平动汤治疗儿童注意力缺陷多动障碍心肝火旺证的临床疗效及对血清皮质醇的影响

Clinical effect of children with heart-liver heat syndrome of attention deficit hyperactivity disorder treated with Pingdong Tang and its influence on serum cortisol

目的观察平动汤治疗儿童注意力缺陷多动障碍(ADHD)心肝火旺证的临床疗效及对血清皮质醇水平的影响,探讨平动汤对ADHD患儿下丘脑-垂体-肾上腺(HPA)轴功能的影响。方法选择100例ADHD心肝火旺证患儿,随机分为平动汤组及利他林组,每组50例,同时设30名健康儿童作为正常组。治疗8周后评价2组的疗效,同时对治疗前后血清皮质醇水平进行统计分析。结果平动汤组总有效率为84.0%,利他林组为88.0%,2组总有效率经统计学分析,差异无统计意义(P>0.05)。治疗前2个治疗组皮质醇水平较正常组明显降低(P<0.05),经治疗后2组皮质醇均较治疗前明显升高(P<0.05)。结论 ADHD患儿血清皮质醇水平偏低,其HPA轴存在低反应性的调节障碍,平动汤和利他林可能通过提高患儿皮质醇水平来达到治疗的目的。

Objective To observe clinical effect of children with heart-liver heat syndrome of attention deficit hyperactivity disorder（ ADHD） treated with Pingdong Tang and its influence on serum cortisol,and then explore the influence on function of ADHD children＇s hypothalamic-pituitary-adrenal（ HPA）.Methods 100 children of heartliver heat syndrome with ADHD were randomly divided into two groups,ritalin group and Pingdong Tang group with50 in each,besides,30 healthy children were organized as the normal group.The treatment results were compared after 8 weeks treatment.The levels of cortisol were evaluated at pre-treament and post-treatment.Results The total effective rate of Pingdong Tang group and ritalin group was 84.0% and 88.0% respectively without significant difference（ P〈0.05）.The level of cortisol in two therapy groups were significantly lower than it in the normal group（ P〈0.05）.After treatment,children with ADHD in two groups had higher cortisol level obviously than those before treatment（ P〈0.05）.Conclusion Children with ADHD have lower serum cortisol and dysfunction of HPA.Both Pingdong Tang and ritalin can treat children with ADHD by improving the serum cortisol levels.