本文選題：兒童抽動(dòng)障礙 + 中醫(yī)辨證治療��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:抽動(dòng)障礙為兒童常見(jiàn)的神經(jīng)精神發(fā)育障礙,近年來(lái),其發(fā)病率不斷上升,得到了家庭和社會(huì)越來(lái)越多的關(guān)注,但現(xiàn)代醫(yī)學(xué)尚未找到安全有效的治療方法。目前,許多文獻(xiàn)報(bào)道,使用中醫(yī)辨證治療兒童抽動(dòng)障礙獲得了滿意的效果,且副作用較少。本研究旨在通過(guò)臨床病例的收集與觀察,在治療前后,分別使用耶魯綜合抽動(dòng)嚴(yán)重程度量表(YGTSS)及中醫(yī)癥候評(píng)分量表來(lái)評(píng)價(jià)中醫(yī)辨證治療兒童抽動(dòng)障礙的臨床效果。方法:使用自身治療前后對(duì)照的研究方法,收集符合診斷標(biāo)準(zhǔn)和納入標(biāo)準(zhǔn)的抽動(dòng)障礙患兒共40例,在治療前、治療4周后及治療8周后,使用耶魯綜合抽動(dòng)嚴(yán)重程度量表(YGTSS)對(duì)患兒的抽動(dòng)癥狀的嚴(yán)重程度進(jìn)行評(píng)定,而其他伴隨癥狀的嚴(yán)重程度則使用中醫(yī)癥候評(píng)分量表進(jìn)行評(píng)價(jià),記錄每次的得分情況,采用尼莫地平計(jì)算法得出治療前后的減分率及總有效率,從而判斷中醫(yī)辨證治療能否有效改善患兒的抽動(dòng)癥狀及其他伴隨癥狀。結(jié)果:納入研究的40例臨床病例中,治療前與治療4周后、治療前與治療8周后、治療4周后與治療8周后的耶魯綜合抽動(dòng)嚴(yán)重程度量表及中醫(yī)癥候量表的得分均具有顯著性差異(P0.01)。在療效評(píng)價(jià)方面,通過(guò)耶魯綜合抽動(dòng)嚴(yán)重程度量表的減分率來(lái)評(píng)價(jià)患兒抽動(dòng)癥狀的改善情況以及對(duì)日常生活的影響情況,研究結(jié)果顯示:治療4周后的總有效率為55%,治療8周后的總有效率為77.5%,經(jīng)統(tǒng)計(jì)學(xué)分析,治療8周后的總有效率與治療4周后的總有效率相比,二者具有顯著性差異(P0.05)。同時(shí)通過(guò)中醫(yī)癥候量表的減分率來(lái)評(píng)價(jià)患兒伴隨癥狀的改善情況,結(jié)果顯示:治療4周后的總有效率為60%,治療8周后的總有效率為85%,經(jīng)統(tǒng)計(jì)學(xué)分析,二者也具有顯著性差異(P0.01)。而且在治療的整個(gè)過(guò)程中,沒(méi)有出現(xiàn)一例藥物不良反應(yīng)。結(jié)論:中醫(yī)辨證治療兒童抽動(dòng)障礙,無(wú)論在是改善患兒的抽動(dòng)癥狀方面,還是在改善其他伴隨癥狀方面,療效肯定,治療8周的臨床效果較治療4周更為顯著,而且安全性好,副作用少。
[Abstract]:Objective: tic disorder is a common neuropsychiatric disorder in children. In recent years, the incidence of twitching disorder has been increasing, which has been paid more and more attention by family and society. However, modern medicine has not found a safe and effective treatment method.At present, it is reported in many literatures that the treatment of children with tic disorder with TCM syndrome differentiation has achieved satisfactory results and fewer side effects.The purpose of this study was to evaluate the clinical effect of TCM syndrome differentiation in children with tic disorder by using YGTSS and TCM symptom scale before and after treatment.Methods: a total of 40 children with tic disorders who met the diagnostic criteria and the inclusion criteria were collected before, 4 weeks and 8 weeks after treatment.Yale comprehensive tic severity scale (YGTSS) was used to assess the severity of the children's tic symptoms, while the severity of other accompanying symptoms was evaluated by the TCM symptom scale to record the scores of each time.The reduction rate and total effective rate before and after treatment were obtained by using Nimodipine calculation method, so as to judge whether TCM syndrome differentiation treatment can effectively improve the tic symptoms and other associated symptoms of children.Results: of the 40 clinical cases included in the study, before and after 4 weeks of treatment, before and after 8 weeks of treatment,The scores of Yale comprehensive tic severity scale and TCM symptom scale after 4 weeks and 8 weeks of treatment were significantly different (P 0.01).In the evaluation of curative effect, the improvement of tic symptoms and the influence on daily life of children were evaluated by the reduction rate of Yale comprehensive tic severity scale.The results showed that the total effective rate was 55 after 4 weeks treatment and 77.5 after 8 weeks treatment. By statistical analysis, there was significant difference between the total effective rate after 8 weeks treatment and the total effective rate after 4 weeks treatment (P 0.05).The results showed that the total effective rate was 60 after 4 weeks treatment and the total effective rate after 8 weeks treatment was 85. The statistical analysis showed that there was also a significant difference between the two groups (P 0.01).And there was no adverse drug reaction during the course of treatment.Conclusion: in the treatment of children's tic disorder with TCM syndrome differentiation, the clinical effect of 8 weeks treatment is more significant than that of 4 weeks, and the safety is good, whether in improving the symptoms of children with tic symptoms or in improving other accompanying symptoms.Less side effects.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R277.7

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