600例多发性抽动症患儿临床特点回顾性分析

郎伯旭 金灵青 郎珈望

[摘要] 目的 探讨多发性抽动症患儿的临床发病特点。 方法 采用自制的多发性抽动症临床研究观察表，采集患者的一般资料、发病年龄、首发症状、主要症状、共患症状、患儿性格、家族史等临床资料，随机选取其中600例进行统计分析，并结合文献进行结果解读。 结果 本病男女构成比为5.52：1;发病年龄为（6.59±2.30）岁;首发症状以头面部的运动性抽动为主，占85.00%，首诊误诊率则高达75.33%;主要症状包括全身各部位的运动性抽动和发声性抽动;共患行为障碍症状中以共患注意缺陷多动障碍及学习困难者为多，分别占73.50%和56.80%;性格内向者占75.50%，急躁者占62.16%;有家族史者占11.00%。 结论 多发性抽动症是一种幼龄高发、症状复杂的疾病，误诊率高，有效治疗手段欠缺，已严重影响广大患儿的身心健康和学习生活，应当引起学术界的广泛重视，并共同探究。

[关键词] 多发性抽动症;临床特点;回顾性分析;共患病

[Abstract] Objective To explore the clinical characteristics of patients with Tourette Syndrome. Methods This study collected the clinical data of general data， age of onset， first symptoms， primary symptoms， co-symptoms， patients′ personality， and family history by using the self-made clinical observation table of Tourette Syndrome. Thereinto，six hundred cases were randomly selected for statistical analysis， and the results were interpreted in combination with the literature. Results The male to the female constituent ratio of the disease was 5.52%; The age of onset was（6.59±2.30） years old; The first symptoms were mainly motor twitches of the head and face， accounting for 85.00%，and the misdiagnosis rate was as high as 75.33%; The main symptoms included motor tic in all parts of the body and vocal tic; Most of the symptoms of comorbid behavioral disorder were attention deficit hyperactivity disorder and learning difficulties， accounting for 73.50% and 56.80%， respectively; Introverts accounted for 75.50%， and impatient persons accounted for 62.16%; Family history accounted for 11%. Conclusion Tourette Syndrome is a disease with a high incidence of childhood and problematic symptoms， with a high misdiagnosis rate and lack of effective treatment， which has seriously affected the physical and mental health and study life of the majority of children， which should be paid attention to and explored by the academic circles.

[Key words] Multipletics; Clinical characteristics; Retrospective analysis; Comorbidities

多發性抽动症又称Tourette综合征（Tourette symdrom，TS），是一种以多发性运动性抽动及不自主发声为主要特点的慢性神经精神障碍性疾病[1]。本病好发于6～12岁的儿童，容易共患各种行为障碍性疾病。近年来，随着电子产品及互联网的普及，发病率明显上升[2-4]，由于此年龄段正值孩子的生理、心理、性格、行为等各方面发育的关键时期，因此加深对此病的认识，具有重要的临床意义。本课题组自2005年起，一直致力于本病的研究，至今运用针灸、正骨的方法治疗了全国各地的1.3万例患者，本文选取其中的600例患儿，对其临床特点进行回顾性分析，现报道如下。……