小儿智力糖浆联合托吡酯治疗儿童抽动障碍的疗效观察

目的探讨小儿智力糖浆联合托吡酯治疗儿童抽动障碍的临床疗效。方法选取2010年6月—2015年6月天津市第五中心医院门诊诊治的儿童抽动障碍患者168例,随机分为对照组和治疗组,每组各84例,对照组口服托吡酯片,起始剂量为0.5 mg/(kg·d),逐步增加剂量,一般维持在2~3 mg/(kg·d),分次口服,在症状完全停止后逐渐减量直至停用。治疗组在对照组的基础上口服小儿智力糖浆,10~15 m L/次,3次/d。两组患者均治疗2个月。观察两组的临床疗效,比较两组耶鲁综合抽动严重程度量表(YGTSS)评分、药物的起效时间和不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为84.5%、90.5%,两组比较差异有统计学意义(P0.05)。治疗4、8周后,两组患儿YGTSS评分均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组YGTSS评分降低更明显,两组比较差异具有统计学意义(P0.05)。治疗组的起效时间显著短于对照组,两组比较差异有统计学意义(P0.05)。两组患儿在治疗过程中均未出现严重不良反应,且两组不良反应发生率比较差异无统计学意义。结论小儿智力糖浆联合托吡酯治疗儿童抽动障碍具有较好的临床疗效,起效速度快,不良反应少,具有一定的临床推广应用价值。

Clinical observation of Xiaoer Zhili Syrup combined with topiramate in treatment of children with tic disorder

Objective To investigate the clinical effect of Xiaoer Zhili Syrup combined with topiramate in treatment of children with tic disorder. Methods Children (168 cases) with tic disorder in Tianjin Fifth Central Hospital from June 2010 to June 2015 were randomly divided into control and treatment groups, and each group had 84 cases. Patients in the control group were po administered with Topiramate Tablets. The initial dosage was 0.5 mg/(kg·d), and the dose was gradually increased, keeping at 2-3 mg/(kg·d) by several times of oral. The dose was gradually decreased until stopped after the symptoms disappeared completely. Patients in the treatment group were po administered with Xiaoer Zhili Syrup on the basis of the control group, 10-15 mL/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and YGTSS scores, onset time, and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.5% and 90.5%, respectively, and there was difference between two groups (P<0.05). After treatment for 4 and 8 months, YGTSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the scores in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). The onset time in treatment group was shorter than that in control group, and there was difference between two groups (P<0.05). There were no serious adverse reactions during the treatment, and there was no significant difference in adverse effects rate between two groups. Conclusion Xiaoer Zhili Syrup combined with topiramate has clinical curative effect in treatment of children with tic disorder, and can shorten onset time with less adverse reaction, which is worthy of clinical application.