Objective:To explore the clinical characteristics and distribution of Tranditional Chinese Medicine (TCM) syndrome types of refractory tic disorders in children based on clustering analysis.Methods:A cross-sectional study. 183 children aged 3-18 years with refractory tic disorders from pediatric encephalopathy outpatient department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine who met the inclusion criteria from October 2015 to January 2022 were recruited. Frequency descriptive analysis, systematic clustering analysis and principal component analysis were conducted by Microsoft Office Excel 2016 and IBM SPSS Statistics 26.0 to explore the clinical characteristics and syndrome distribution of the disease.Results:The TCM symptoms of 183 children with refractory tic disorders were clustered into 6 categories, and finally 5 types of syndrome were obtained, among which the syndrome of spleen deficiency and liver hyperactivity mixed with dampness accounted for the largest proportion (27.32%), followed by the syndrome of phlegm-fire disturbing spirit (21.31%), the syndrome of wind-heat invading lung (18.03%), the syndrome of phlegm-qi stagnation (17.49%), and the syndrome of dampness and yin deficiency (15.85%).Conclusion:Through the mining and analysis of the outpatient information of pediatric encephalopathy in our hospital, the common syndrome differentiation types of refractory tic disorder are obtained, which can provide a reference for the TCM syndrome differentiation types of refractory tic disorder in children.

This study analyzed the outcome index and related design elements of randomized controlled trials （RCTs） of traditional Chinese medicine （TCM） in the treatment of children with tic disorder （TD） in the past ten years， so as to provide a basis for the construction of the core index set of TCM in the treatment of children with TD. Eight databases were searched， including four English databases （PubMed， Web of Science， Embase， and Cochrane Library） and four Chinese databases， including China National Knowledge Infrastructure （CNKI）， Wanfang Database， VIP Database， and China Biology Medicine disc （CBMdisc）， as well as ClinicalTrials.gov and China Clinical Trial Registry. The search time was limited to from January 1， 2013 to October 29， 2023. RCTs on the TD in children treated with TCM were collected. Two researchers independently conducted literature screening， data extraction， and literature quality evaluation and summarized clinical outcome indexes and related trial design elements through qualitative analysis. A total of 67 RCTs were included， including 63 outcome indexes， with a total frequency of 348 times. The related outcome indexes could be divided into six categories： 12 symptom/sign indexes with a frequency of 134 （38.5%）， seven TCM symptom/syndrome indexes with a frequency of 31 （8.9%）， 33 physical and chemical examination indexes with a frequency of 97 （27.9%）， four safety indexes with a frequency of 67 （19.3%）， three long-term prognostic indexes with a frequency of 14 （4.0%）， and one kind of quality-of-life evaluation index （0.3%）. Currently， the RCTs research design of TCM in the treatment of TD in children has not yet formed a unified standard， and there are many problems in the quality of methodology， which reduces the authenticity and reliability of clinical conclusions. There are problems with clinical outcome indexes， such as significant quantity differences， unclear primary and secondary outcome indexes， unreasonable alternative indexes， non-standard TCM syndrome types and TCM evaluation indexes， lack of economic evaluation indexes， and less attention to long-term prognostic indexes and safety indexes. It is suggested that the researchers should design a more rigorous trial scheme and reasonably design the outcome index which is in line with the clinical trial efficacy evaluation of TCM， so as to construct the core index set with the characteristics of TCM for the treatment TD in children.