抽动障碍患儿的药物治疗与心理治疗临床分析

目的:探讨治疗抽动障碍(TD)的药物疗法与心理疗法及效果.方法:以1999年6月～2000年12月就诊并接受治疗的58例抽动障碍患儿为对象,分别对不同类TD患者(TTD、CTD、TS三类)施以不同的治疗方法,对TTD采用四步心理治疗法,对CTD、TS患者给予小剂量每日1次的氟哌啶醇(视病情变量)药物治疗配合心理调适.结果:小剂量每日1次服用氟哌啶醇同时配合心理治疗对CTD、TS有效.四步法心理治疗方案对TTD患儿有效,伴发声性抽动患儿进行心理调适,同时有必要选择性用药.结论:四步心理疗法及新的用药方案有效.     

抽动障碍患儿的药物治疗与心理治疗临床分析

目的 :探讨治疗抽动障碍 (TD)的药物疗法与心理疗法及效果。方法 :以 1999年 6月～ 2 0 0 0年12月就诊并接受治疗的 5 8例抽动障碍患儿为对象 ,分别对不同类TD患者 (TTD、CTD、TS三类 )施以不同的治疗方法 ,对TTD采用四步心理治疗法 ,对CTD、TS患者给予小剂量每日 1次的氟哌啶醇 (视病情变量 )药物治疗配合心理调适。结果 :小剂量每日 1次服用氟哌啶醇同时配合心理治疗对CTD、TS有效。四步法心理治疗方案对TTD患儿有效 ,伴发声性抽动患儿进行心理调适 ,同时有必要选择性用药。结论 :四步心理疗法及新的用药方案有效。     

抽动障碍的神经心理研究进展

抽动障碍(tic disorders,TD)是一种于儿童期起病的比较常见的神经精神性疾病,其病因未明,主要表现为不自主的、反复的、快速的、一个或多个部位运动性抽动或发声性抽动,并可伴有多动、注意力不集中、强迫性动作和思维或其他行为症状.根据病程、临床表现等将TD分为短暂性TD、慢性TD(CTD)以及多发性抽动症(又称Tourette综合征,TS).其中,CTD和TS的抽动症状都在一年以上,而且伴随的行为问题复杂多样,不同程度地影响患儿的学习和生活,给患儿及其家长带来沉重的心理负担.研究TD儿童的神经心理学特征,可为进一步探讨其病因和发病机制提供信息,也为其综合防治提供一定的依据.本文从智力、记忆、注意、行为等方面做一综述.     

抽动障碍的神经心理研究进展

抽动障碍（tic disorders,TD）是一种于儿童期起病的比较常见的神经精神性疾病,其病因未明,主要表现为不自主的、反复的、快速的、一个或多个部位运动性抽动或发声性抽动,并可伴有多动、注意力不集中、强迫性动作和思维或其他行为症状.根据病程、临床表现等将TD分为短暂性TD、慢性TD（CTD）以及多发性抽动症（又称Tourette综合征,TS）.其中,CTD和TS的抽动症状都在一年以上,而且伴随的行为问题复杂多样,不同程度地影响患儿的学习和生活,给患儿及其家长带来沉重的心理负担.研究TD儿童的神经心理学特征,可为进一步探讨其病因和发病机制提供信息,也为其综合防治提供一定的依据.本文从智力、记忆、注意、行为等方面做一综述.     

齐拉西酮联合中药治疗Tourette综合征临床观察

Tourette综合征(TS)又称发声与多种运动联合抽动障碍,或抽动一秽语综合征,以进行性发展的多部位运动抽动和发声抽动为主要特征的慢性神经精神障碍疾病,起病于儿童期,年龄2～21岁,平均7岁,男女患病比为3～4:1.     

氟哌啶醇联合可乐定透皮贴剂治疗儿童难治性Tourette综合征及对Th1/Th2的影响

目的观察氟哌啶醇联合可乐定透皮贴剂治疗难治性Tourette综合征及对Th1/Th2的影响。方法选择2013年12月—2015年3月在河北省沧州市中心医院儿童保健科诊治的难治性Tourette综合征患儿40例为研究对象(观察组)。另选择同期体检健康儿童40例作为健康对照组。观察组患儿给予氟哌啶醇联合可乐定透皮贴剂治疗,治疗前后采用耶鲁抽动严重程度评估量表(YGTSS)、注意力缺陷多动障碍(ADHD)评分进行症状评定,检测血清中IFN-γ、IL-4、IL-13的水平,并对IFN-γ、IL-13、IL-13与YGTSS评分、ADHD评分进行相关性分析。结果治疗后,患儿YGTSS各项评分及ADHD各项评分均较治疗前降低(P<0.05)。治疗前,观察组IFNγ、IL-13水平均高于健康对照组(P<0.05),IL-4水平低于健康对照组;治疗后,血清IFN-γ、IL-4、IL-13水平较治疗前明显改善,差异均有统计学意义(P<0.05)。IFN-γ水平与YGTSS评分、ADHD评分均呈正相关(r=0.312、P=0.007;r=0.305、P=0.011);IL-4水平与YGTSS评分、ADHD评分均呈负相关(r=-0.317,P=0.004;r=-0.302,P=0.014);IL-13水平与YGTSS评分、ADHD评分均呈正相关(r=0.306,P=0.011;r=0.291,P=0.021)。患儿未出现严重不良反应。结论氟哌啶醇联合r可乐定透皮贴剂治疗难治性Tourette综合征可有效改善临床症状,且安全性高。     

Tourette综合征共患病研究进展

<正>Tourette综合征(TS)是抽动障碍(TD)的亚型之一,其症状较复杂,病情较重,病程较长,且共患病较多。大约72.7%共患注意缺陷多动障碍(ADHD);40%~75%共患强迫障碍(OCD);25%~30%共患睡眠障碍(SD);20%~25%共患情绪障碍(ED)等。共患病的存在,影响到TS的治疗效果,及患儿身心健康。本文对Tourette综合征共患病近年来的研究进展作一综述。     

可乐定控释贴剂联合安舒汤治疗抽动障碍临床观察

<正>抽动障碍(tic disorders,TD)起病于儿童期,是以抽动为主要临床表现的神经精神疾病[1]。主要表现为不自主、反复、快速而又无目的的一个或多个部位肌肉运动性或发声性的抽动。根据临床症状、病情的轻重及病程的长短,抽动障碍分为短暂性抽动障碍、慢性抽动障碍、多发性抽动症(Tourette综合征)3种类型[2]。1临床资料2014年12月—2015年11月我院儿童神经专     

脑电生物反馈治疗抽动障碍的临床疗效观察

目的 探讨抽动障碍儿童脑电生物反馈治疗前后症状缓解程度及脑电的变化,对生物反馈治疗的临床疗效进行评价.方法 对19例短暂性抽动症、20例慢性抽动症、15例Tourette综合征患儿,进行40次的脑电生物反馈治疗,并于治疗前后分别采用耶鲁抽动症整体严重度量表(YGTSS)和脑电θ/β、θ/SMR功率比值的变化进行疗效评定.结果 ①经40次脑电生物反馈治疗后,短暂性抽动症显效17例,有效2例;慢性抽动症显效14例,有效6例;Tourette综合征显效2例,有效12例,无效1例;3组抽动障碍患儿总有效率达93.33％.②短暂性抽动[前(10.32 ±0.82)分,后(5.91 ±5.74)分]、慢性抽动[前(12.35±1.50)分,后(4.00 ±2.22)分]、Tourette综合征[前(25.33 ±2.80)分,后(13.73 ±4.22)分]治疗后YGTSS总分较治疗前降低,差异有统计学意义(P＜0.01).③短暂性抽动治疗后θ/β功率比值[前(2.52 ±0.38),后(2.33±0.32)]、慢性抽动[前(2.43±0.39),后(2.21 ±0.30)]、Tourette综合征[前(2.64±0.35),后(2.39±0.26)]较治疗前下降,差异有统计学意义(P＜0.01).④短暂性抽动治疗后θ/SMR功率比值、慢性抽动、Tourette综合征较治疗前降低,差异有统计学意义(P＜0.01).结论 脑电生物反馈治疗对三个亚型抽动障碍患儿均有效,并且能够提高患者大脑的SMR波和改善脑功能活动.     

儿童抽动障碍100例脑电图分析

抽动障碍(tic disorders,TD)起病年龄为1-21岁,学龄前期和学龄期儿童为发病高峰人群.临床表现为运动性抽动或发声抽动,可先后出现或同时出现,通常以眼部、面部或头部的抽动作为首发症状,而后逐步向颈、肩、肢体或躯干发展,眨眼是常见的首发症状.TD的病因和发病机制尚未明了,TD发病的三个主要危险因素是男性、低龄和TD家族史.现总结了100例抽动障碍患儿的脑电图临床资料,进行分析来探讨对大脑功能的影响.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.