三种治疗方法对儿童注意力缺陷多动障碍疗效的临床评价

Clinical evaluation of the curative effects of three therapeutic methods for children with attention deficit hyperactivity disorder

目的:探讨三种治疗方法对儿童注意力缺陷多动障碍(Attention deficit hyperactivity disorder,ADHD)的临床治疗效果。方法:随机选择2009年3月～2011年2月来我院治疗的1～3年级的ADHD小学生135例,其中语文、数学成绩好、中、差学生各占45例。其症状及诊断均符合《精神障碍诊断与统计手册(第4版)》的诊断标准,将患儿分为择思达组(A组)、利他林组(B组)及择思达+心理行为治疗组(C组)各45例,每组于治疗前和治疗7个月后进行破坏性行为障碍评定量表(Disruptive behavior disorder rate scale,DBDRS)、大体评定量表(Clinical grobal impressions scale,CGI)以及患儿学习成绩水平变化等比较。结果:治疗前三个组的各个评分项差异均无统计学意义(P>0.05),治疗后三组的DBDRS症状评分比较无统计学差异(P>0.05),C组CGI评分低于A、B两组(P<0.01),学习成绩变化趋势与A组、B组比较差异显著(P<0.01)。A、B两组治疗后的各项评分比较无统计学差异(P>0.05)。C组治疗后的有效率为88.89%(40/45),与A组有效率75.56%(34/45)、B组有效率73.33%(33/45)比较有显著性差异(P<0.05)。结论:择思达联合心理行为治疗ADHD患儿能更有效的提高儿童的学习能力,改善儿童行为的异常,从而有利于儿童身心健康的发育,更减轻了家长的负担,值得临床上进一步研究应用。

Objective：To explore the clinical curative effects of three therapeutic methods for children with attention deficit hyperactivity disorder（ADHD）. Methods：One hundred and thirty-five primary school students in Grade 1-3 who were treated in the hospital from March 2009 to February 2011 were selected randomly,then they were divided into three groups according to the academic records of Chinese and math,45 students in each group.The symptoms and diagnosis were coincidence with the diagnostic criteria of Diagnostic and statistical manual of mental disorders（4th edition）,the children were divided into elective Star group（group A）,Ritalin group（group B）,and elective Star＋psychological and behavioral therapy group（group C）,45 children in each group;Disruptive behavior disorder rate scale（DBDRS） and Clinical global impressions scale（CGI） were conducted before and at seven months after treatment in each group,the changes of academic records in the three groups were compared. Results：There was no significant difference in the scores among the three groups before treatment（P0.05）,after treatment,there was no significant difference in the score of DBDRS symptom among the three groups（P0.05）,CGI score of group C was significantly lower than those in group A and group B（P0.01）,there was significant difference in the change tendency of academic records between group C and group A,group B（P0.01）.There was no significant difference in the scores after treatment between group A and group B（P0.05）.The effective rates after treatment in group A,group B,and group C were 75.56%（34/45）,73.33%（33/45）,and 88.89%（40/45）,respectively,there was significant difference between group C and group A,group B（P0.05）. Conclusion：Elective Star combined with psychological and behavioral therapy can improve the learning ability of children with ADHD effectively,improve behavioral abnormality of children,which is helpful to physiological and psychological development of children,and the method can relieve the burdens of their parents,more studies and applications are needed in clinic.