阿立哌唑治疗Tourette综合征共患注意缺陷多动障碍研究

杨合俭张福业史宝海　刘亚蒙杨新利陈丽萍张素梅

阿立哌唑治疗Tourette综合征共患注意缺陷多动障碍研究

杨合俭*张福业*史宝海△刘亚蒙*杨新利△陈丽萍△张素梅*

目的 探索阿立哌唑治疗Tourette综合征共患注意缺陷多动障碍患儿的疗效及安全性。方法 选择Tourette综合征共患注意缺陷多动障碍患儿44例，随机分为阿立哌唑组和氟哌啶醇组，分别给予阿立哌唑和氟哌啶醇治疗12周，治疗前后采用耶鲁综合抽动严重程度量表（Yale global tic severity scale，YGTSS）和Conners（父母）症状问卷提供的多动指数标准评估患儿抽动症状及多动指数改善情况，并记录治疗过程中发生的药物副反应。结果 重复测量方差分析示，对于YGTSS评分，分组主效应无统计学意义（P＞0.05），时间主效应、分组与时间的交互效应有统计学意义（P＜0.05）；对于多动指数，分组主效应、时间主效应、分组与时间的交互效应均有统计学意义（P＜0.05）。治疗12周时，两组YGTSS评分无统计学差异（P＞0.05），阿立哌唑组多动指数低于氟哌啶醇组（P＜0.01）。阿立哌唑组出现副反应者（3/22）比氟哌啶醇组（6/22）少（P＜0.05）。结论 阿立哌唑治疗Tourette综合征共患注意缺陷多动障碍患儿的抽动症状与氟哌啶醇相当，且可一定程度减轻其多动、注意力缺陷等症状，副作用较氟哌啶醇少。

Tourette综合征 注意力缺陷障碍伴多动 氟哌啶醇 儿童

【Abstract】Objective To evaluate the efficacy and safety of aripiprazole treatment for co-morbid attention deficiency hyperactivity disorder（ADHD）in children with Tourette syndrome（TS）.Methods Forty four TS children with co-morbid ADHD were randomly divided into aripiprazole group and haloperidol group.The aripiprazole group and haloperidol group received aripiprazole and haloperidol treatment for 12 weeks，respectively.Yale global tic severity scale （YGTSS）and Conners parent symptom questionnaire（PSQ）were used to assess the tic and ADHD symptoms before，2，4，8 and 12 weeks after treatment.Side effects were recorded weekly.Results Repeated measure ANOVA indicated that the main effects of groups was not significant to the YGTSS scores（P＞0.05），but significant to the PSQ scores（P＜0.05）. After 12-week treatment，the YGTSS scores between two groups were not significantly different（P＞0.05）.The PSQ scores of aripiprazole group were significantly lower than that of haloperidol group.The adverse reactions of aripiprazole group were milder compared with the haloperidol group（P＜0.05）.Conclusions The present study demonstrates that aripiprazole has the same efficacy in the treatment of tics as haloperidol，improves co-morbid ADHD symptoms，and its adversereactions are much less compared with haloperidol.

【Key words】Tourette syndrome Attention deficiency hyperactivity disorder Haloperidol Children

Tourette综合征（Tourette syndrome，TS）是一种慢性神经精神系统疾病，多在儿童及青少年时期发病。有研究显示，50%～90%的TS患者伴有一种或多种精神或行为疾病，最常见的为注意缺陷多动障碍（attention deficiency hyperactivity disorder，ADHD）和强迫症，抑郁症、焦虑症、学习障碍及行为异常等亦可伴发于TS［1］。……