调神益智汤、托莫西汀结合生物反馈对学龄期注意力缺陷多动障碍患儿的临床应用价值研究

Study on the clinical application value of Tiaoshen Yizhi Decoction,Tomoxetine combined with biofeedback in school-age children with attention deficit hyperactivity disorder

探讨调神益智汤、托莫西汀结合生物反馈对学龄期注意力缺陷多动障碍(Attention-Deficit Hyperactivity Disorder,ADHD)患儿的临床应用价值。选择秦皇岛市军工医院康复医学科2019年7月-2022年9月收治的96例学龄期ADHD患儿,采用随机数字表法分为两组各48例。对照组给予托莫西汀结合生物反馈治疗,观察组在对照组基础上联合调神益智汤治疗。对比两组临床疗效、治疗前后行为表现康复程度(斯诺佩注意缺陷多动障碍筛查量表(Swanson child behavior checklist,SNAP-Ⅳ)、Conners父母用症状问卷(Parental Symptom Questionnaire,PSQ))、神经递质因子(去甲肾上腺素(Norepinephrine,NE)、多巴胺(Dopamine,DA)、皮质酮(corticosterone,Cor))、不良反应。观察组临床有效率(95.83%)明显高于对照组(77.08%)(P<0.05)。将两组的SNAP-Ⅳ、PSQ、NE、DA、Cor在治疗前就进行对比分析,差异无统计学意义(P>0.05),治疗后观察组SNAP-Ⅳ(13.45.±4.25)分、PSQ评分(19.54±5.21)分低于对照组(18.12±4.32)分、(24.32±5.68)分,而NE(19.84±2.89)ng/mL、DA(6.94±1.53)ng/mL、Cor(374.56±54.29)nmol/L因子水平明显高于对照组(17.44±2.35)ng/mL、(6.34±1.28)ng/mL、(345.68±51.25)nmol/L(P<0.05)。两组不良反应发生率(疲劳、胃肠道不适、食欲减退),分别为8.33%、12.50%,对比差异无统计学意义(P>0.05)。调神益智汤、托莫西汀结合生物反馈应用于学龄期ADHD患儿效果显著,可有效改善神经递质及患儿行为表现,且安全性较高。

To explore the clinical application value of Tiaoshen Yizhi Decoction,Combination of Tomoxetine and Biofeedback in Children with Attention Deficit Hyperactivity Disorder(ADHD).Ninety-six school-age children with ADHD admitted to the Rehabilitation Medical Department of Qinhuangdao Military Industry Hospital from July 2019to September 2022were randomly divided into two groups with 48cases each.The control group was treated with Tomoxetine combined with biofeedback,while the observation group was treated with Tiaoshen Yizhi Decoction on the basis of the control group.The clinical efficacy,the degree of behavioral rehabilitation before and after treatment(Swanson child behavior checklist(SNAP-IV),the Parental Symptom Questionnaire(PSQ),the neurotransmitter factors(norepinephrine(NE),dopamine(DA),corticosterone(Cor))and adverse reactions were compared between the two groups.Compared with the control group(77.08%),the clinical efficacy was higher(95.83%)(P<0.05).There was no significant difference in SNAP-Ⅳ、PSQ、NE、DA、Cor before treatment(P>0.05).After treatment,SNAP-Ⅳ(13.45.±4.25)and PSQ score(19.54±5.21)in the observation group were lower than those in the control group(18.12±4.32)and(24.32±5.68),while the levels of NE(19.84±2.89)ng/mL,DA(6.94±1.53)ng/mL,and Cor(374.56±54.29)nmol/L were significantly higher than those in the control group(17.44±2.35)ng/mL,(6.34±1.28)ng/mL(345.68±51.25)nmol/L(P<0.05).The incidence rates of adverse reactions(fatigue,gastrointestinal discomfort,and decreased appetite)between the two groups were 8.33%and 12.50%,respectively,with no statistically significant difference(P>0.05).Tiaoshen Yizhi Decoction,Tomoxetine combined with biofeedback have significant effects on school-age children with ADHD,which can effectively improve neurotransmitters and children's behavior,and have high safety.