维生素D联合ω-3脂肪酸治疗儿童孤独症的疗效

Efficacy of vitamin D combined with ω-3 fatty acid in treatment of children with autism spectrum disorder

目的:观察服用维生素D(VD)联合ω-3脂肪酸治疗孤独症(autism spectrum disorder,ASD)患儿的疗效。方法:本研究为48名年龄在5～12岁、新诊断的ASD患儿参与的随机双盲临床试验。患儿分成4组,每组12例。对照组患儿服用安慰剂,VD组患儿服用VD 800U/d,ω-3脂肪酸组患儿服用ω-3脂肪酸900mg/d,联合用药组患儿联合服用VD 800U/d及ω-3脂肪酸900mg/d。用药同时所有患儿针对症状进行结构化训练,地点为医院,时间为4h/d,每周5d。在用药12个月后采用儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)评估治疗后的临床症状改善情况。结果:治疗12个月后,与对照组比较,VD组及联合用药组患儿大部分CARS评分明显降低(P<0.05)。联合用药组患儿视觉反应及听觉反应评分较VD组下降更明显(P<0.05),且联合用药组焦虑反应评分较ω-3脂肪酸组下降更明显(P<0.05)。结论:在结构化训练的同时补充VD或VD联合ω-3脂肪酸可有效改善ASD患儿的症状。VD联合ω-3脂肪酸有望成为治疗儿童ASD的有效辅助方法。

Objective： To observe the efficacy of vitamin D combined with ω-3 fatty acid in treatment of children with au tism spectrum disorder （ASD）. Methods： Forty eight children aged 5 to 12 years old who were newly diagnosed as ASD were enrolled for the randomized double blind clinical trial .All the patients were randomly divided into 4 groups ,each consisting of 12 patients .The patients in the control group received placebo , while the patients in the vitamin D group received vitamin D at a dosage of 800 U/d, and the patients in the ω-3 fatty acid group received ω-3 fatty acid at a dosage of 900 mg/d .The patients in the combined treatment group received vitamin D （800 U/d） and ω-3 fatty acid （900 mg/d）.During treatment ,all the patients were trained by using Treatment and Education of Autistic and related Communication handicapped Children （TEACCH） inter vention approach in the hospital ,4 hours a day ,5 days a week .Clinical symptoms were evaluated by Childhood Autism Rating Scale（CARS） 12 months after treatment .Results： After 12 months of treatment ,the scores of CARS significantly decreased in the vitamin D group and the combined treatment group compared with those of the control group （P〈0.05）.Compared to the vitamin D group ,the scores of visual and auditory response in the combined treatment group dropped more significantly （P〈0.05 ）. Compared to the ω-3 fatty acid group ,the scores of anxiety of the combined treatment group decreased more significantly （P〈0.05 ）.Conclusion： Vitamin D or vitamin D combined with ω-3 fatty acid supplemented with TEACCH intervention approach could improve symptoms of children with ASD .Vitamin D plus ω-3 fatty acid could be an effective adjuvant treatment for children with ASD .