptoms were controlled or the therapeutic dose of 10 mg per day was reached, followed by dose reduction for maintenance treatment. On the basis of the regimen of the control group, the treatment group was additionally given oral Shaoma Zhijing Granules at a dose of 5 g each time, three times daily. Both groups received continuous treatment for 8 weeks. The two groups were compared in terms of clinical efficacy, tic symptoms evaluated by the Yale Global Tic Severity Scale (YGTSS), self-concept assessed by the Piers-Harris Children’s Self-Concept Scale (PHCSS), quality of life measured by the Gilles de la Tourette Syndrome Quality of Life Scale (GTS-QOL), and serum levels of neurotransmitters including dopamine (DA), 5-hydroxytryptamine (5-HT) and γ-aminobutyric acid (GABA). Results After treatment, the total effective rate of the treatment group (95.00%) was significantly higher than that of the control group (77.50%, P < 0.05). Compared with baseline, the subscale scores of motor tics, vocal tics and overall impairment on the YGTSS were markedly decreased in both groups after treatment (P < 0.05); and all the above YGTSS subscale scores in the treatment group were lower than those in the control group (P < 0.05). The subscale scores of the PHCSS were significantly elevated in both groups after treatment relative to pretreatment levels (P < 0.05), with higher scores observed in the treatment group (P < 0.05). After treatment, the subscale scores of physical and daily life impacts, obsessive-compulsive symptoms, cognitive dysfunction, psychological problems, as well as the total score of GTS-QOL were significantly reduced in both groups (P < 0.05); all subscale scores of GTS-QOL in the treatment group were lower than those in the control group after treatment (P < 0.05). Serum levels of 5-HT and DA decreased significantly, while GABA levels increased in both groups after treatment (P < 0.05). The treatment group presented lower serum 5-HT and DA levels and higher GABA levels compared with the control group after treatment (P < 0.05). Conclusion For children with tic disorders, Shaoma Zhijing Granules combined with aripiprazole is significant. It can effectively relieve tic symptoms, regulate the expression of neurotransmitters, and improve children’s self-concept and quality of life.

R971

南阳市科技计划基础与前沿项目（JCQY015）