本文選題：抽動障礙　切入點(diǎn)：靜心制動方　出處：《北京中醫(yī)藥大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的 本課題通過靜心制動隨癥加減治療抽動障礙的臨床觀察,比較治療前后癥狀變化,并通過對抽動障礙患兒血清神經(jīng)遞質(zhì)多巴胺(DA)、5-羥色胺(5-HT)、P物質(zhì)(SP)及一氧化氮(N0)檢測,比較中醫(yī)治療前后濃度變化,探討抽動障礙與神經(jīng)遞質(zhì)的關(guān)系,靜心制動方治療抽動障礙療效,以及靜心制動方對于神經(jīng)遞質(zhì)的作用。 研究方法及內(nèi)容 本課題采用病例前后對照研究方法,臨床采用靜心制動結(jié)合隨證加減方法,療程為半年,觀察中藥治療前后患兒抽動癥狀變化,用耶魯綜合抽動嚴(yán)重程度量表進(jìn)行癥狀評分及嚴(yán)重程度評定,使用評分減分率評定療效；使用酶聯(lián)ELISA化學(xué)發(fā)光法,對抽動障礙患者血清多巴胺(DA)、5-羥色胺(5-HT)P物質(zhì)(SP)及一氧化氮(N0)進(jìn)行檢測,觀察治療前后的變化。 研究結(jié)果 最終入選病例18例,男孩15例,女孩3例,男孩明顯多于女孩；患兒年齡為6～18歲,平均年齡(11.34-3.1)歲,病程1～7年,平均病程為(3.0+1.9)年,患兒年齡,病程差異無統(tǒng)計(jì)學(xué)意義(P0.05)。療效評定,顯效9例,好轉(zhuǎn)9例,無效0例,有效率100%；療前輕度病例0例,中度病例13例,重度病例5例,治療后輕度病例13例,中度病例5例,重度病例0例,而且治療后耶魯評分較療前顯著減少,具有統(tǒng)計(jì)學(xué)意義(P0.01)；中藥治療后血清多巴胺與療前相比明顯下降,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；療后血清5-HT、SP、NO與療前相比,其差異無統(tǒng)計(jì)學(xué)意義(P0.05) 結(jié)論 靜心制動方治療前后血清DA濃度有明顯差異,抽動患兒可能存在神經(jīng)遞質(zhì)失衡,但5-HT、NO及SP與抽動障礙的相關(guān)性需進(jìn)一步研究。 靜心制動方治療抽動障礙總有效率為100%,療效顯著。靜心制動方治療抽動障礙的作用機(jī)制可能與調(diào)節(jié)血清神經(jīng)遞質(zhì)濃度有關(guān)。
[Abstract]:Research purpose. In this study, we compared the changes of symptoms before and after the treatment of dysphoria by the clinical observation of the addition and subtraction of cardiac immobilization with syndrome, and detected the serum neurotransmitter dopamine (dopamine), 5-hydroxytryptamine (5-HT), substance P (SPN) and nitric oxide (N _ 0) in children with dysphoria, and compared the changes of symptoms before and after treatment. To compare the change of concentration before and after TCM treatment, to explore the relationship between twitch disorder and neurotransmitter, the curative effect of Jingxinjiaofang on tic disorder, and the effect of Jingxinshuifang on neurotransmitter. Research methods and contents. In this paper, we used the method of case control study, the clinical use of static braking combined with syndrome plus or minus method, the course of treatment is half a year, observe the changes of children's tic symptoms before and after treatment with traditional Chinese medicine. The symptoms and severity were evaluated with the Yale Comprehensive tic severity scale, the efficacy was evaluated by the score reduction rate, and the enzyme linked ELISA chemiluminescence method was used. In order to observe the changes before and after treatment, the serum levels of serotonin 5 HT P (SP) and nitric oxide (N 0) were measured in patients with tic disorder. Research results. 18 cases were selected, 15 boys and 3 girls, the age of the children was 6 years old, mean age was 11.34-3.1) years, the course of disease was 1 ~ 7 years, the average course of disease was 3.01.9 years, the age of the children was 3.01.9 years. There was no significant difference in course of disease (P 0.05). There were 9 cases of marked effect, 9 cases of improvement, 0 cases of ineffective, 100 cases of effective rate, 0 cases of mild, 13 cases of moderate, 5 cases of severe, 13 cases of mild and 5 cases of moderate before treatment. There were 0 severe cases, and the Yale score after treatment was significantly lower than that before treatment, which had statistical significance (P 0.01), the serum dopamine level was significantly decreased after treatment with Chinese medicine, the difference was statistically significant (P 0.05), and the serum 5-HTP SPN no after treatment was significantly lower than that before treatment. The difference was not statistically significant (P0.05). Conclusion. There was significant difference in serum DA concentration before and after treatment with Jingxinjiaofang, and there might be neurotransmitter imbalance in children with twitch, but the correlation between 5-HTN no and SP and tic disorder needed to be further studied. The total effective rate of Jingxinjiaofang in the treatment of tic disorders is 100 and the curative effect is remarkable. The mechanism of Jingxinjiaofang in treating tic disorders may be related to regulating the concentration of serum neurotransmitters.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R272

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