长期补充维生素D联合综合行为疗法治疗儿童短暂性抽动障碍的疗效观察

doi:10.20274/j.cnki.issn.1674-3865.2026.03.015

摘要/Abstract

摘要：

目的探讨长期补充维生素D联合综合行为疗法治疗儿童短暂性抽动障碍（TTD）的临床疗效。方法选择2023年1月至2024年6月新疆医科大学第二附属医院收治的TTD儿童150例为研究对象，随机分为对照组和观察组各75例。对照组予综合行为疗法，观察组在对照组治疗基础上联合维生素D干预。24周疗程结束后，比较治疗总有效率、抽动障碍严重程度、淋巴细胞亚群、脑源性神经营养因子（BDNF）和特异性烯醇化酶（NSE）水平。结果观察组治疗总有效率为92.0%（69/75），高于对照组80.0%（60/75），差异有统计学意义（P<0.05）。治疗后8周、16周、24周观察组耶鲁综合抽动严重程度量表（YGTSS）评分均低于对照组，差异有统计学意义（P<0.05）。治疗后观察组淋巴细胞亚群改善优于对照组，差异有统计学意义（P<0.05）。观察组治疗后BDNF水平高于对照组，NSE水平低于对照组，差异有统计学意义（P<0.05）。结论长期补充维生素D联合综合行为疗法治疗TTD相比于单一综合行为疗法，治疗总有效率更高，抽动症状、淋巴细胞亚群、BDNF和NSE水平改善更显著，临床上值得应用。

关键词: 短暂性抽动障碍, 维生素D, 综合行为疗法, 淋巴细胞亚群, 儿童

Abstract:

Objective To explore the clinical efficacy of long-term vitamin D(VitD) supplementation combined with comprehensive behavioral therapy in the treatment of transient tic disorder(TTD) in children. Methods Totally 150 TTD children who were admitted to the Second Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2024 were selected as study subjects, and they were randomly divided into the control group and the observation group with 75 cases in each group. Both groups received comprehensive behavioral therapy, while the observation group received additional vitamin D intervention. After the treatment course of 24 weeks, the total effective rate of treatment, tic disorder severity, lymphocyte subsets, brain-derived neurotrophic factor(BDNF) and neuron-specific enolase(NSE) levels were compared. Results The total effective rate of treatment in the observation group was 92.0%(69/75), which was higher than that in the control group (80.0%, 60/75), being with statistical difference(P<0.05). After 8 weeks, 16 weeks and 24 weeks of treatment, the Yale global tic severity scale(YGTSS) scores in the observation group were all lower than those in the control group, and there were statistical differences(P<0.05). After treatment, the improvement in lymphocyte subsets in the observation group was better than that in the control group, and the differences were statistically significant(P<0.05). After treatment, the BDNF level in the observation group was higher than that in the control group, while the NSE level was lower than that in the control group, both differences being statistically significant(P<0.05). Conclusion Compared to comprehensive behavioral therapy alone, the long-term supplementation of vitamin D combined with comprehensive behavioral therapy for the treatment of TTD has a higher total effective rate of treatment and more significant improvement in tic symptoms, lymphocyte subsets, and levels of BDNF and NSE, which is worthy of clinical application.

Key words: Transient tic disorder, Vitamin D, Comprehensive behavioral therapy, Lymphocyte subsets, Child

中图分类号:

R748

贾鑫, 张捷, 陈斐斐, 吴安祺, 王丽颖. 长期补充维生素D联合综合行为疗法治疗儿童短暂性抽动障碍的疗效观察[J]. 中国中西医结合儿科学, 2026, 18(3): 272-276.

Xin JIA, Jie ZHANG, Feifei CHEN, Anqi WU, Liying WANG. Study on clinical efficacy of long-term vitamin D supplementation combined with comprehensive behavioral therapy in the treatment of transient tic disorder in children[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(3): 272-276.

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组别	n	临床痊愈	显效	有效	无效	总有效
对照组	75	10（13.3）	19（25.3）	31（41.3）	15（20.0）	60（80.0）
观察组	75	20（26.7）	40（53.3）	9（12.0）	6（8.0）	69（92.0）^a

组别	n	治疗前	治疗后8周	治疗后16周	治疗后24周	F值	P值
对照组	75	38.12±6.62	27.60±5.41^a	20.68±3.84^a	16.39±4.74^a	102.859	<0.001
观察组	75	38.55±4.64	22.29±4.65^a	16.11±2.35^a	11.99±4.68^a	102.859	<0.001
t值		0.461	6.446	8.791	5.721
P值		0.646	<0.001	<0.001	<0.001

组别	n	CD4^＋（%）		CD8^＋（%）		CD4^＋/CD8^＋
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	29.22±3.54	34.90±3.67^a	33.11±3.10	27.96±2.83^a	0.89±0.13	1.26±0.20^a
观察组	75	29.51±3.24	39.38±3.38^a	33.89±3.82	23.91±3.05^a	0.88±0.15	1.67±0.26^a
t值		0.523	7.776	1.373	8.430	0.436	10.825
P值		0.602	<0.001	0.172	<0.001	0.663	<0.001

组别	n	BDNF		NSE
组别	n	治疗前	治疗后	治疗前	治疗后
对照组	75	2.23±0.49	3.45±0.60^a	22.06±3.21	17.21±2.43^a
观察组	75	2.37±0.52	5.03±0.72^a	22.58±3.51	12.13±1.82^a
t值		1.697	14.600	0.947	14.491
P值		0.092	<0.001	0.345	<0.001

组别	n	治疗前	治疗后	t值	P值
对照组	75	22.11±4.16	23.13±3.63	1.600	0.112
观察组	75	23.10±3.57	34.07±3.21	19.788	<0.001
t值		1.564	19.552
P值		0.120	<0.001