目的 探討瀉青丸聯(lián)合可樂定透皮貼片治療兒童抽動障礙的臨床療效。方法 選取2023年8月—2024年8月在河北省中醫(yī)院接受治療的抽動障礙患兒102例，隨機分為對照組和治療組，每組各51例。對照組使用可樂定透皮貼片，按20 kg≤體質(zhì)量≤40 kg、40 kg＜體質(zhì)量≤60 kg、體質(zhì)量＞60 kg分別給予1.0、1.5、2.0 mg/次，每7天更換1次。在對照組基礎(chǔ)上，治療組口服瀉青丸，7 g/次，2次/d。兩組患兒療程12周。觀察兩組患者臨床療效，比較治療前后兩組患者耶魯綜合抽動嚴重程度量表（YGTSS）、少心理健康量表（MHS-CA）和兒童少年生活質(zhì)量量表（QLSCA）評分，及血清多巴胺（DA）、5-羥色胺（5-HT）、白細胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）、膠質(zhì)纖維酸性蛋白（GFAP）和腦源性神經(jīng)營養(yǎng)因子（BDNF）水平。結(jié)果 治療后，治療組總有效率明顯高于對照組（92.16% vs 76.47%，P＜0.05）。治療6、12周后，兩組YGTSS評分都低于組內(nèi)治療前（P＜0.05），且治療組YGTSS評分明顯低于對照組（P＜0.05）。治療后，兩組MHS-CA和QLSCA評分均高于組內(nèi)治療前（P＜0.05），且治療組評分明顯高于對照組（P＜0.05）。治療后，兩組血清DA、5-HT、IL-17、TNF-α、GFAP水平都低于組內(nèi)治療前，而BDNF水平高于組內(nèi)治療前（P＜0.05），且治療組這些因子水平明顯好于對照組（P＜0.05）。結(jié)論 瀉青丸聯(lián)合可樂定透皮貼片治療兒童抽動障礙，能安全有效地調(diào)節(jié)神經(jīng)遞質(zhì)，減輕神經(jīng)炎癥，促進神經(jīng)損傷修復(fù)及抽動癥狀好轉(zhuǎn)，利于患兒心理健康和生活質(zhì)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

政府資助臨床醫(yī)學(xué)優(yōu)秀人才培養(yǎng)項目（ZF2023170）；河北省中醫(yī)藥管理局科研計劃項目（2022022）