Investigation Of Etiology Of TS In Children And Clinical Research By Using The Method Of Nourishing Kidney And Smothing Liver

BackgroundTourette's syndrome,I.e Gilles de la Tourette Syndrome(TS),also known as multiple Tic Disorder(Multiple Tics,MT),is a chronic nerve disorder,characterized by involuntary muscle and vocal tic.Etiology of TS is not clear yet,and because of the complexity and recurrent of the clinical symptoms,clinical efficacy is poor.Reports showed good therapeutic effect of Chinese medicine,but the study did not use the method of RCT (Randomized Clinical Trial)to evaluating,then resulting in the effect and prognosis are not been convincde strongly.Therefore,using evidence-based medicine approach,and making a scientific evaluation of the effect,are the key points to raising the clinical effect.ObjectiveThe obsject of this study including three aspects.First is using epidemiological methods to investigate the risk factors of TS,and help prevention.The second is to analyze the clinical symptoms of TS,and research the theory of TCM Syndrome,and pathogenesis.The third is using randomized single-blind controlled study,combined with domestic and foreign generic rating scale of TS,and self-made Chinese medicine syndrome scale,to make a objective evaluation of the thrapy of nourishing kidney and smothing liver, analyze the relapse rate and security,look for safe and effective treatment methods of TS.MethodsIn this paper,according to basic,theoretical and clinical evidence,we evaluated effect of Chinese medicine to treating TS,and based on epidemiological research methods, analyzed the risk factors of disease.The full text is divided into two parts.1.Pathogenesis research:According to the approach of epidemiology,using questionnaire forms,case-control method,investigated 160 cases of TS and 100 cases of children without TS.The survey included living habits,related diseases,personal history,family history,living conditions,and then used LOGISTIC regression analysis to making statistics.Made a systematic evaluation of relevant reprots,discussed TCM theories,and then made a propose that the thrapy of nourishing kidney and smothing liver is kidney are closely related with onset of tics.13.3%and 7.3%respectively,physician agreed the heart,the lung related with TS.Liver wind is dominant in pathogenesis of TS,and about 72.7 percent of the physician agreed it is the main risk factors of TS.41.8 percent of the records emphasize sputum.Other such as fire-evil,stagnated blood,stagnation of food occupied the plot ratio of 6.4%,4.5%,2.7%.(4)Pathogenesis analyses:Innate deficiency,emotional damage,overstrain,improper diet,external injury are concerned with the etiology of TS.The basic pathogenesis of TS is deficiency of viscera,spleen deficiency and liver excessive,water not nurishing wood, wind and sputum stiring up.Disease involving five internal organs,but the liver rulls core responsibilities.The spleen,the kidney closely related to disease,and the heart and the lung have some relevance too.The foundation of TS are the spleen,the kidney and the liver,wind and sputum are outside manifest of TS.The excess and the deficiency,the wind and the sputum are coexisted.2.Evaluation of curative effect(1)The soup of Zishen Tiaogan,method of nourishing kidney and smothing liver relieved following symptome in TS,including irritability,mental fatigue,etiolate complexion,feverish sensation of five centres,loss of appetite,forgetfulness,sweating abnormalities,sleep disorders,pulse in Chinese medicine.In addition to the abnormal stool and tongue,all improved better than tiapride group.(2)The soup of Zishen Tiaogan relieved movement tic,vocal tic,reduce comprehensive damage,the overall score using the scale of YGTSS,the effect is better than the control group.Clinical assessment showed the test group recovery rate was 12.5 percent, recovered and obvious efficiency rate was 50%,and effective power was 97.5%.For the control group the recovery rate was 5 percent,recovered and obvious efficiency rate was 18.75%,the effective power was 65 percent.There is a high degree of statistical significance between two gruops(p＜0.01).The test group was obviously better than the control group(p＜0.01).(3)The soup of Zishen Tiaogan was obviously better than the control group(p＜0.01)in improving the TCM symptoms and relieving tics,after Six months later follow-up.(4)we did not find adverse impact and abnormal reaction on the heart,the liver,the kidney and blood system,The soup of Zishen Tiaogan.showed high security in clinical test.