Abstract: Objective To study the treatment of systematize group behavior intervention on tic disorders (TD) child patients,and provide clinical guideline of behavior therapy on TD child patients. Method sProspective case-control method was used.132 chronic chronic tic disorders (CTD) or Tourette's syndrome (TS) child patients were chosen as research objects from child neurology clinic in our hospital,which were randomly divided into three groups as behavior intervention group (n=47),medicine treatment group (n=47) and combined intervention group (n=38).1) Intervention methods:"CHEN four stages" group-behavior intervention was designed based on psychological behavior treatment principle.Behavior intervention group adopted the group-behavior intervention,medicine treatment group adopted clonidine slow-release patch treatment,and combined intervention group combined with the group-behavior intervention and the original therapeutic dose.2)Clinical curative effect:the clinically curative effect was assessed by Yale Global Tie Severity Scale (YGTSS).3) The treatment security was assessed by Treatment Emergent Symptom Scale(TESS),and the obedience was observed during the treatment. Results 1) Comparison of clinical curative effect:YGTSS reducing rate of combined intervention group at the 4th,8th and 12th week after intervention were 41.48±16.39,53.39±16.59,67.6±19.31,which were greater than those of behavior intervention group(33.35±17.84,43.69±22.27,55.59±22.44),and were greater than those of medicine treatment group(24.79±19.94,34.49±30.79,44.13±26.57),all the differences were statistically significant (P<0.05,or <0.001).2) There were no significant differences on security and obedience assessment among three groups(all P>0.05). Conclusion There are obvious improvement in the symptoms and psychological health of TD child patients by specific group behavior intervention treatment,basing on clinical symptoms of TD child patients and the psychology characteristics of their parents.

Key words: tic disorders, group behavior intervention, clinical effect, child

摘要： 目的 探讨抽动障碍(TD)患儿系统化行为干预的方法,以期为TD患儿的行为治疗提供临床指导。方法 采用前瞻性病例对照研究方法,选取在福建医科大学协和临床学院儿童神经内科门诊就诊的慢性抽动障碍(CTD)和Tourette综合征(TS)患儿132人,随机分为行为干预组(n=47)、药物治疗组(n=47)及联合干预组(n=38)。1)干预方法:行为干预组采用自行设计的四阶段CHEN团体行为干预方法;药物治疗组采用可乐定缓释透皮贴剂干预;联合干预组在维持原药物治疗的同时加用行为干预治疗。2)抽动严重程度评估:根据耶鲁综合抽动严重程度量表(YGTSS)评定。 3)干预安全性采用治疗副反应量表系统(TESS)进行评定,并评估干预依从性。结果 1)干预后4周,8周,12周,联合干预组YGTSS减分率分别为(41.48±16.39,53.39±16.59,67.6±19.31)>行为干预组(33.35±17.84,43.69±22.27,55.59±22.44)>药物治疗组(24.79±19.94,34.49±30.79,44.13±26.57),差异有统计学意义(P<0.05或P<0.001);2)三组间安全性及依从性比较,差异无统计学意义(P均>0.05)。结论 结合抽动障碍患儿临床症状及其与家长的心理行为特点,实施针对性的团体心理行为干预对抽动障碍儿童的症状和心理健康有显著的改善作用。

关键词: 抽动障碍, 团体行为干预, 临床疗效, 儿童