Long - Term Follow - Up Of Children With Tic Disorder And Its Prognostic Factors

Objectives:The purpose of this article is to explore the long-term effect of the treatment, the prognosis of tic disorder, and the related factors of the recurrence through retrospective study. The children with TD who were cured by traditional Chinese medicine in the past eight years, are compared and analyzed from the aspects of the incidence, improvement of TCM symptoms, and mental and psychological factors, so as to provide more evidence for improving clinical efficacy, reducing the recurrence rate, guiding prevention.Method:Diagnosed and cured 205 cases of TD from September 2007 to September 2015 in Guang anmen hospital were selected as the subjective. The situation of the incidence, the recrudescence, improvement of TCM symptoms, and mental and psychological factors were filled through the follow-up questionnaire, and relationships between these were analyzed so as to explore the related factors of recurrence.Result:1. Basic situation:In the 205 drug stopped children, the peak of onset was 5 to 7 years old, the average age of onset was 6.55+2.02 years old. The average length of the treatment was 30.68+12.13 months. The shortest was 11 months, and the longest was 68 months. In the surveyed 205 cases,86 cases had appeared tic symptoms after withdrawal, accounted for 42.0% of the total studied population, and 119 cases did not relapse, accounted for 58.0% of the total number of research. Most of the patients relapsed during 6 months to 1 year after withdrawal, accounted for 58.1% of the total number of recurrence. The symptoms are more unitary and low seizure frequency. Duration of symptoms was no longer than 2 months, and the shortest lasted only several days. Symptoms can disappeared after the diet controlling and living habits adjustment in 84 patients. Symptoms of 5 patients disappeared by Chinese medicine treatment. There were no patients relapsed after stopping the medicine more than 2 years.2. The factors, such as different syndromes, gender, disease duration, stop time of the drug, taking western medicine respectively with recurrence of tic symptoms by the chi-square test, P values 0.215,0.834,0.735,0.65 and 0.952(P> 0.05). The difference was not statistically significant, suggesting that these 5 factors had no correlation with recurrence of tic symptoms. With the growth of the time of withdrawal, the ratio of children with relapse to the no relapse gradually increased. The frequency of recurrence between 6 months to 1 year was the highest, accounting for 58.1% of the total recurrence.3. The academic pressure and recurrence of tic symptoms were significant by chi-square test (P< 0.05). The academic pressure and recurrence of tic symptoms is related. Mobile TV controlling, diet controlling and recurrence of tic symptoms showed no significant correlation by chi-square test by the chi-square test (P> 0.05).4. Traditional Chinese medicine treatment has obvious effect in improving the symptoms. Respectively comparing poor appetite, poor sleeping, enuresis, frequent urination, constipation, stuffy nose, pharynx unwell, sweating, allergic skin itching, abdominal pain, chest tightness with recurrence of tic symptoms, the three such as poor sleeping, frequent micturition and nasal symptoms were related to recurrence. The other eight showed no correlation.5. In psychiatric and psychological factors, the quick temper, timid, grievance, anxiety, movement behavior problems, poor concentration, communication disorder and with recurrence of tic symptoms by the chi-square test, P valued 0.303,0.088,0.000,0.000,0.000, 0.886,0.247. Grievance, anxiety sensitivity, movement behavior (P< 0.05), the difference was statistically significant, suggesting that the three related to recurrence.Conclusion:5 to 7 years old is the peak incidence. The disease is still not stable and prone to recrudesce in the early healing period, especially in 6 months to 1 year after withdrawal. During this period, the children’s diet should still be controlled. The instructor believes that the disease is mainly due to the heart disorders. Through the treatment from the heart, the TCM symptoms were significantly improved and had a lasting curative effect. The long-term effect of the treatment was significant. One of the causes of recurrence is the pressure. Children in the stage of education are more likely to relapse after stopping the drug, whom should be paid more attention, have a good rest and avoid fatigue. The probability of recurrence in children with poor sleeping, stuffy nose, and frequent urination was higher than that without the symptoms. The improvement of these three aspects has a certain effect on reducing the risk of recurrence of tic symptoms. The children who were grievance, anxiety, or had movement behavior problems were more likely to relapse after withdrawal, which suggested that psychological problems were the main factors for local recurrence. On one hand, this is in line with the instructor’s theory, on the other hand, in addition to traditional Chinese medicine treatment, appropriate psychological counseling should also be given to children, so as to ease the tension of the children, stabilize the disease, and prevent recrudesce.