柴芍制动方治疗儿童多动症脾虚肝亢型临床观察

Clinical Observation of Chaishaozhifang in Treating 78 Children with ADHD with Spleen Deficiency and Hyperactivity of the Liver

目的:观察验方柴芍制动方治疗儿童多动症脾虚肝亢型患儿的临床疗效,评估多动、冲动核心症状的改善情况,为中医干预儿童多动症提供新方法。方法:选取2018年7月—2019年12月期间就诊于河南中医药大学第一附属医院、河南省儿童医院门诊患儿,将符合纳排标准的78例儿童多动症(脾虚肝亢型)的患儿作为研究对象,分为试验组和对照组,选取分组对照的方法,试验组予中药验方柴芍制动方加减治疗,对照组予盐酸哌甲酯缓释片治疗,观察周期12周。比较2组患儿治疗前后SNAP-IV量表(注意力不集中、多动-冲动、对立违抗)、多动指数、中医证候积分量表(主症、次症)积分的改善情况。结果:治疗12周,试验组总有效率为85%,对照组总有效率为86.8%,试验组与对照组疗效相当(P>0.05);两组治疗后SNAP-IV量表(注意力不集中、多动-冲动、对立违抗)、多动指数积分均明显降低(P<0.05),组间比较无明显差异(P>0.05);治疗12周试验组在中医主症积分、次症积分与总积分的改善程度优于对照组(P<0.05),且试验组对神疲乏力、偏食纳呆、脘腹胀满、面色无华、大便不调症状的改善程度优于对照组(P<0.05)。结论:验方柴芍制动方能显著改善儿童多动症脾虚肝亢型患儿多动、冲动核心症状,且对神疲乏力、偏食纳呆、脘腹胀满、面色无华、大便不调症状的改善程度优于盐酸哌甲酯缓释片。柴芍制动方在观察周期未见不良反应,安全性高。

Objective:To observe the clinical efficacy of the experimental formula Chaishao Zhidong decoction in the treatment of children with ADHD with spleen deficiency and hyperactivity of the liver,to evaluate the improvement of the core symptoms of hyperactivity and impulsivity,and to provide a new method for traditional Chinese medicine to intervene in children with ADHD.Methods:Selected children fro m July 2018 to December 2019 who were treated in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine and Henan Provincial Children’s Hospital,and 78 children with ADHD(spleen deficiency and liver hyperactivity type)who met the admission and discharge criteria were selected.The children were divided into the experimental group and the control group as the research objects.The method of group control was selected.The experimental group was treated with the traditional Chinese medicine prescription Chaishao Zhidong decoction,and the control group was treated with methylphenidate hydrochloride sustained-release tablets.The observation period was 12 weeks.The improvement of scores of SNAP-IV scale(inattention,hyperactivity-impulsivity,oppositional defiant),hyperactivity index and TCM syndrome score scale(main symptom and secondary symptom)were compared between the two groups before and after treatment.Results:After 12 weeks of treatment,the total effective rate of the experimental group was 85%,and that of the control group was 86.8%.The therapeutic effect of the experimental group was comparable to that of the control group(P>0.05).The scores of concentration,hyperactivity-impulsivity,oppositional defiant)and hyperactivity index were significantly decreased(P<0.05),and there was no significant difference between the groups(P>0.05).The improvement degree of the total score was better than that of the control group(P<0.05),and the improvement degree of the symptoms of fatigue,partial eclipse,abdominal distention,pale complexion,and irregular stool in the experimental group was better than that in the control group(P<0.05).Conclusion:The prescription Chaishao Zhidong decoction can significantly improve the core symptoms of hyperactivity and impulsivity in children with ADHD,spleen deficiency and hyperactivity of the liver,and improve the degree of improvement in the symptoms of mental fatigue,partial eclipse anorexia,abdominal distention,pale complexion,and irregular stools.Better than methylphenidate hydrochloride sustained-release tablets.No adverse reactions were found in the Chaishao Zhidong decoction during t he observation period,and the safety was high.