盐酸哌甲酯控释片联合小儿智力糖浆治疗儿童多动症的临床效果及安全性

Clinical efficacy and safety of methylphenidate hydrochloride controlled-release tablets combined with children intelligence syrup in treatment of children with attention deficit hyperactivity disorder

目的观察盐酸哌甲酯控释片联合小儿智力糖浆治疗儿童多动症(ADHD)临床疗效及药物不良反应,为ADHD治疗方案的选择提供参考依据。方法选择2010年1月-2016年10月天津市第五中心医院诊治的ADHD患儿108例作为研究对象,将其按照就诊顺序编号,采用数字随机表法将患儿分为A、B、C 3组,每组36例,A组采用盐酸哌甲酯控释片治疗,B组采用小儿智力糖浆治疗,C组采用盐酸哌甲酯控释片联合小儿智力糖浆治疗,3组患儿均连续治疗3个疗程,比较3组患儿治疗前后的多动症评分变化及治疗后临床疗效,治疗过程中出现的药物不良反应。结果两组患儿性别、年龄、体质量、体质量指数、ADHD病程、ADHD病情严重程度分级、入组时ADHD行为量表评分比较,差异无统计学意义(P>0.05)。3组患儿完成3个治疗疗程后,多动症评分均较治疗前有明显降低(P<0.05),但C组患儿降低幅度明显高于A组和B组,B组降低幅度低于A组(P<0.05)。C组患儿临床总有效率明显高于A、B组患儿,A组患儿临床总有效率明显高于B组患儿(P<0.05)。A、C组患儿治疗过程中出现药物不良反应率高于B组患儿(P<0.05),A、C两组患儿药物不良反应比较差异无统计学意义(P>0.05)。结论盐酸甲酯控释片联合小儿智力糖浆治疗小儿多动症临床疗效较满意,但在临床治疗方案制定时应充分考虑患儿身体条件,充分考虑药物不良反应对患儿生长发育可能造成的影响,提高患儿治疗时的安全性。

Objective To observe the clinical efficacy and adverse reactions of methylphenidate hydrochloride controlled-release tablets combined with children intelligence syrup in treatment of children with attention deficit hyperactivity disorder（ ADHD）,provide reference for choice of ADHD therapeutic schemes. Methods A total of 108 children with ADHD diagnosed and treated in the hospital from January 2010 to October 2016 were selected and divided into group A,group B,and group C according to random number table based on the sequence of going to the hopsital,36 children in each group. The patients in group A were treated by methylphenidate hydrochloride controlled-release tablets,the patients in group B were treated by children intelligence syrup,and the patients in group C were treated by methylphenidate hydrochloride controlled-release tablets combined with children intelligence syrup. All the children in the three groups were treated for continuous three courses of treatment. The changes of ADHD scores beofre and after treatment,clinical curative effects after treatment,drug adverse reactions in the process of the treatment in the three groups were compared. Results There was no statistically significant difference in gender,age,weight,body mass index（ BMI）,course of the disease,severity of ADHD,and ADHD behavior scale score between the two groups（ P〉0. 05）. After treatment,ADHD scores in the three groups were statistically significantly lower than those before treatment（ P〈0. 05）; the decreasing degree of ADHD score in group C was statistically significantly higher than those in group A and group B（ P〈0. 05）,the decreasing degree of ADHD score in group B was statistically significantly lower than that in group A（ P〈0. 05）. The total clinical effective rate in group C was statistically significantly higher than those in group A and group B（ P〈0. 05）,the total clinical effective rate in group A was statistically significantly higher than that in group B（ P〈0. 05）. The incidence rates of drug adverse reactions in group A and group C were statistically significantly higher than that in group B（ P〈0. 05）; there was no statistically significant difference in the incidence rate of drug adverse reactions between group A and group C（ P〉0. 05）. Conclusion The clinical effect of methylphenidate hydrochloride controlled-release tablets combined with children intelligence syrup in treatment of children with ADHD is satisfactory,but physical conditions of ADHD children and the effects of drug adverse reactions on growth and development of ADHD children should be considered fully when developing clinical treatment programs to improve the safety of children during treatment.