6~11 岁脾虚肝亢型抽动障碍男童的行为学特点
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R749.94

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2024年广东省名中医传承工作室建设项目(0102018005);广东省中医院岭南儿科杜明昭学术流派传承工作室建设项目[中医二院(2013) E43608]


Behavioral Characteristics of Boys Aged 6-11 with Tic Disorder of Spleen Deficiency and Liver Hyperactivity Type
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    摘要:

    目的:探讨6~11岁脾虚肝亢型抽动障碍男童的行为学特点,为抽动障碍共病行为问题的早期识 别及干预治疗提供理论依据。方法:采取横断面问卷调查方式,招募符合纳排标准的30例男童,14例抽动障 碍患儿作为抽动组及16 例非抽动障碍患儿作为对照组,使用儿童行为量表(CBCL)、Conners 父母症状问 卷(PSQ) 进行行为问题评估,比较2组得分差异;使用耶鲁综合抽动严重程度量表(YGTSS) 评估抽动症状 严重程度,分析抽动障碍和行为问题的相关性。结果:抽动组CBCL问卷评分行为问题检出率为35.7%(5/14), 高于对照组6.3% (1/16),差异有统计学意义(P<0.05)。抽动组CBCL总分高于对照组,PSQ总分高于对照 组,差异均有统计学意义(P<0.05)。在社交能力方面,抽动组的活动能力得分低于对照组,差异有统计学意 义(P<0.05);在行为问题方面,多动、强迫性、分裂样、躯体诉述4 个行为因子得分抽动组均高于对照 组(P<0.05);抽动组内化性行为、外化性行为均高于对照组(P<0.05)。在PSQ中,抽动组品行问题、心身 问题、冲动多动、焦虑4个因子得分均高于对照组(P<0.05);在学习问题和多动症指数上,2组得分比较, 差异无统计学意义(P>0.05)。Spearman相关性分析,CBCL提示抽动症状的整体损害与多动、交往不良、社 交退缩存在正相关(rs=0.59~0.74),活动能力下降与干扰程度存在负相关(rs=-0.57);PSQ提示学习问题和 整体损害存在正相关(rs=0.78),焦虑和抽动次数存在正相关(rs=0.56),均有统计学意义(P<0.05)。结论: 6~11岁脾虚肝亢型抽动障碍的男童存在活动能力下降、焦虑强迫和躯体化不适等行为问题,同时,随着抽动 障碍程度加重,社交问题和学习问题越为明显。

    Abstract:

    Abstract: Objective: To explore the behavioral characteristics of boys aged 6-11 with tic disorder of spleen deficiency and liver hyperactivity type, and to provide a theoretical basis for the early identification and intervention treatment of comorbid behavioral problems in tic disorder. Methods: A cross-sectional questionnaire survey was conducted,recruiting 30 boys who met the inclusion and exclusion criteria,including 14 children with tic disorder as the tic group and 16 children without tic disorder as the control group. Behavioral problems were assessed using the Child Behavior Checklist (CBCL) and Conners′ Parent Symptom Questionnaire (PSQ),and differences in scores between the two groups were compared. The severity of tic symptoms was evaluated using the Yale Global Tic Severity Scale (YGTSS), and the correlation between tic disorder and behavioral problems was analyzed. Results: The detection rate of behavioral problems in the tic group was 35.7%( 5/14),higher than that of 6.3%( 1/16) in the control group,with significance in the difference (P<0.05). The CBCL total score and PSQ total score in the tic group were higher than those in the control group (P<0.05). In terms of social ability,the activity ability score in the tic group was lower than that in the control group (P<0.05). In terms of behavioral problems, the scores for hyperactivity, obsessive-compulsive,schizoid,and somatic complaints were higher in the tic group than in the control group (P< 0.05). The internalizing and externalizing behavior scores were also higher in the tic group (P<0.05). In the PSQ,the scores for conduct problems, psychosomatic problems, impulsive hyperactivity, and anxiety were higher in the tic group (P<0.05). There was no significant difference in learning problems and ADHD index between the two groups (P>0.05). Spearman correlation analysis showed that the overall impairment of tic symptoms was positively correlated with hyperactivity, poor social interaction, and social withdrawal (rs=0.59-0.74), and the decline in activity capacity is negatively correlated with the level of interference (rs=-0.57). The PSQ showed that learning problems were positively correlated with overall impairment (rs=0.78), and anxiety was positively correlated with tic frequency (rs=0.56), all with statistical significance (P<0.05). Conclusion: Boys aged 6-11 with tic disorder of spleen deficiency and liver hyperactivity type exhibit behavioral problems such as decreased activity ability, anxiety, obsessive-compulsive behavior,and somatic discomfort. Moreover,as the severity of tic disorder increases,social and learning problems become more pronounced.

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彭润芯,彭贝如,许尤佳.6~11 岁脾虚肝亢型抽动障碍男童的行为学特点[J].新中医,2025,57(23):49-55

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  • 在线发布日期: 2025-12-12
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