内科

目的探讨针刺结合加味菖蒲郁金汤治疗小儿多发性抽动症的疗效及对患儿总IgE水平和神经递质的影响。方法选取2015年10月至2017年3月我院收治的小儿多发性抽动症患儿82例，随机分成观察组和对照组，每组41例。对照组患儿给予针刺治疗，观察组患儿在对照组治疗的基础上联合加味菖蒲郁金汤治疗。比较两组患儿的中医证候疗效、症状改善情况、血清总IgE阳性率及神经递质水平。结果治疗3个月，观察组患儿的总有效率为92.68%，对照组为75.61%，观察组患儿的中医证候疗效明显优于对照组，差异有统计学意义(P＜0.05）；两组患儿的YGTSS评分均明显降低，观察组患儿的评分显著低于对照组(P＜0.01)；观察组患儿血清总IgE阳性率（31.71%）显著低于对照组（53.66%），差异有统计学意义(P＜0.05)；两组患儿的血浆多巴胺(DA)、5-羟色胺（5-HT）及去甲肾上腺素（NE）水平均显著降低，观察组患儿的DA、5-HT及NE水平均显著低于对照组(P＜0.05)；两组患儿的血清谷氨酸（GLU）水平均明显降低、γ-氨基丁酸（GABA）水平均明显升高，观察组血清GABA水平高于对照组，差异有统计学意义(P＞0.05)。结论应用加味菖蒲郁金汤联合针刺治疗小儿多发性抽动症患儿，能明显提高临床疗效，降低血清总IgE阳性率，改善神经递质水平。

ObjectiveTo investigate the therapeutic effect of acupuncture combined with modified Changpu Yujin Decoction on children with Tourette syndrome and its effect on total IgE level and neurotransmitter. Methods82 children with Tourette syndrome admitted to our hospital from October 2015 to March 2017 were selected. They were randomly divided into the observation group and the control group, with 41 cases in each group. The control group were given acupuncture treatment, and the observation group was treated with modified Changpu Yujin Decoction on the basis of the control group′s treatment. The efficacy of TCM syndrome, the improvement of symptoms, the positive rate of serum total IgE and the level of neurotransmitters were compared between the two groups. Results3 months of treatment, the total effective rate of the children in the observation group was 92.68% and the control group was 75.61%. The curative effect of the TCM syndrome in the observation group was obviously superior to the control group, the difference was statistically significant (P＜0.05). The YGTSS scores of the two groups were significantly decreased, and the scores of the observation group were significantly lower than those of the control group (P＜0.01). The positive rate of serum total IgE in observation group (31.71%) was significantly lower than that in control group (53.66%), and the difference was statistically significant (P＜0.05). The plasma DA, 5-HT and NE levels of the two groups were significantly lower than those of the control group (P＜0.05). The level of serum GLU in the two groups were obviously decreased and the level of GABA increased obviously. The serum GABA level of the observation group was higher than that of the control group, the difference was statistically significant (P＞0.05). ConclusionThe modified Changpu Yujin Decoction and acupuncture in children with multiple Tourette syndrome can obviously improve the clinical effect, reduce the positive rate of serum total IgE, and improve the level of neurotransmitter.