目的 探討芍麻止痙顆粒聯合硫必利治療兒童抽動癥的臨床療效。方法 選取2021年5月-2021年9月駐馬店市精神病醫(yī)院兒科接診的70例兒童抽動癥患兒,按照隨機數字表法分為對照組和治療組,每組各35例。對照組患兒口服鹽酸硫必利片,從50 mg/次開始,2次/d,根據抽動發(fā)作情況可加量至150 mg/次,2次/d,癥狀控制后改維持劑量50~150 mg/d,分成2次服用。治療組患兒在對照組治療基礎上口服芍麻止痙顆粒,5 g/次,3次/d。兩組患兒連續(xù)用藥8周。觀察兩組的臨床療效,比較兩組臨床癥狀好轉時間、耶魯綜合抽動嚴重程度量表(YGTSS)評分和血清炎癥因子指標。結果 治療后,治療組總有效率是97.14%,顯著高于對照組74.29%(P<0.05)。治療后,治療組患兒出現聳肩、伸脖子、咧嘴、擠眼等癥狀好轉時間均明顯短于對照組(P<0.05)。治療后,兩組運動性抽動評分、發(fā)聲性抽動評分均較治療前顯著降低(P<0.05);治療后,治療組YGTSS評分顯著低于對照組(P<0.05)。治療后,兩組白細胞介素-6(IL-6)、5-羥色胺(5-HT)、神經元特異性醇化酶(NSE)、谷氨酸(GLU)水平均較治療前顯著降低(P<0.05);且治療后治療組IL-6、5-HT、NSE、GLU水平均低于對照組(P<0.05)。結論 芍麻止痙顆粒聯合硫必利治療兒童抽動癥具有較好的臨床療效,可明顯改善患兒癥狀,并能有效降低炎癥反應因子和神經遞質水平,值得臨床推廣應用。

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

河南省醫(yī)學科技攻關計劃項目（2018020174）