目的 探讨泻青丸联合可乐定透皮贴片治疗儿童抽动障碍的临床疗效。方法 选取2023年8月—2024年8月在河北省中医院接受治疗的抽动障碍患儿102例，随机分为对照组和治疗组，每组各51例。对照组使用可乐定透皮贴片，按20 kg≤体质量≤40 kg、40 kg＜体质量≤60 kg、体质量＞60 kg分别给予1.0、1.5、2.0 mg/次，每7天更换1次。在对照组基础上，治疗组口服泻青丸，7 g/次，2次/d。两组患儿疗程12周。观察两组患者临床疗效，比较治疗前后两组患者耶鲁综合抽动严重程度量表（YGTSS）、少心理健康量表（MHS-CA）和儿童少年生活质量量表（QLSCA）评分，及血清多巴胺（DA）、5-羟色胺（5-HT）、白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）、胶质纤维酸性蛋白（GFAP）和脑源性神经营养因子（BDNF）水平。结果 治疗后，治疗组总有效率明显高于对照组（92.16% vs 76.47%，P＜0.05）。治疗6、12周后，两组YGTSS评分都低于组内治疗前（P＜0.05），且治疗组YGTSS评分明显低于对照组（P＜0.05）。治疗后，两组MHS-CA和QLSCA评分均高于组内治疗前（P＜0.05），且治疗组评分明显高于对照组（P＜0.05）。治疗后，两组血清DA、5-HT、IL-17、TNF-α、GFAP水平都低于组内治疗前，而BDNF水平高于组内治疗前（P＜0.05），且治疗组这些因子水平明显好于对照组（P＜0.05）。结论 泻青丸联合可乐定透皮贴片治疗儿童抽动障碍，能安全有效地调节神经递质，减轻神经炎症，促进神经损伤修复及抽动症状好转，利于患儿心理健康和生活质量水平提高。

Objective To investigate the clinical efficacy of Xieqing Pills combined with Clonidine Transdermal Patches in treatment of tic disorder in children. Methods Children (102 cases) with tic disorder in Hebei Provincial Hospital of Traditional Chinese Medicine from August 2023 to August 2024 were randomly divided into control and treatment group based on the principle of inter-group matching, and each group had 51 cases. Children in the control group were administered with Clonidine Transdermal Patches, they were given 1.0, 1.5 and 2.0 mg each time respectively for 20 kg≤ body weight ≤40 kg, 40 kg < body weight ≤60 kg and body weight > 60 kg, and replaced every 7 d. Children in the treatment group were po administered with Xieqing Pills on the basis of the control group, 7 g/time, twice daily. Children in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the scores of YGTSS, MHS-CA and QLSCA, and the levels of DA, 5-HT, IL-17, TNF-α, GFAP and BDNF in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (92.16% vs 76.47%, P < 0.05). After 6 and 12 weeks of treatment, the YGTSS scores in two groups were lower than those before treatment (P < 0.05), and the YGTSS scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the MHS-CA and QLSCA scores in two groups were higher than those before treatment (P < 0.05), and the scores in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum DA, 5-HT, IL-17, TNF-α, and GFAP levels in two groups were lower than before treatment, while the BDNF level was higher than before treatment (P < 0.05), the levels of these factors in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Xieqing Pills combined with Clonidine Transdermal Patches in the treatment of tic disorder in children can safely and effectively regulate neurotransmitters, reduce neuroinflammation, promote the repair of nerve injury and the improvement of tic symptoms, which is conducive to the improvement of children's mental health and quality of life.

R971

政府资助临床医学优秀人才培养项目（ZF2023170）；河北省中医药管理局科研计划项目（2022022）