静灵口服液治疗儿童注意缺陷多动障碍肝肾阴虚证33例疗效观察

Clinical observation on 33 cases of children with attention deficit hyperactivity disorder(liver-kidney yin deficiency syndrome) treated with Jingling Oral Liquid

目的观察静灵口服液治疗儿童注意缺陷多动障碍(ADHD)肝肾阴虚证的临床疗效。方法选取符合第5版精神疾病诊断与统计手册(DSM-V)诊断标准、中医辨证属肝肾阴虚证、年龄6~12岁的患儿33例,采用静灵口服液治疗,连续服药12周。治疗前后使用Swanson儿童行为量表(Swanson,Nolan and Pelham IV,SNAP-IV)、视听整合持续注意力测试(IVA-CPT)记录注意力及多动、冲动症状的变化,并通过中医证候积分观察患儿中医适应证的变化情况。结果 1)SNAP-IV量表评估:与治疗前比较,减分率≥40%者有18例,总有效率为54.5%,治疗后多动冲动与对立违抗症状评分均降低,差异有统计学意义(P<0.01);注意力不集中症状比较差异无统计学意义(P>0.05)。2)IVA-CPT评分:治疗后,控制力商数评分明显提高,差异有统计学意义(P<0.01);注意力商数评分比较差异无统计学意义(P>0.05)。3)中医证候积分比较:与治疗前比较,多动不宁、多言多语、冲动任性、暴躁易怒的主症积分和烦躁不安、口干多饮、小便短黄、大便干结的次症积分均显著降低(P<0.01),而注意力不集中主症积分和学习困难次症积分改善不明显,差异均无统计学意义(P>0.05)。结论静灵口服液能有效改善ADHD患儿的核心症状——多动、冲动,并减轻共病对立违抗障碍的程度,不良反应少。

Objective To observe the clinical effect of children with attention deficit hyperactivity disorder （ADHD） （liver-kidney yin deficiency syndrome） treated with Jingling Oral Liquid. Methods 33 cases of 6-12 years old patients consistent with DSM-V, which were diagnosed as liver-kidney yin deficiency syndrome in TCM, were given Jingling Oral Liquor constantly for 12 weeks. Before and after treatment, the attention,hyperactivity and impulsion were recorded by SNAP-IV and IVA-CPT, meanwhile, changes of symptoms were observed by TCM syn- drome integral. Results 1 ）Evaluation from SNAP-IV：after treatment, 18 cases was score-reducing rate ~40% ,and the effective rate was 54.5% ;the scores of hyperactivity and oppositional defiant disorder symptoms in patients of two groups were both reduced with significant differences （P〈0.01） ;poor concentration symptom had no significant differences （ P〉0.05 ）. 2） Scores from evaluation of IV322CPT： after treatment, scores of FSRCQ improved obviously with significant differences （ P〈0.01 ） ; scores of FSAQ had no significant differences （ P〉0.05 ）. 3 ） Comparison of TCM symptom integral ： after treatment, the main symptom integrals, like hyperactive, talkative, impulsive, irritable, and the secondary symptom integrals, like upset, dry mouth, urinating short and yellow, dry stool, were dropped obviously （P〈0.01）, but there were no significant differences in the improvement of main symptom integrals （poor concentration symptom） and secondary symptom integrals （learning disability） （P〉0.05）. Conclusion Jingling Oral Liquid can improve hyperactivity and impulsiveness, the main symptoms of children with ADHA, relieve oppo- sitional defiant disorder symptom with small untoward effect.