目的 总结抽动障碍(TD)各类型在儿童中的分布特点,为临床诊治提供科学依据。方法 对2017年06月～2019年07月在江苏省中医院儿科门诊就诊的160例TD患儿的临床资料回顾性进行分析,总结TD临床表现,描述各类型的年龄、性别分布特点,比较各类型TD的共病及耶鲁评分情况。结果 抽动障碍发病男孩明显高于女孩,约4.9:1,发病年龄以5~8岁学龄期最为常见,临床类型以Tourette综合征为主(占59.38%),临床表现以眨眼、清嗓子等简单性抽动最为常见。短暂性抽动(TTD)、慢性抽动(CTD)、Tourette综合征(TS)的年龄及性别分布无明显差异(P=0.329、0.441＞0.05),但TS的伴共病情况明显高于TTD、CTD(P=0.008、0.011＜0.0167),注意力缺陷多动障碍(ADHD)是常见共病,且TS伴ADHD情况明显高于TTD(P=0.011＜0.0167)。出生前后脑损伤是发病高危因素,看电视、情绪变化是主要的诱发/加重因素。耶鲁评分比较显示TS组显著高于TTD、CTD组(P=0.000、0.000＜0.05),实验室检查无特异性异常指标。中医证型方面,以实证居多(70%),其中肝亢风动证、气郁化火证、痰火扰神证最为多见,虚实夹杂证(脾虚痰聚证)次之,虚证(阴虚风动证)少见。以结论 抽动障碍临床就诊率逐年增高,就诊年龄多集中在学龄期儿童,Tourette综合征病情更为严重、复杂,应引起临床重视。

ABSTRACT: Objective The article concluded characteristics of each type of tic disorder in order to provide scientific evidence for clinical diagnosis and treatment. Methods The article analysed 160 patients’ clinical cases collected in pediatrics of Jiangsu province hospital of Chinese medicine from June 2017 to July 2019. We summarized clinical features of TD, described age and gender distribution characteristics of each type, and compared comorbidity and YGTSS scores of each type. Results Most patients were boys at school age, mostly were from 5 to 8 years old. The ratio between boys and girl was 4.9:1. The clinical type of TD was given priority to with Tourette's syndrome (59.38%). Clinical features included simple tics such as blink, clearing throat, et al. No obvious difference was found between age and gender distribution of each type (P=0.329, 0.441＞0.05). ADHD was the most popular comorbidity, and Tourette's syndrome with ADHD was significantly higher than TTD (P=0.011＜0.0167). Cerebral injury before or after birth were high risk factors of it, watching TV and emotional changes were dominating induction or exacerbation factors. YGTSS scores of TS group was significantly higher than TTD and CTD groups (p=0.000、0.000＜0.05), and there are no special laboratory examination indexes. In terms of TCM syndromes, most of them were empirical (70%), among which, the syndrome of hyperactivity of liver and wind, the syndrome of qi stagnation melting fire, and the syndrome of phlegm and fire disturbing the spirit were the most common, followed by the syndrome of deficiency and reality (syndrome of spleen deficiency and phlegm gathering), and the deficiency syndrome (syndrome of Yin deficiency and wind moving) was rare. Conclusion The rate of clinical diagnosis of tic disorder is increasing year by year, and the age is concentrated in school-age children, TS is most serious and complicated of all types which clinical attention should be paid to.

国家自然科学基金项目（面上项目，重点项目，重大项目）