团体认知行为干预联合重复经颅磁刺激对小儿孤独症谱系障碍睡眠质量及行为状态的影响

Effects of group cognitive behavioral intervention combined with repetitive transcranial magnetic stimulation on sleep quality and behavioral status in children with autism spectrum disorder

目的通过给予孤独症患儿团体认知行为干预联合重复经颅磁刺激,探讨其疗效及对患儿行为状态、睡眠质量的影响。方法选取2020年2月~2023年7月本院收治的孤独症患儿102例,依据随机表分为磁复组(n=51)和常复组(n=51);常复组给予常规康复治疗,磁复组在此基础上给予重复经颅磁刺激治疗以及团体认知行为干预。比较两组治疗疗效、自闭程度、发育商(Developmental quotient,DQ)、行为状态以及睡眠质量指数(PSQI)。采用SPSS 22.0软件进行统计学分析。结果磁复组治疗有效率高于常复组(P<0.05)。磁复组和常复组治疗前CARS评分基本相同(P>0.05),磁复组和常复组治疗6、12周后CARS评分低于治疗前,磁复组治疗6、12周后CARS评分低于常复组(P<0.05)。磁复组和常复组治疗前ABC评分基本相同(P>0.05),磁复组和常复组治疗6、12周后ABC评分低于治疗前,磁复组治疗6、12周后ABC评分低于常复组(P<0.05)。磁复组和常复组治疗前DQ基本相同(P>0.05),磁复组和常复组治疗6、12周后DQ高于治疗前,磁复组治疗6、12周后DQ高于常复组(P<0.05)。睡眠质量分析提示,治疗前两组患儿PSQI总分及各个条目分值水平差别未见统计学意义;治疗后,两组患儿的评分均有显著降低(P<0.05),且治疗后观察组患儿的得分均低于对照组(P<0.05)。结论团体认知行为干预联合重复经颅磁刺激可提高孤独症患儿治疗疗效,且可改善患儿自闭程度、发育商以及睡眠质量,有利于改善患儿行为状态,值得临床推广。

Objective To explore the effects of group cognitive behavioral intervention combined with repetitive transcranial magnetic stimulation on behavioral status and sleep quality of children with autism.Methods A total of 102 children with autism admitted to our hospital from February 2020 to July 2023 were divided into magnetic complex group(n=51)and constant complex group(n=51)according to a random table The recurrent group was given routine rehabilitation treatment,and the magnetic recurrent group was given repeated transcranial magnetic stimulation therapy and group cognitive behavioral intervention on this basis.The therapeutic effect,degree of autism,developmental quotient(DQ),behavioral status and sleep quality index were compared between the two groups.SPSS 22.0 software was used for statistical analysis.Results The effective rate of magnetic compound group was higher than that of regular compound group(P<0.05).CARS scores in the magnetic recombination group and the regular recombination group before treatment were basically the same(P>0.05),CARS scores in the magnetic recombination group and the regular recombination group after 6 and 12 weeks of treatment were lower than before treatment,and CARS scores in the magnetic recombination group after 6 and 12 weeks of treatment were lower than those in the regular recombination group(P<0.05).The ABC scores before treatment were basically the same between the two groups(P>0.05).After 6 and 12 weeks of treatment,the ABC scores of the magnetic recombination group and the regular recombination group were lower than those before treatment,and the ABC scores of the magnetic recombination group were lower than those of the regular recombination group after 6 and 12 weeks of treatment(P<0.05).DQ in the magnetic recombination group and the regular recombination group was basically the same before treatment(P>0.05),DQ in the magnetic recombination group and the regular recombination group was higher than before treatment after 6 and 12 weeks,and DQ in the magnetic recombination group was higher than that in the regular recombination group after 6 and 12 weeks(P<0.05).Sleep quality analysis indicated that there was no statistical significance in PSQI total scores and scores of each item between the two groups before treatment,and after treatment,the scores of the two groups were significantly reduced(P<0.05),and the scores of the observation group were lowerthan those of the control group after treatment(P<0.05).Conclusion Group cognitive behavioral intervention combined with repetitive transcranial magnetic stimulation can improve the therapeutic effect of children with autism,and can improve the degree of autism,development quotient and sleep quality of children,which is beneficial to improve the behavioral status of children,and is worthy of clinical promotion.