Clinical Observation On The Treatment Of Children With Tic Disorders (Hyperhepatism Syndrome) By Combination Of Tianma Gouteng Decoction Combined With Screw Acupuncture

ObjectiveTo observe the clinical efficacy of Tianma Gouteng Decoction combined with screw acupuncture in the treatment of children with tic disorders(hyperhepatism syndrome),provide a new idea for the treatment of children with tic disorders,and provide data support for the promotion and application of tap acupuncture as an appropriate technology of Traditional Chinese medicine in the treatment of children with tic disorders,and improve the service ability of traditional Chinese medicine for children with tic disorders.MethodsA prospective study was used to select 90 children who met the inclusion criteria and were admitted to the pediatric tic disorders outpatient clinic of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from September 2020 to December 2021,and were randomly divided into 3 groups: TCM combined with screw acupuncture group,TCM combined with ear bean group and TCM group.The group of Chinese medicine combined with screw acupuncture was treated with Tianma Gouteng Decoction combined with screw acupuncture,the group of Chinese medicine combined with ear bean was treated with Tianma Gouteng Decoction combined with ear bean,and the group of Chinese medicine only was treated with Tianma Gouteng Decoction.4 weeks as a course of treatment,a total of2 courses.The Yale Global Tic Severity Scale(YGTSS)and TCM syndrome Score Scale were used to score before treatment,4 weeks after treatment,and 8 weeks after treatment,respectively,and adverse events were recorded.SPSS 26.0 software was used for statistical analysis.To evaluate the efficacy and safety of Tianma Gouteng Decoction combined with screw acupuncture in the treatment of children with tic disorders(hyperhepatism syndrome).Results1.There were no statistically significant differences in age,gender,course of disease,severity of disease,YGTSS score before treatment and TCM syndrome score among the three groups(P > 0.05).2.Evaluation results of YGTSS scale(1)YGTSS score:(1)Intra-group comparison: Compared with before treatment,YGTSS score of TCM combined with acupuncture group,TCM combined with ear bean group and TCM group showed significant decrease after 4 and 8 weeks of treatment(P <0.01);Compared with 4 weeks after treatment,YGTSS scores of the three groups decreased significantly after 8 weeks(P < 0.01).(2)Comparison between groups: after 4 weeks of treatment,compared with the Chinese medicine group,the difference between the traditional Chinese medicine group and the TCM combined with acupuncture group was more obvious(P < 0.05),while there was no statistical significance in the difference between the TCM combined with acupuncture group and the Tianma Gouteng Decoction combined with ear bean group,or between the Tianma Gouteng Decoction combined with ear bean group and Tianma Gouteng Decoction Group(P > 0.05).After 8 weeks of treatment,the reduction of YGTSS score in the TCM combined with acupuncture group was better than that in the other two groups,with statistical difference(P < 0.05).There was no statistical difference in score reduction between the TCM combined with ear bean group and the TCM group(P > 0.05).(2)Evaluation of disease efficacy:(1)Intra-group comparison: the total effective rate was 65.5% after 4 weeks and 89.7% after 8 weeks in the group of traditional Chinese medicine combined with acupuncture;The total effective rate was 50.0% after 4 weeks and85.7% after 8 weeks in the group of traditional Chinese medicine combined with ear bean.The total effective rate of TCM group was 39.3% after 4 weeks and 71.4% after 8 weeks in the group of traditional Chinese medicine.It is suggested that the total treatment efficiency of the three groups increased with the increase of treatment course.(2)Comparison between groups: after 4 weeks of treatment,the total effective rate of TCM combined with acupuncture group was 65.5%,the total effective rate of TCM combined with ear bean group was 50.0%,and the total effective rate of TCM group was 39.3%.There was no statistical difference among the three groups(P > 0.05).The effective rate of TCM combined with screw acupuncture group was better than that of TCM combined with ear bean group(P < 0.05),but there was no difference between TCM combined with ear bean group(P > 0.05).There was no difference in the effective rate between TCM group and TCM group(P > 0.05).After 8weeks of treatment,the total effective rate of TCM combined with acupuncture group was89.7%,the total effective rate of TCM combined with ear bean group was 85.7%,and the total effective rate of TCM group was 71.4%,and there was statistical difference among the three groups(P < 0.05).The effective rates of TCM combined with screw acupuncture group and TCM combined with ear bean group were better than those of TCM combined with ear bean group(P < 0.05),but there was no difference between TCM combined with screw acupuncture group and TCM combined with ear bean group(P > 0.05).It is suggested that the combination of internal and external treatment of traditional Chinese medicine has better curative effect on tic disorders than oral Chinese medicine alone.3.TCM syndrome evaluation results(1)TCM syndrome score:(1)Intra-group comparison: compared with before treatment,TCM syndrome score of TCM combined with acupuncture group,TCM combined with ear bean group and TCM group decreased significantly after 4 and 8 weeks of treatment,with statistical difference(P < 0.01);Compared with 4 weeks of treatment,TCM syndrome scores of the three groups decreased significantly after 8 weeks of treatment(P < 0.01).(2)Comparison between groups: after 4 weeks of treatment,TCM syndrome scores of the three groups decreased,and the difference between the three groups was statistically significant(P< 0.05).Compared with the group of TCM combined with ear bean and the group of TCM,the difference between the group of TCM combined with acupuncture decreased more significantly(P < 0.05).There was no statistical significance in the difference between the TCM group and the TCM group(P > 0.05).After 8 weeks of treatment,in terms of reducing TCM syndrome score,the group of TCM combined with acupuncture was significantly better than the group of TCM combined with ear bean and the group of TCM(P < 0.05),while there was no statistical significance between the group of TCM combined with ear bean and the group of TCM(P > 0.05).The results showed that the combination of gastrodia elata uncaria decoction with screw acupuncture,TCM combined with ear bean and TCM alone could effectively reduce TCM syndrome score,and TCM combined with screw acupuncture had more advantages.4.Safety evaluationAmong the 85 children included in this study,there were no obvious side effects or adverse reactions in the two courses of receiving screw acupuncture,auricular acupoint pressing and oral Chinese medicine treatment.Conclusion1.For children with tic disorders(hyperhepatism syndrome),the combination of Tianma uncaria decoction combined with acupuncture,or combined with ear bean,or used alone can effectively reduce YGTSS score and improve TCM syndrome,with definite curative effect and good safety.2.As a suitable technique of traditional Chinese medicine in treating children with tic disorders,screw acupuncture is worthy of further popularization and application.