Tourette综合征150例的个体化治疗

目的 探讨Tourette 综合征个体化的治疗方法。方法 Tourette 综合征患儿150例均于就诊时进行耶鲁抽动症严重度量表（YGTSS）评分并给与心理行为治疗。依据YGTSS评分及目标症状的不同选择个体化治疗方法，至少8周后再次评分观察疗效，随诊6月以上，记录药物副作用。结果 以抽动为目标症状者137例。其中YGTSS评分≤24分的42例轻度患者接受心理行为治疗；25~39分的73例中度患者中服用肌苷5例，泰必利56例，氟哌啶醇6例；40分以上重-极重度患者中22例服用氟哌啶醇，3例氟哌啶醇加丙戊酸钠；以ADHD为目标症状患者11例，均给利他林，6例加泰必利，5例加氟哌啶醇；以OCD为目标症状者5例用利培酮。用药后8周YGTSS评分均低于24分，3例出现药物副作用。结论 依据病情严重度评分及目标症状选择个体化治疗方法治疗Tourette 综合征效果满意度高，副作用发生率低。

Individualized treatment for one handred and fifty patients of Tourette syndrome

Objective The aim of this study was to determine the method of individualized treating Tourette syndrome.Methods One hundred and fifty patients were all assessed by the Yale Global Tic Severity Scale(YGTSS) and gave psychotherapy and behavioral therapy.The individualized treatment plan was selected by the results of YGTSS and the most troublesome symptom which should be targeted first,the second assessment was made in order to determine the efficacy after eight weeks at least，the following visit continued more than six months for the purpose of estimating side effects.Result One hundred and thirty seven patients were in the group of tic. Fourty-two patients whose YGTSS score less than twenty-four accepted psychotherapy and behavioral therapy;there were seventy-three patients scored twenty-five to thirty-nine,among which five took carnine,fifty-six took tiapride,six took haloperidol;among the patients whose score more than fourty ,twenty-two took haloperidol,three took haloperidol and sodium valproate;eleven patients in the ADHD group all took methylphenidate , among which six added tiapride,five added haloperidol;OCD group had five patients ,all took risperidone. Every patient,s score was less than twenty-four after taking medicine for eight weeks. Side effects were noted in three patients only. Conclusions It is a effective and safe method for treating Tourette syndrome with individualized treatment which selected by the results of YGTSS and the most troublesome symptom.