健脾平肝汤加葛根联合外治法对注意缺陷多动障碍合并抽动秽语综合征患儿的影响

郑健斌; 于乐; 张莹莹

doi:10.7619/jcmp.20210372

健脾平肝汤加葛根联合外治法对注意缺陷多动障碍合并抽动秽语综合征患儿的影响

Influence of Jianpi Pinggan Decoction plus Gegen combined with external therapy for children with attention deficit hyperactivity disorder and Tourette syndrome

摘要

摘要:
目的探讨健脾平肝汤加葛根联合外治法对注意缺陷多动障碍（ADHD）合并抽动秽语综合征（TS）患儿的免疫功能及辅助性T细胞（Th）细胞的影响。
方法将135例ADHD合并TS患儿随机分为西医组（45例，接受常规西医治疗）、中医组（45例，采用健脾平肝汤加葛根联合外治法治疗）和中西医结合组（45例，同时接受常规西医治疗和健脾平肝汤加葛根联合外治法治疗），均连续治疗2周。比较治疗前后3组催乳素（PRL）水平、免疫功能及Th细胞因子水平，并观察不良反应发生情况。
结果与治疗前比较，3组患儿治疗后血清PRL水平均升高，且中西医结合组高于中医组和西医组，差异有统计学意义（P < 0.05）。治疗后，3组患儿CD4⁺、CD4⁺/CD8⁺及血清干扰素γ（IFN-γ）水平均升高，CD8⁺及白细胞介素（IL）-4水平均降低，且与中医组和西医组比较，中西医结合组变化更显著，差异均有统计学意义（P < 0.05）。治疗期间，3组患儿总不良反应发生率差异无统计学意义（P>0.05）。
结论葛根加健脾平肝汤联合外治法治疗可显著降低ADHD合并TS患儿的血清PRL水平，改善患儿机体免疫功能，有效调节Th细胞水平，且安全性高。

Abstract:
Objective To investigate the influence of Jianpi Pinggan Decoction plus Gegen combined with external therapy on the immune function and helper T (Th) cells of children with attention deficit hyperactivity disorder (ADHD) and Tourette syndrome (TS).
Methods A total of 135 children with ADHD and TS were randomly divided into western medicine group (45 cases, receiving conventional western medicine treatment), Chinese medicine group (45 cases, using Jianpi Pinggan Decoction plus Gegen combined with external therapy) and combined traditional Chinese and western medicine group (45 cases, received conventional western medicine treatment and Jianpi Pinggan Decoction plus Gegen combined with external therapy), all patients were treated for two weeks. The levels of prolactin (PRL), immune function and Th cytokine levels before and after treatment among the three groups were compared, and the occurrence of adverse reactions was observed.
Results Compared with before treatment, the serum PRL levels of the three groups after treatment significantly increased, and the level of PRL in the combined traditional Chinese and western medicine group was significantly higher than the western medicine group and Chinese medicine group(P < 0.05). Compared with before treatment, the CD4⁺, CD4⁺/CD8⁺ and serum interferon γ (IFN-γ) levels of the three groups after treatment significantly increased, and the CD8⁺ and serum IL-4 levels significantly reduced, and the changes in the combined traditional Chinese and western medicine group were more obvious, the differences were statistically significant compared with the western medicine group and Chinese medicine group (P < 0.05). During the treatment, there was no significant difference in the incidence of total adverse reactions among the three groups (P>0.05).
Conclusion Jianpi Pinggan Decoction plus Gegen combined with external therapy can significantly reduce the serum PRL level in children with ADHD and TS, improve the immune function, and effectively regulate the levels of Th cells, and it has higher safety.

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