Real-World Study Of Tic Disorders In Children With Syndrome Of Phlegm-Fire Disturbing Mind

Objective:This project explores the general characteristics,clinical features,efficacy and recurrence-related factors of tic disorders(TD).Methods:Statistically analyzed case information of tic disorders in children with syndrome of phlegm-fire disturbing mind from the pediatric outpatient clinic of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.(1)Correlation with risk factors is explored by grouping of symptoms of tic disorders;(2)The Yale Global Tic Severity Scale(YGTSS)and medication status before and after treatment were recorded,and used to evaluate the efficacy;(3)Explored the correlation between recurrence and risk factors based on the presence or absence of recurrence.Results:1.The study showed that the median age of onset was 9(7,11)years,and it was concentrated in school-age children(7~+-14 years),accounting for 67.6%of collected cases;The incidence rate of boys(90.1%)is significantly higher than that of girls(9.9%)in collected cases;The number of Tourette syndrome(TS)cases was 42(59.2%)and chronic tic disorder(CTD)was 29(40.8%).2.In the completed case,the average YGTSS before treatment was YGTSS 30.32±9.64,and there were 19 cases(30.2%)in the mild group and 44 cases(69.8%)in the moderate group;Symptoms were divided into the face symptoms(69.8%),neck symptoms(28.6%),shoulders symptoms(25.4%),limbs symptoms(20.6%),torso symptoms(22.2%)and vocal symptoms(71.4%);The risk factors were allergic diseases(52.4%),scoliosis(12.7%),stressful home environment(28.6%),excessive intake of drinks and snacks(30.2%),sleep disturbance(12.7%),excessive schoolwork burden(14.3%),and longer screen exposure(44.4%).3.The effects of scoliosis on neck and trunk symptoms were statistically significant(P=0.009;P=0.024);The remaining risk factors had no statistically significant effect on symptoms of tic disorders(P>0.05).4.Among the included traditional Chinese medicines,the top 16 in frequency were tangerine peel,licorice,calamus,fang feng,citrus husk,ban xia,qiang huo,skullcap,jie geng,cicada molt,gardenia,hou po,fu ling,nan xing,chai hu,bai shao;YGTSS at week8,12 were compared with YGTSS at week 0,the overall mean differences were statistically significant(P<0.001;P<0.001);The total effective rates at week 8 and week 12 were 55.6%and 85.7%.5.The proportion of combined drugs was 49.2%,and there was no significant difference in various treatment options at weeks 8 and 12(P=0.938;P=0.929).6.The recurrence rate was 29.4%,and the effect of family environment tension on recurrence was statistically significant(P=0.018).Conclusion:1.School-age children(7~+-14 years old)and male children account for a higher proportion of TD with Syndrome of Phlegm-fire Disturbing Mind.2.It is more common with vocal symptoms of TD with Syndrome of Phlegm-fire Disturbing Mind.3.The treatment effect of this study was remarkable,and the effect of traditional Chinese medicine combined with proprietary Chinese medicine or western medicine is not better than that of traditional Chinese medicine alone.4.Tense family circumstances(eg,strained parental relationships,single-parent families,frequent reprimands or abuse)are the causes of recurrence.5.Scoliosis is a contributing factor to the onset of neck and trunk symptoms.