CBIT聯(lián)合泰必利治療兒童抽動障礙的臨床療效研究
發(fā)布時間：2018-10-23 20:46
【摘要】：目的:抽動障礙(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兒童為研究對象,隨機(jī)分為研究組(CBIT聯(lián)合泰必利治療)10例,對照組(單獨使用泰必利治療)21例。觀察治療效果共4個月,在治療開始前、治療1月、2月和4月4個時間點應(yīng)用“耶魯綜合抽動嚴(yán)重程度量表(Yale Global Tic Severity Scale,YGTSS)”和“臨床療效總評量表(Clinical Global Impression,CGI)”分別進(jìn)行評分和療效比較。使用SPSS17.0軟件包建立數(shù)據(jù)庫并進(jìn)行統(tǒng)計分析。數(shù)據(jù)處理計數(shù)資料采用X~2檢驗,計量資料采用t檢驗,等級資料的比較采用秩和檢驗。兩組整體比較時采用兩因素重復(fù)測量數(shù)據(jù)方差分析,組間比較時采用成組t檢驗,組內(nèi)比較時采用重復(fù)測量數(shù)據(jù)多重比較配對的t檢驗,即Bonferroni法,以α=0.05為檢驗水準(zhǔn)。結(jié)果:治療1月后,兩組運動抽動得分的差異有統(tǒng)計學(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)計學(xué)意義(P0.05),其中治療2月后的差異有顯著的統(tǒng)計學(xué)意義(P0.01)。其余各時間點各因子得分的組間比較,差異均無統(tǒng)計學(xué)意義(P0.05)。兩組內(nèi)部3個因子得分在治療4個月后與治療前相比,除研究組發(fā)聲抽動得分外,差異均有統(tǒng)計學(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)計學(xué)意義(P0.008)。兩組間治療前與治療后各個時間點CGI-S、CGI-I的比較,差異均無統(tǒng)計學(xué)意義(P0.05)。兩組內(nèi)治療前與治療后各時間點CGI-S的比較,差異均有統(tǒng)計學(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與單獨使用泰必利比較,不僅能更好地減少運動抽動和發(fā)聲抽動癥狀,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)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.94
本文編號：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)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.94
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