重复经颅磁刺激联合脑电生物反馈治疗在孤独症患儿康复治疗中的应用

Applica tion of repetitive transcranial magnetic stimulation combined with neurofeedback in the rehabilitation of children with autism

目的探究重复经颅磁刺激(r TMS)联合脑电生物反馈(NFB)治疗在孤独症患儿康复中的应用效果。方法选取2019年7月—2020年12月商丘市某医院收治的86例孤独症患儿为研究对象,采用随机数字表法分为观察组和对照组,每组43例。对照组患儿接受r TMS治疗,观察组患儿接受r TMS+NFB治疗。比较2组患儿治疗前后孤独症行为检查量表(ABC)评分、儿童孤独症症状(CARS)评分、重复刻板行为检查表(RBS-R)评分、发育商(DQ);比较2组患儿临床疗效及治疗期间睡眠障碍、焦虑情绪、食欲不振等不良反应发生情况。结果观察组患儿治疗总有效率为86.05%,高于对照组的67.44%,差异有统计学意义(P<0.05)。治疗后,2组患儿ABC及CARS评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患儿DQ评分均高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患儿RBS-R评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。对照组患儿治疗期间发生睡眠障碍1例,焦虑情绪2例,不良反应发生率为6.98%;观察组患儿发生焦虑情绪1例,食欲不振1例,不良反应发生率为4.65%。2组患儿不良反应发生率比较,差异无统计学意义(χ^(2)=0.212,P=0.645)。结论r TMS+NFB方案治疗孤独症患儿的效果明显优于单用r TMS的治疗方案,患儿人际交往障碍、行为方式刻板等均得到显著改善,DQ评分也获得提高,值得在临床上推广使用。

Objective To investigate the application of repetitive transcranial magnetic stimulation(r TMS)combined with neurofeedback(NFB)in the rehabilitation of children with autism.Methods Eighty-six cases of children with autism admitted to a hospital in Shangqiu from July 2019 to December 2020 were selected as subjects and assigned to an observation group and a control group using random number table,with 43 cases in each group.The children in the control group received r TMS treatment,the children in the observation group received r TMS combined with NFB treatment.The scores of Autism Behavior Checklist(ABC),Childhood Autism Rating Scale(CARS)score,Repetitive Behavior Scale-Revised(RBSR)score,and Developmental Quotient(DQ)of the children in the two groups were compared before and after treatment.The clinical efficacy of the children in the two groups and adverse reactions such as sleep disturbance,anxiety,and loss of appetite during the treatment were compared.Results The total effective rate of treatment for children in the observation group was 86.05%,which was higher than that of the control group(67.44%),and the difference was statistically significant(P<0.05).After treatment,the ABC and CARS scores of children in the two groups were lower than those before treatment,and the observation group had lower scores than the control group,with statistically significant difference(P<0.05).The DQ scores of children in both groups after treatment were higher than before treatment,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05);the RBS-R scores of children in both groups after treatment were lower than before treatment,and the observation group had lower scores than the control group,and the differences were statistically significant(P<0.05).In the control group,one event of sleep disturbance and two events of anxiety occurred during the treatment,and the incidence rate of adverse reactions was 6.98%;one event of anxiety and one event of loss of appetite occurred in the observation group,and the incidence rate of adverse reactions was 4.65%;the difference in the incidence of adverse reactions between the two groups was not statistically significant(χ^(2)=0.212,P=0.645).Conclusion The combined treatment of r TMS+NFB for children with autism was significantly more effective than the r TMS treatment,and the children’s symptoms such as interpersonal interaction disorder and stereotyped behavior were significantly improved,and the DQ scores were also improved,which is worth promoting in clinical practice.