Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; Department of Epidemiology, West China School of Public Health, and West China Fourth Hospital, Sichuan University.
Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education.
Psychiatry Res. 2020 May;287:112905. doi: 10.1016/j.psychres.2020.112905. Epub 2020 Mar 1.
To conduct an updated overview of systematic reviews (SRs) summarizing the efficacy and safety of various strategies used to treat tic disorders (TDs) in children. We searched the Cochrane Library, PubMed, EMBASE, and relevant reference lists for articles published between the search deadline from our last overview and April 2019 and included 16 SRs. The results presented that antipsychotics, a2-adrenergic receptor agonists, and HRT/CBIT still appeared to be the most robust evidence-based options for the treatment of TDs. Compared with our last overview, more robust evidence showed that aripiprazole and acupuncture was effective treatment in treating children TDs, and DBS for medication-refractory and severely affected patients. In addition, physical activity or exercise may be promising treatments, and the clonidine adhesive patch is an effective, safe, and convenient treatment option for TDs. Moreover, methylphenidate, guanfacine, and desipramine appeared to reduce ADHD symptoms in children with tics. However, no research studies have examined HRT/CBIT alone compared with HRT/CBIT in combination with medication. More high-quality clinical trials comparing different interventions for TDs including economic evaluations should be encouraged.
对治疗儿童抽动障碍（TD）的各种策略的疗效和安全性进行综述的系统评价（SRs）进行更新。我们检索了 Cochrane 图书馆、PubMed、EMBASE 和我们上次综述的截止日期与 2019 年 4 月之间发表的相关参考文献，并纳入了 16 项 SRs。结果表明，抗精神病药、α2-肾上腺素能受体激动剂和 HRT/CBIT 似乎仍然是治疗 TD 的最有力的循证选择。与我们上次综述相比，更多的有力证据表明，阿立哌唑和针刺治疗儿童 TD 有效，DBS 对药物难治性和严重影响的患者有效。此外，身体活动或运动可能是有前途的治疗方法，氯硝西泮贴剂是治疗 TD 的有效、安全和方便的选择。此外，哌甲酯、胍法辛和去甲丙咪嗪似乎可减轻抽动儿童的 ADHD 症状。然而，没有研究比较 HRT/CBIT 与 HRT/CBIT 联合用药的单独治疗效果。应该鼓励开展更多比较不同 TD 干预措施（包括经济评估）的高质量临床试验。
