学校及家庭行为矫正辅助哌甲酯治疗儿童注意缺陷多动障碍的疗效

Efficacy of behavior modification technique of school-family assisted with methylphenidate in treating children attention deficit hyperactivity disorder

目的探讨学校及家庭行为矫正辅助哌甲酯治疗儿童注意缺陷多动障碍(ADHD)的疗效。方法 256例ADHD患儿分为PI组(注意缺陷为主型,108例)、HI组(多动/冲动为主型,58例)及CT组(混合型,90例)。采用学校及家庭行为矫正治疗,辅助口服盐酸哌甲酯片20-60mg/d,疗程为24个月,治疗6、12、18和24个月时评定疗效和观察不良反应。结果治疗6、12、18和24个月,PI组治疗有效率分别为62.30%、70.91%、75.00%和79.59%,HI组分别为51.11%、56.10%、60.00%和63.16%,CT组分别为30.00%、35.42%、36.96%和38.64%;PI、HI组各时间段治疗有效率均高于CT组(P<0.05)。治疗6个月内不良反应主要为食欲下降、入睡困难、体重下降、头晕和乏力,12个月后主要为头晕和乏力。结论学校及家庭行为矫正辅助哌甲酯治疗PI、HI型ADHD患儿效果好。

Objective To explore the efficacy of behavior modification technique of schoolfamily assisted with methylphenidate in treating children attention deficit hyperactivity disorder（ADHD）.Methods A total of 225 ADHD children was divided into groups of PI（predominantly inattentive type,108cases）,HI（hyperactive impulsive type,58cases）and CT（combined type,90cases）.Behavior modification technique of school-family assisted with methylphenidate 20-60 mg per day orally taken were adopted to treat ADHD children for 24 months.The efficacy and adverse effects in the 6th,12 th,18th and 24 th month during treatment were evaluated.Results In the 6th,12 th,18th and 24 th month of treatment,the effectiveness rates were 62.30%,70.91%,75.00% and 79.59%in group PI,which were 51.11%,56.10%,60.00% and 63.16% in group HI and 30.00%,35.42%,36.96% and 38.64%in group CT.The effective rate in groups of PI and HI was higher than that in group CT（P〈0.05）.Adverse effects within 6 months treatment mainly were loss of appetite,difficulty sleeping,weight loss,dizziness and fatigue,which after 12 months treatment mainly were dizziness and fatigue.Conclusion Behavior modification technique of school-family assisted with methylphenidate has better effect on treating PI and HI types children with ADHD.