Study On The Dynamic Curative Effect Of Jingxin Zhidong Recipe In The Treatment Of Tic Disorders In Children

Objective:1.To explore the dynamic efficacy of jingxinzhidong prescription in the treatment of TD,and to analyze the influence of different visiting frequency(differentiation and treatment frequency)and different degree of illness on the therapeutic effect of jing xinzhidong prescription in the treatment of TD,so as to obtain a more optimized differentiation and treatment scheme for children with TD,and further guide clinical treatment.2.To study the improvement of TCM symptoms and signs of jingxinzhidong prescription in the treatment of TD,the distribution of TCM syndromes and types of TD,and to evaluate the efficacy of TCM symptoms of TD in different time periods after treatment.3.Based on the traditional Chinese medicine inheritance and assistance system,the data mining of medication law of professor jingxinzhidong prescription was carried out,so as to summarize the clinical experience of TD treatment by professor hanfei and further improve the diagnosis and treatment experience of TD by herself.Methods:1.Cases were selected from August 2017 to March 2019 in the TD children’s outpatient clinic of the Department of Pediatrics,Guan’an men Hospital,and based on the TD in the Diagnostic and Statistical Manual of Mental Disorders,5th Edition(DSM-5).The diagnostic criteria included 120 patients with mild to moderate disease between3 and 16 years of age.They were randomly divided into 2 weeks of visit frequency(group A),4 weeks of visit frequency(group B),and 6 weeks of treatment.There were three groups of frequency(group C),15cases of mild children and 25 cases of moderate cases.All TD children in groups A,B and C were treated with jingxinzhidong prescription for 6 months,and YGTSS was used to evaluate the clinical dynamic efficacy of TD children after the first dose,12 weeks after treatment,and 24 weeks after treatment,respectively.SPSS21.0 software was used for statistical analysis,and the liver and kidney function and urine routine were regularly monitored to evaluate the drug safety.2.The change of TCM symptoms and signs and the curative effect of TCM symptoms and signs before and after the treatment of TD children were evaluated with the graded quantitative table of TCM symptoms and signs,and to explore the distribution characteristics of TCM symptoms and signs of TD children.SPSS21.0 statistical software was used for correlation statistical processing.3.With the help of the software of"traditional Chinese medicine inheritance assistance system(V2.5)",data mining was conducted on 212 TD outpatient prescriptions of traditional Chinese medicine in this study.Result:1.In this study,all TD children were evaluated for clinical efficacy after 6 months of treatment:45 cases(37.50%)showed significant effect,60 cases(50.00%)were effective,15 cases(12.50%)were ineffective,and the total effective rate was 87.50%.2.The efficacy of the first dose at 2weeks,4 weeks and 6 weeks for mild children in groups A,B and C was the best when the frequency of diagnosis and treatment(visit frequency)was once every 2 weeks.The efficacy of the first dose at 2 weeks,4 weeks and 6 weeks in the three groups of A,B and C was the best when the frequency of diagnosis and treatment(visit frequency)was once every 2 weeks,and once every 4 weeks was the same as once every 6 weeks.The total effective rates of all patients in groups A,B and C after the first dose were 92.50%,85.00%and 60.00%respectively,and the differences between groups were statistically significant(P<0.01).There were significant differences between group A and group C in efficacy after the first dose(P<0.05).There was A significant difference in the total curative effect between group B and group C after the first dose(P<0.01),and the total curative effect of the three groups after the first dose A=B>C.3.When the frequency of diagnosis and treatment was once every 4 weeks,the clinical efficacy of mild children in groups A,B and C improved after 12 weeks of treatment compared with that after the first treatment.When the frequency of diagnosis and treatment(visit frequency)of the three groups of moderate children was once every 4 weeks,the clinical efficacy was also improved after 12weeks of treatment compared with that after the first treatment.The total effective rates of all the patients in group A,B and C at 12weeks after treatment were 90.00%,95.00%。and 65.00%respectively,and the differences between the groups were statistically significant(P<0.01).Meanwhile,pairwise comparison showed that the total therapeutic effects of group A and group B at 12 weeks after treatment were insignificant(P>0.05).The total curative effect of group A and group C at 12 weeks after treatment was significantly different(P<0.01).The total curative effect of group B and group C at 12 weeks after treatment was significantly different(P<0.01),and the total curative effect of group B=A>C at 12 weeks after treatment.4.The efficacy of mild children in groups A,B and C at 24 weeks after treatment,that is,12,6 and 4visits respectively,may reach the best when the frequency of diagnosis and treatment(visit frequency)is once every 2 weeks.Moderate children in groups A,B and C were treated once every 4 weeks after treatment for 24 weeks,which may achieve A satisfactory effect.The total effective rates of all patients in groups A,B and C at 24 weeks after treatment were 92.50%,97.50%and 72.50%,respectively.The differences between groups were statistically significant(P<0.01).The efficacy of group A and group C at 24 weeks after treatment was significantly different(P<0.05).There was A significant difference in the curative effect between group B and group C at 24 weeks after treatment(P<0.05),and the total curative effect of group B=A>C at 24 weeks after treatment.5.Effect of TCM syndrome:the effective rate after12weeks of treatment was61.67%;After treatment for 24 weeks,the effective rate was80.83%.In addition,there was a statistically significant difference in the curative effect of TCM symptoms between 12 weeks after treatment and 24 weeks after treatment,P<0.05.6.Distribution of TCM symptoms:irritability 96.67%,dry eyes,itching 84.17%,pharynx itching,pain 83.33%,pharynx red 83.33%,neck discomfort 48.33%,sleep disturbance 33.33%,inappetence 32.50%,defecate secretion/dry knot31.67%,slow sleep 30.83%,dry mouth 24.17%,mouth ulcer 21.67%and other heart and liver hot syndrome.7.Distribution of TCM syndromes:65 cases(54.17%)of heart-liver fire flourishing type,39 cases(32.50%)of heart-kidney Yin deficiency,and 16 cases(13.33%)of lung-spleen deficiency.Moreover,there was no significant difference in the distribution of the three TCM syndromes among groups A,B and C(P>0.05).8.Drug distribution:cold(38.95%);Wen(30.26%);(28.09%);Cool(2.66%);Heat(0.04%).Drug meridian distribution:heart,liver,lung,stomach,kidney and so on;Commonly used medicines:calcined keels,zizyphus seed,bupleurum bupleurum,magnolia magnoliae,batryticated silkworms,angelica dahuricae,cypress seed,radix aconiti,calc:ined oysters,etc.;Common drugs:calcined keels,jujube kernel;Bupleurun,calcined keels;Burnt yucca herb;Bupleurum,jujube kernel;Calcined keel,stiff silkworm;Magnolia magnolia,jujube kernel;Bupleurum batryticum silkworm;Jujube kernel,stiff silkworm;Xinyi,bupleurum;Magnolia magnolia,stiff silkworm,etc;Core drugs:calcined keels,calcined oysters,zizyphus jujube kernel,cypress seed,angelica dahuricae,magnolia magnoliae,bupleurum chinensis,bombyx batrytici,radix aconiti,etc.Conclusion:1.Jingxinzhidong prescription has better dynamic efficacy in the treatment of TD and higher drug safety,so as to verify the correctness of han shi’s idea of"treating twitching disorder from the heart".2.In the early stage of treatment,the best treatment plan for children with mild and moderate TD is to visit once every 2 weeks,which may achieve the best effect of early treatment.In the middle stage of treatment,the best treatment plan for mild and moderate children is once every4 weeks,which can make the curative effect more stable.In the later stage of treatment,the best treatment plan for children with mild and moderate diseases is to visit once every4 weeks,which can achieve better clinical efficacy.Among them,children with mild TD with good economic conditions and close distance can also be treated once every two weeks.3.It is speculated that 2 weeks after taking the medicine may be the drug onset time segment of jingxinzhidong prescription in the treatment of children with mild and moderate TD.4.Treatment for 24 weeks can significantly improve the TCM symptoms of TD children,and there is no significant correlation between the improvement of TCM symptoms and the frequency of visit(frequency of diagnosis and treatment).The TCM syndromes of TD children patients are mostly those of flourishing heart and liver fire,and the syndromes are consistent in group A,B and C.5.According to the data mining of medication law,the medication of the combination prescription of han shi treatment for tic disorder was relatively mild,and the basic structure of the drug combination of "jingxinzhidong prescription"was relatively stable.