目的 探討菖麻熄風(fēng)片聯(lián)合硫必利治療小兒多發(fā)性抽動(dòng)癥的臨床療效。方法 選取2019年6月-2022年6月哈爾濱醫(yī)科大學(xué)附屬第六醫(yī)院（江南院區(qū)）收治的102例多發(fā)性抽動(dòng)癥患兒，按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各51例。對(duì)照組口服鹽酸硫必利片，起始劑量0.5片/次，1次/d；根據(jù)抽動(dòng)發(fā)作情況劑量可增至0.5片/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服菖麻熄風(fēng)片，7~12歲者2片/次，12歲者3片/次，均為3次/d。兩組療程均為12周。觀察兩組的臨床療效，比較治療前后兩組耶魯抽動(dòng)癥整體嚴(yán)重程度量表（YGTSS）評(píng)分、中醫(yī)癥狀積分、兒少心理健康量表（MHS-CA）、兒童生活質(zhì)量普適性核心評(píng)定量表4.0（PedsQL4.0）評(píng)分及血漿多巴胺（DA）、5-羥色胺（5-HT）、神經(jīng)元特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組總有效率是92.16%，顯著高于對(duì)照組的76.47%（P<0.05）。治療后，兩組YGTSS中運(yùn)動(dòng)性抽動(dòng)、發(fā)聲性抽動(dòng)評(píng)分、缺損評(píng)分及其總分均顯著降低（P<0.05），以治療組降低更顯著（P<0.05）。治療后，兩組中醫(yī)癥狀積分均顯著降低，但MHS-CA、PedsQL4.0評(píng)分均顯著增高（P<0.05），以治療組改善更顯著（P<0.05）。治療后，兩組血漿DA、5-HT、NSE水平均顯著下降（P<0.05）；且治療后，治療組血漿DA、5-HT、NSE水平均顯著低于對(duì)照組（P<0.05）。結(jié)論 菖麻熄風(fēng)片聯(lián)合硫必利治療小兒多發(fā)性抽動(dòng)癥能安全有效地緩解患兒臨床癥狀，改善患兒心理健康狀況及生活質(zhì)量，糾正體內(nèi)神經(jīng)遞質(zhì)失調(diào)，減輕神經(jīng)損傷，整體療效較為滿(mǎn)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

黑龍江省自然科學(xué)基金資助項(xiàng)目（LH2020H065）