天麻钩藤饮联合哌甲酯治疗注意缺陷多动障碍的研究

Tianma Gouteng Decoction Combined with Methylphenidate in the Treatment of Attention Deficit Hyperactivity disorder

目的:探讨天麻钩藤饮联合哌甲酯治疗注意缺陷多动障碍的临床效果。方法:按照样本量计算公式,选取2020年1月—2021年1月于该院就诊的ADHD患者70例,按照随机数字表法分为西医组及中西医组,每组35例,西医组给予哌甲酯治疗,中西医组在其基础上使用天麻钩藤饮,观察两组患者疗效,大脑基底动脉(basilar artery,BA)、左(L)和右(R)侧的大脑椎动脉(vertebral artery,VA)、中动脉(middle cerebral artery,MCA)、前动脉(anterior cerebral artery,ACA)、后动脉(posterior cerebral artery,PCA)的血流速度,Conners评分,ADHD评分及IL-4和INF-γ表达情况。结果:中西医组效果优于西医组[85.7%比74.3%,χ^(2)=18.271,P<0.001]。治疗后两组Conners评分均有下降,组内比较(P<0.05);且中西医组效果优于对西医组(P<0.01)。治疗后两组ADHD评分均有下降,组内比较(P<0.05);且中西医组效果优于对西医组(P<0.01)。治疗后两组PCA-L、PCA-R血流速度增快(P<0.05);中西医组MCA-L、ACA-L、ACA-R及PCA-L血流速度较治疗前也增快(P<0.05),且中西医组MCA-L、ACA-L、ACA-R及PCA-L血流速度快于西医组(P<0.05)。治疗后两组IL-4表达水平降低,INF-γ表达水平升高,组内比较(P<0.05);且中西医组效果优于对西医组(P<0.01)。结论:天麻钩藤饮联合哌甲酯可以提高ADHD治疗效果,改善大脑血流灌注,提高机体免疫力。

Objective:To explore the clinical effect of Tianma Gouteng Decoction combined with methylphenidate in the treatment of attention deficit hyperactivity disorder.Methods:According to the sample size calculation formula,70 ADHD patients who were treated in this hospital from January 2020 to January 2021 were selected and divided into the Western medicine group and the Chinese and Western medicine group according to the random number table method,35 cases in each group,and the Western medicine group was given In the treatment of methylphenidate,the traditional Chinese and Western medicine group used Tianma Gouteng decoction on the basis of it.The curative effect of the two groups of patients was observed.The basilar artery (BA),left (L) and right (R) vertebral artery (vertebral) Blood flow velocity of artery,VA,middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA),Conners score,ADHD score,IL-4 and INF-γ express the situation.Results:The effect of the traditional Chinese and western medicine group is better than that of the western medicine group[85.7% vs.74.3%,χ^(2)=18.271,P<0.001].After treatment,the Conners scores of both groups decreased,comparing within the group (P<0.05);and the effect of the traditional Chinese and western medicine group was better than that of the western medicine group (P<0.01).After treatment,the ADHD scores of both groups decreased,compared within the group (P<0.05);and the effect of the traditional Chinese and western medicine group was better than that of the western medicine group (P<0.01).After treatment,the blood flow velocity of PCA-L and PCA-R increased faster in the two groups (P<0.05);the blood flow velocity of MCA-L,ACA-L,ACA-R and PCA-L in the traditional Chinese and Western medicine group also increased faster than before treatment (P<0.05),and the blood flow velocity of MCA-L,ACA-L,ACA-R and PCA-L in the traditional Chinese and western medicine group was faster than that in the western medicine group (P<0.05).After treatment,the expression level of IL-4 decreased in the two groups,and the expression level of INF-γ increased in the two groups (P<0.05);and the effect of the traditional Chinese and western medicine group was better than that of the western medicine group (P<0.01).Conclusion:Tianma Gouteng decoction combined with methylphenidate can improve the treatment effect of ADHD,improve cerebral blood perfusion,and improve the body’s immunity.