脑电生物反馈治疗小儿注意力缺陷伴多动障碍的疗效及合适疗程探讨

Effects of EEG Biofeedback in the Treatment of Children Attention Deficit Hyperactivity Disorder

目的 探讨脑电生物反馈诊断治疗仪（A620）对注意力缺陷伴多动障碍（attention deficit hyperactivity disorder，ADHD）患儿治疗的近期疗效及合适的疗程。方法 对242例符合美国精神病学会出版的《精神病诊断统计手册》第4版DSM—Ⅳ诊断标准的ADHD患儿用脑电生物反馈诊断治疗仪进行诊断和训练治疗，逐渐增加16—21Hz的B波，抑制4—8Hz的θ波，并观察θ/β比值的变化；结合有关神经心理测试量表对其ADHD表现的症状行为进行测评，主要通过Achenbach儿童行为量表（CBCL）、Conners教师评定量表（TRS）及美国简化康奈尔儿童行为量表（简称康氏表）进行评定，结果 242例ADHD儿童经1～4个疗程治疗后，各疗程与治疗前相比。脑电θ/β值均有显著性下降（P〈0．01），治疗2个疗程以上，CBCL、TRS及康氏袁评定分值有明显降低（P〈0．05）；治疗4个疗程后这3种量表评分值与治疗1个疗程时相比，也有显著下降（P〈0．05）。结论 脑电生物反馈诊断治疗仪所测得的θ/β值对ADHD患儿有辅助诊断价值，但在临床应用中不要过于强调θ/β值，应结合临床症状和各种量表。以减少漏诊；经脑电生物反馈诊断治疗仪治疗后患儿的注意力、行为问题均有不同程度的改善，以治疗4个疗程及以上为宜。

Objective To study the effects of EEG biofeedback in the treatment of children attention deficit hyperactivity disorder （ADHD）. Methods 242 children diagnosed as ADHD were given EEG biofeedback to diagnose and treat by A620 instrument. The EEG Biofeedback protocol reinforced the enhancement of β brain waves （16 -21 Hz） and the suppression of θ brain waves （4-8 Hz）. The change of θ/β value was observed before biofeedback and after each course of biofeedback. Psychological evaluation included Achenbach index of child behavior checklist （CBCL）, Conners index teacher rating scale （TRS） and simplified Conners Behavior Rating Scales. Results The average θ/β values of 242 ADHD children after each course were lower than that before biofeedback （ P 〈0.01 ）. The scores of psychological evaluations （CBCL, TRS and Conners） were descending after treatment of 2 courses （ P 〈 0.05）. There were also obvious descending in scores of CBCL, TRS and Conners between the treatment of 4 courses and 1 course （ P 〈 0.05）. Children＇s attention and cognitive ability after EEG biofeedback treatment enhanced, and the symptoms of hyperactivity disorder lessened. Conclusion The θ/β value detected by EEG biofeedback A260 instrument was a valuable way for children ADHD diagnosis. The ADHD children＇s attention and behavior problems could be improved through EEG biofeedback treatment, especially after 4 courses treatment.