行为疗法、针灸疗法结合专注达治疗儿童多动症疗效及安全性观察

Observation of Validity and Safety of Behavior Therapy,Acupuncture Therapy Combined with Methylphenidate in Treatment of Attention Deficit Hyperactivity Disorder

目的:寻找治疗儿童多动症(ADHD)有效且不良反应少的治疗方案。方法:根据纳入和排除标准纳入120例ADHD患儿,随机分为A、B、C 3组,每组40例;A组接受药物治疗配合心理行为治疗,B组接受药物治疗配合针灸治疗,C组接受单纯药物治疗;比较3组临床疗效、Conners多动指数治疗前后变化以及药物不良反应等指标。结果:3组患儿治疗前后临床疗效比较差异有统计学意义,两两比较发现,A组与C组临床疗效差异有统计学意义;3组患儿治疗前后CIH评分经配对t检验比较差异有统计学意义;治疗后CIH 3组间比较差异有统计学意义,两两比较显示C组与A组、B组差异有统计学意义;经观察发现3组患儿均出现药物不良反应,其中,B组较A组、C组出现的药物不良反应少。结论:3种治疗方案均能显著改善多动症患儿的症状,且行为治疗增强专注达临床疗效的效果明显,而针灸治疗减少专注达不良反应效果明显,可将行为治疗、针灸疗法与药物治疗结合使用,以提高治疗方案的有效性及安全性。

Objective： In search of effective and less side-effective treatment protocols of de- ficient hyperactivity disorder （ADHD）. Methods： 120 children met the inclusive and exclusive criterion were randomized into 3 groups： 40 cases in Group A with medications combined with be- havior therapy, 40 cases in Group B with medications combined with acupuncture therapy and 40 cases in Group C with medications alone. The outcomes of clinical efficacy, Conners index of hy- peractivity （CIH） and adverse drug reaction among the three groups were compared respectively. Results： Significant differences were found in the clinical efficacy among 3 groups before and after treatment, and there were significant differences between Group A and C. The CIH scores of 3 groups all showed significantly reduction before and after treatment, significant differences were found in post-treatment scores of CIH among 3 groups, especially Group A vs C and Group B vs C. Adverse drug reaction was observed in all 3 groups, and Group B with less adverse drug reac- tion than Group A and C. Conclusion： The 3 interventions all have the effect of reducing the symptoms of ADHD. The behavior therapy can obviously increase the clinical effect of Methylphenidate, while acupuncture can obviously reduce the adverse drug reaction of Methylphenidate. It should be combined with behavior therapy, acupuncture and medications, in order to increase the validity and safety of the intervention on ADHD.