托吡酯与氟哌啶醇治疗Tourette综合征临床对照观察

目的　探讨托吡酯与氟哌啶醇治疗Tourette综合征的疗效。方法　 6 0例患儿随机分为观察组和对照组 ,分别给予托吡酯 12 .5～ 37.5mg·次-1,或氟哌啶醇 0 .2 5～ 2mg·次 -1,均每日 2次 ,于治疗前及治疗后 3个月用耶鲁抽动症整体严重程度量表 (YGTSS)评估疗效 ,并观察药物副作用。结果　观察组与对照组患儿治疗前YGTSS分值无显著差异 (t=0 .0 8,P >0 .0 5 ) ,治疗后有显著差异 (t=4 .19,P <0 .0 0 1)。观察组 3例出现疲乏 ,1例嗜睡 ,均不影响治疗 ;对照组 7例出现锥体外系症状 ,另 2例分别出现幻觉和严重多动症状而被迫停药。结论　托吡酯治疗Tourette综合征疗效好 ,副作用轻微 ,可作为治疗该病的首选药物。

The comparison study of the therapeutic effect of topiramate and haloperidol in children with Tourette syndrome

Objective To explore the differences of therapeutic effects between topiramate and Haloperidol in children with Tourette syndrome(TS).Methods Sixty TS children were divided randomly into topiramate group,which were treated with topiramate (12.5～37.5mg/dose,bid),and haloperidol group,which were treated with haloperidol(0.25～2mg/dose,bid).The therapeutic effects of both groups were assessed using Yale Global Tic Severity Scale(YGTSS)before and 3 months after treatment and the side-effects of the durgs were observed.Results The differences of YGTSS scores before treatment were not significant between two groups(21.9±11.5 versus 21.7±7.6,t=0.08,P>0.05),however,those were significant after treatment(1.5±1.4 versus 5.9±5.5,t=4.19,P<0.01).In topiramate group 3 children had fatigue signs and 1 child had lethargy sign,but both were not influential.In haolperidol group 7 children had extrapyramidal signs and 2 cases had hallucinations and severe hyperactivity signs whose treatment were shut off unwillingly.Conclusion The topiramate is more effective than haloperidol in the treatment of TS with fewer side-effects,it may be selected firstly in the treatment of TS in children.