| BackgroundTic disorder(TD)is a neuropsychiatric disorder of unknown cause,manifested as involuntary exercise tics and/or vocal tics,which may be associated with mental illnesses such as obsessive-compulsive disorder,emotional disorders.Neurotransmitter abnormalities and receptor dysfunction are considered to be potential pathophysiological mechanisms of tics.In recent years the incidence of TD has increased significantly.Due to involuntary facial movements,physical movements,and abnormal vocalizations,the attention of people around them has caused abnormal emotional and behavioral problems such as inferiority,anxiety,coercion,depression,etc.,which seriously affecting the physical and mental development of children.The common drugs for treating tic disorder are anti-psychotic drugs such as tiapride,aripiprazole,and haloperidol.Tiapride is the first-line drug for the treatment of TD in China.The main pharmacological effect is to inhibit the dopaminergic motor function of the midbrain limbic system by blocking the central dopamine receptor,which can alleviate most TD symptoms,but side effects of the extra-vertebral system are common,such as sedation,gastrointestinal reactions,dizziness,etc.,and Children are poorly tolerated.Clonidine is an alpha2-adrenergic receptor agonist that has been used to treat hypertension.Small doses of clonidine can reduce the tics of withdrawal by activating blue presynaptic autoreceptors and reducing the release of noradrenalin(NE).In the 1980 s,it was reported for the first time in the world that clonidine treatment TD is effective,and it has been used for the treatment of TD for more than 30 years.Clonidine transdermal patch is a transdermal therapeutic system,which can continuously release clonidine into the body for 7 days.There is no peak concentration of blood concentration in oral preparations,which can reduce the number of doses of patients,provide more sustained and stable drug effects,and have fewer side effects,so that patients have better compliance.However,due to the controversy of curative effect,Clonidine transdermal patch has not been promoted in China,and more clinical research and experimental data are needed to observe its efficacy and safety.Objective1.Prospective observation of the clinical efficacy of clonidine transdermal patch in the treatment of children with tic disorder.2.To observe the safety of clonidine transdermal patch in children with tic disorder by recording the adverse reactions of clonidine transdermal patch in patients with tic disorder.MethodsThe children with tic disorder who were diagnosed in the pediatric neurology clinic of the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2018 were selected and divided into clonidine group and tiapride group.The clonidine group was given a transdermal patch of clonidine,and the tiapride group was given to the thiophene tablets for 8 weeks.Exclude midway exiters,lost visitors,etc.At the time of enrollment,the second weekend of treatment,4th weekend,6th week,and 8th weekend,the Yale Comprehensive Tic Severity Scale was used to score,and the blood routine,liver and kidney function were improved to evaluate drug safety.Statistical analysis of experimental data was performed using SPSS 21.0 software.Results1.126 children with TD were enrolled and randomly divided into two groups,clonidine group and tiapride group,then deducted cases(5 cases of clonidine transdermal patch group and 8 cases of tiapride group),and finally there were 58 patients in the clonidine group and 55 patients in the tiapride group.There were no significant differences in age,gender,disease duration,and disease type between the two groups(P>0.05).There was no significant difference in the four scores of YGTSS between the two groups.2.At the 2nd weekend,4th weekend,6th week and 8th weekend of treatment,there was no significant difference in efficacy and efficiency between the two groups(P>0.05).On the 8th weekend of treatment,clonidine transdermal patch group: 23 cases were cured,20 cases were markedly effective,11 cases were effective,4 cases were ineffective,and the total effective rate was 93.10%.The tiapride group: 22 cases were cured,and 19 cases were markedly effective.,10 cases were effective,4 cases were ineffective,and the total effective rate was 92.73%.Efficient comparison,P>0.05,no statistical significance.3.At the 2nd weekend,4th weekend,6th weekend,and 8th weekend of treatment,there was no significant difference in the reduction rate of YGTSS between the two groups.4.The adverse effects in the clonidine transdermal patch group were 4 cases showed skin itching and redness,1 case dissociated,1 case thirsty and the adverse reaction rate was about 10.3%.The other group were 7 cases drowsiness,3 case nausea,2 case dizziness,1 case thirsty and the adverse reaction rate was about 23.6%.During the treatment both were no serious adverse reactions such as arrhythmia,abnormal blood pressure,etc.The adverse reaction rate was compared,P<0.05,which was statistically significant.Conclusions1.Clonidine transdermal patch treatment and tiapride treatment of children with tic disorder are effective,no significant difference in efficacy.2.Clonidine transdermal patch for children with tic disorder adverse reactions are relatively mild,relatively safe,and high compliance. |
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