CBIT聯(lián)合泰必利治療兒童抽動(dòng)障礙的臨床療效研究
發(fā)布時(shí)間：2018-10-23 20:46
【摘要】：目的:抽動(dòng)障礙(Tic Disorder,TD)常伴發(fā)心理和行為問題,藥物治療有其自身的局限性。綜合行為干預(yù)療法(Comprehensive Behavioral Interventions for Tics,CBIT)作為一種心理治療方法有其獨(dú)特的優(yōu)勢,在國際專業(yè)領(lǐng)域已經(jīng)被認(rèn)可,而在國內(nèi)還沒有臨床應(yīng)用的研究報(bào)道。本研究旨在探索CBIT聯(lián)合泰必利治療TD的有效性,找到一種更優(yōu)化的治療方案。方法:以符合美國《精神疾病診斷與統(tǒng)計(jì)手冊》第5版(Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V)中TD診斷標(biāo)準(zhǔn)的31例8~13歲的TD兒童為研究對(duì)象,隨機(jī)分為研究組(CBIT聯(lián)合泰必利治療)10例,對(duì)照組(單獨(dú)使用泰必利治療)21例。觀察治療效果共4個(gè)月,在治療開始前、治療1月、2月和4月4個(gè)時(shí)間點(diǎn)應(yīng)用“耶魯綜合抽動(dòng)嚴(yán)重程度量表(Yale Global Tic Severity Scale,YGTSS)”和“臨床療效總評(píng)量表(Clinical Global Impression,CGI)”分別進(jìn)行評(píng)分和療效比較。使用SPSS17.0軟件包建立數(shù)據(jù)庫并進(jìn)行統(tǒng)計(jì)分析。數(shù)據(jù)處理計(jì)數(shù)資料采用X~2檢驗(yàn),計(jì)量資料采用t檢驗(yàn),等級(jí)資料的比較采用秩和檢驗(yàn)。兩組整體比較時(shí)采用兩因素重復(fù)測量數(shù)據(jù)方差分析,組間比較時(shí)采用成組t檢驗(yàn),組內(nèi)比較時(shí)采用重復(fù)測量數(shù)據(jù)多重比較配對(duì)的t檢驗(yàn),即Bonferroni法,以α=0.05為檢驗(yàn)水準(zhǔn)。結(jié)果:治療1月后,兩組運(yùn)動(dòng)抽動(dòng)得分的差異有統(tǒng)計(jì)學(xué)意義(P0.05),治療2月和4月后功能受損得分的差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中治療2月后的差異有顯著的統(tǒng)計(jì)學(xué)意義(P0.01)。其余各時(shí)間點(diǎn)各因子得分的組間比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組內(nèi)部3個(gè)因子得分在治療4個(gè)月后與治療前相比,除研究組發(fā)聲抽動(dòng)得分外,差異均有統(tǒng)計(jì)學(xué)意義(P0.008),在治療2月后與治療1月后相比,差異均無統(tǒng)計(jì)學(xué)意義(P0.008)。兩組間治療前與治療后各個(gè)時(shí)間點(diǎn)CGI-S、CGI-I的比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組內(nèi)治療前與治療后各時(shí)間點(diǎn)CGI-S的比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組均未出現(xiàn)嚴(yán)重的不良反應(yīng)。結(jié)論:CBIT聯(lián)合泰必利治療TD與單獨(dú)使用泰必利比較,不僅能更好地減少運(yùn)動(dòng)抽動(dòng)和發(fā)聲抽動(dòng)癥狀,而且可以更有效地緩解患兒的功能受損。
[Abstract]:Objective: tic disorder (Tic Disorder,TD) is often associated with psychological and behavioral problems. Drug therapy has its own limitations. Comprehensive behavioral intervention therapy (Comprehensive Behavioral Interventions for Tics,CBIT) as a psychotherapy has its unique advantages, has been recognized in the international professional field, but there is no clinical application in China. The purpose of this study was to explore the efficacy of CBIT combined with tiapride in the treatment of TD and to find a more optimal treatment scheme. Methods: a total of 31 813 year old TD children who met the diagnostic criteria of TD in the fifth edition of (Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V were randomly divided into study group (CBIT combined with tiapride). There were 21 cases in the control group (treated with tiapride alone). The therapeutic effect was observed for 4 months. In the first month, two months and four months after treatment, the Yale Comprehensive tic severity scale (Yale Global Tic Severity Scale,YGTSS) and the Clinical curative effect scale (Clinical Global Impression,CGI) were used to evaluate and compare the efficacy. Use SPSS17.0 software package to build database and make statistical analysis. X2 test is used for data processing, t test is used for measurement data, and rank sum test is used for the comparison of grade data. Two factors repeated measurement data analysis of variance (ANOVA) was used in the whole comparison of the two groups, the group t test was used in the comparison between groups, and the t test of multiple comparisons of repeated measurement data in the group was used in the intra-group comparison, that is, the Bonferroni method was used to test the level of 偽 = 0. 05. Results: after 1 month treatment, there was significant difference between the two groups (P0.05), and the difference between the two groups after 2 months and 4 months was statistically significant (P0.05), and there was significant difference after 2 months of treatment (P0.01). There was no significant difference in the scores of each factor between the other time points (P0.05). The scores of three factors in the two groups were significantly different after 4 months of treatment compared with those before treatment except for the phonation twitching score of the study group (P0.008). There was no significant difference between the two groups after 2 months of treatment and 1 month after treatment (P0.008). There was no significant difference in CGI-S,CGI-I between the two groups before and after treatment (P0.05). There were significant differences in CGI-S between the two groups before and after treatment (P0.05). There were no serious adverse reactions in both groups. Conclusion: compared with tiapride alone, CBIT combined with tiapride can not only reduce the symptoms of motor twitch and phonation, but also relieve the impairment of function more effectively.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749.94
本文編號(hào)：2290422
[Abstract]:Objective: tic disorder (Tic Disorder,TD) is often associated with psychological and behavioral problems. Drug therapy has its own limitations. Comprehensive behavioral intervention therapy (Comprehensive Behavioral Interventions for Tics,CBIT) as a psychotherapy has its unique advantages, has been recognized in the international professional field, but there is no clinical application in China. The purpose of this study was to explore the efficacy of CBIT combined with tiapride in the treatment of TD and to find a more optimal treatment scheme. Methods: a total of 31 813 year old TD children who met the diagnostic criteria of TD in the fifth edition of (Diagnostic and Statistic Manual of Mental Disorders-Fifth Edition,DSM-V were randomly divided into study group (CBIT combined with tiapride). There were 21 cases in the control group (treated with tiapride alone). The therapeutic effect was observed for 4 months. In the first month, two months and four months after treatment, the Yale Comprehensive tic severity scale (Yale Global Tic Severity Scale,YGTSS) and the Clinical curative effect scale (Clinical Global Impression,CGI) were used to evaluate and compare the efficacy. Use SPSS17.0 software package to build database and make statistical analysis. X2 test is used for data processing, t test is used for measurement data, and rank sum test is used for the comparison of grade data. Two factors repeated measurement data analysis of variance (ANOVA) was used in the whole comparison of the two groups, the group t test was used in the comparison between groups, and the t test of multiple comparisons of repeated measurement data in the group was used in the intra-group comparison, that is, the Bonferroni method was used to test the level of 偽 = 0. 05. Results: after 1 month treatment, there was significant difference between the two groups (P0.05), and the difference between the two groups after 2 months and 4 months was statistically significant (P0.05), and there was significant difference after 2 months of treatment (P0.01). There was no significant difference in the scores of each factor between the other time points (P0.05). The scores of three factors in the two groups were significantly different after 4 months of treatment compared with those before treatment except for the phonation twitching score of the study group (P0.008). There was no significant difference between the two groups after 2 months of treatment and 1 month after treatment (P0.008). There was no significant difference in CGI-S,CGI-I between the two groups before and after treatment (P0.05). There were significant differences in CGI-S between the two groups before and after treatment (P0.05). There were no serious adverse reactions in both groups. Conclusion: compared with tiapride alone, CBIT combined with tiapride can not only reduce the symptoms of motor twitch and phonation, but also relieve the impairment of function more effectively.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749.94
【參考文獻(xiàn)】
相關(guān)期刊論文 前4條
1 陳青廣;;鹽酸硫必利片對(duì)多發(fā)性抽動(dòng)癥患兒血清興奮性氨基酸水平的影響[J];中國鄉(xiāng)村醫(yī)藥;2014年01期
2 朱秋暹;;利培酮與泰必利治療小兒多發(fā)性抽動(dòng)癥的效果比較[J];吉林醫(yī)學(xué);2012年30期
3 鄭清芬;趙德運(yùn);張古英;李現(xiàn)力;孔祥武;;硫必利和肌苷及賴氨肌醇維生素B_(12)治療兒童抽動(dòng)癥療效觀察[J];河北醫(yī)藥;2012年17期
4 鐘佑泉;吳懼;謝曉麗;胡文廣;周文智;;耶魯抽動(dòng)癥整體嚴(yán)重度量表對(duì)抽動(dòng)障礙患兒的臨床評(píng)估[J];中國實(shí)用兒科雜志;2006年03期
，本文編號(hào)：2290422
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2290422.html
最近更新
教材專著
