盐酸哌甲酯缓释片治疗注意缺陷为主型、冲动-多动为主型及混合型注意缺陷多动障碍的效果及安全性

Efficacy and safety of methylphenidate hydrochloride extended-release tablets in the treatment of attention deficit hyperactivity disorder of predominantly inattentive, hyperactive-impulsive and combined types

目的探讨盐酸哌甲酯缓释片治疗注意缺陷为主型、冲动-多动为主型及混合型注意缺陷多动障碍的效果及安全性。方法抽取2019年3月至2020年3月郑州大学附属洛阳中心医院收治的64例注意缺陷多动障碍患儿,根据DSM-V标准分为注意缺陷为主型、冲动-多动为主型及混合型,分别为21例、21例、22例。三型患儿均给予盐酸哌甲酯缓释片进行单药口服治疗,持续使用6周。观察比较三型患儿SNAP-IV父母评定量表评分、Conners父母症状评价量表评分、治疗有效率及不良反应情况。结果冲动-多动为主型患儿SNAP-IV评分差值高于注意缺陷为主型及混合型患儿(P<0.05)。冲动-多动为主型患儿Conners评分差值高于注意缺陷为主型及混合型患儿(P<0.05)。冲动-多动型有效率高于注意缺陷为主型及混合型(P<0.05),注意缺陷为主型、混合型有效率比较差异未见统计学意义(P>0.05)。三组食欲不振、睡眠障碍、头晕、腹痛不良反应发生率比较,差异未见统计学意义(P>0.05)。结论盐酸哌甲酯缓释片单药口服治疗对注意缺陷多动障碍患儿具有显著疗效,但不同亚型疗效有一定差异,其中冲动-多动型疗效更佳,无明显严重不良反应,安全性较高,可推荐使用。

Objective To investigate the efficacy and safety of methylphenidate hydrochloride extended-release tablets in the treatment of attention deficit hyperactivity disorder of predominantly inattentive,hyperactive-impulsive and combined types.Methods A total of 64 children with attention deficit hyperactivity disorder in Luoyand central Hospital Affiliated to Zhengzhou University from March 2019 to March 2020 were enrolled,and divided into three groups according to different subtypes such as,predominantly inattentive(n=21),hyperactive-impulsive(n=21)and combined types(n=22).All children received oral administration of methylphenidate hydrochloride extended-release tablets for 6 weeks.SNAP-IV score,Conners score,treatment efficiency and adverse reactions were compared among theree types.Results SNAP-IV score of hyperactive-impulsive types was higher than that of predominantly inattentiveand combined types(P<0.05).Conners score of hyperactive-impulsive types was higher than that of predominantly inattentiveand combined types(P<0.05).The treatment efficacy of hyperactive-impulsive types was higher than that of predominantly inattentiveand combined types(P<0.05),while no significant difference was found between predominantly inattentiveand combined types(P>0.05).The incidence rates of adverse reactions such as loss of appetite,sleep disturbance,dizziness,and abdominal pain had no significant differences among the three types(P>0.05).Conclusions Oral administration of methylphenidate hydrochloride extended-release tablets in the treatment of attention deficit hyperactivity disorder has different efficacy among the children with different types,which is best in hyperactive-impulsive types,with no obvious serious adverse reactions and high safety.