托莫西汀治疗注意力缺陷多动障碍患儿疗效观察

Clinical efficacy of atomoxetine in the treatment of children with attention deficit/hyperactivity disorder

目的探究注意力缺陷/多动障碍(ADHD)患儿接受托莫西汀治疗的临床效果。方法选取宝鸡高新医院2019年1月至2021年1月收治的70例ADHD患儿,按随机数表法分为哌甲酯组与托莫西汀组各35例,哌甲酯组患儿予以哌甲酯治疗,托莫西汀组患儿予以托莫西汀治疗,比较两组患儿治疗前、治疗后1周、4周、8周的血清白介素-6(IL-6)水平,利用ADHD父母评定量表及韦氏儿童智力量表(C-WISC)评估治疗前后患儿注意力缺陷/多动障碍情况、认知功能,统计给药期间两组患儿的毒副反应发生情况。结果治疗前两组患儿的血清IL-6水平比较差异无统计学意义(P>0.05),治疗后1周、4周、8周时,两组患儿的血清IL-6水平较治疗前显著下降,差异均有统计学意义(P<0.05),但托莫西汀组治疗后各时间点的血清IL-6水平与哌甲酯组比较差异均无统计学意义(P>0.05);治疗前两组患儿的ADHDRS-Ⅳ总分及两个分量表评分(注意力缺陷评分、多动/冲动评分)比较差异均无统计学意义(P>0.05),治疗后两组患儿的ADHDRS-Ⅳ总分及两个分量表评分明显下降,差异均有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05);治疗前两组患儿的认知功能各项评分比较差异均无统计学意义(P>0.05),治疗后两组患儿的认知功能各项评分明显上升,与治疗前比较差异均有统计学意义(P<0.05),但两组间比较差异均无统计学意义(P>0.05);托莫西汀毒组患儿和副反应发生率为5.71%,明显低于哌甲酯组的22.86%,差异有统计学意义(P<0.05)。结论托莫西汀治疗ADHD可降低患儿的血清IL-6水平,改善患儿的注意力缺陷/多动障碍症状,提高其认知能力,治疗效果与哌甲酯相似,但其药物毒副作用小,安全性高。

Objective To explore the clinical effects of atomoxetine treatment in children with attention deficit/hyperactivity disorder(ADHD).Methods A total of 70 children with ADHD admitted to Baoji High-tech Hospital from January 2019 to January 2021 were selected and divided into methylphenidate group and atomoxetine group according to the random number table,with 35 children in each group.The children in methylphenidate group were treated with methylphenidate,and those in the atomoxetine group were treated with atomoxetine.The serum IL-6 levels of the two groups before treatment,1 week,4 weeks,and 8 weeks after treatment were compared using ADHD.The parental rating scale and the C-WISC for Children's Intelligence Scale(C-WISC)were used to evaluate the attention deficit/hyperactivity disorder and cognitive function of the children before and after treatment,and the incidence of toxic and side effects in the two groups during the administration period was counted.Results There was no significant difference in serum IL-6 levels between the two groups before treatment(P>0.05).At 1 week,4 weeks,and 8 weeks after treatment,the serum IL-6 levels of the two groups were significantly decreased compared with those before treatment(P<0.05),but there was no significant difference in serum IL-6 levels between the atomoxetine group and the methylphenidate group at each time point after treatment(P>0.05).Before treatment,there was no significant difference in the ADHDRS-Ⅳtotal score and the two subscale scores(attention deficit score,hyperactivity/impulsivity score)between the two groups before treatment(P>0.05);after treatment,the ADHDRS-Ⅳtotal score and the scores of the two subscales decreased significantly(P<0.05),but the differences between the groups were not statistically significant(P>0.05).In the comparison of cognitive function scores,there was no statistically significant difference in the scores(C factor,arithmetic,mathematical breadth,coding)between the groups before treatment(P>0.05);the scores increased after treatment,which was statistically different from those before treatment(P<0.05);but the difference between the methylphenidate group and the atomoxetine group was not statistically significant(P>0.05).The incidence of toxicity and side effects of atomoxetine was significantly lower than that of the methylphenidate group,and the difference was statistically significant(P<0.05).Conclusion Atomoxetine in the treatment of ADHD can reduce the serum IL-6 level,improve the symptoms of attention deficit/hyperactivity disorder,and improve the cognitive ability of the children.It brings similar therapeutic effect to methylphenidate,small drug side effects,and high safety.