脑电生物反馈改善注意缺陷多动障碍患儿行为问题的评价  

Effect of electroencephalogram biofeedback on behavioral problems of children with attention deficit hyperactivity disorder

作　　者：张风华[1] 张劲松[1] 金星明[1] 

机构地区：[1]上海第二医科大学附属新华医院儿童医学中心儿童保健科,上海市200092

出　　处：《中国临床康复》2006年第10期74-76,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:随机对照比较脑电生物反馈和利他林改善注意缺陷多动障碍患儿行为问题的疗效。方法:①选择新华医院儿童保健科就诊的未曾接受任何治疗的注意缺陷多动障碍患儿44例。随机平均分为反馈组1和利他林组;②反馈组2为同期同院既往曾接受系统利他林治疗至少3个月,无明显效果的注意缺陷多动障碍患儿20例。对反馈1组和反馈2组给予强化16～20Hzβ波,抑制4～8Hzθ波为治疗方案的脑电生物反馈。每次分为5段治疗,第一段为基线水平检测及训练目标确定阶段,为2min;其余4段为反馈治疗5min。3～5次/周,疗程3个月,总次数为35～40次。治疗次数少于20次计为失访。利他林组给予国产利他林,从5mg开始每日晨服,根据病情变化逐渐加量至满意疗效而无明显不良反应为止,疗程3个月。不足1个月计为失访。采用Conners儿童行为评定量表父母问卷(48个条目,分为品行问题、学习问题、心身问题、冲动-多动、焦虑、多动指数6个因子)评价患儿行为症状的变化,采用4级评分,即按问题的有无和表现的程度分别选“0”、“1”、“2”、“3”,将条目得分相加除以条目数即为因子分。在治疗前、治疗中(反馈治疗20次,利他林治疗1.5个月)、治疗结束及随访1,3,6个月时进行评定,反馈组2于3,6个月时进行随访和评定。结果:随访时间为1,3,6个月,反馈组1有1例失访,利他林组有6例失访。反馈组2有1例失访。反馈组1有21例、利他林组有16例、反馈组2有19例进入结果分析。①反馈组1Conners儿童行为评定量表父母问卷所有因子分在治疗中期已比治疗前显著下降(P<0.05),随访6个月保持稳定。利他林组除心身问题和焦虑因子外,其他因子分在治疗中期也较治疗前显著下降(P<0.05)。②反馈组1在治疗结束时心身问题、焦虑因子得分明显低于利他林组(P<0.05),而治疗中期多动指数高于利他林组(P<0.05),治疗�AMI： To perform a random and controlled comparison in the effects of electroencephalogram biofeedback （EEG BF） and methylphenidate （MPH） on improving behavioral problems of children with attention deficit hyperactivity disorder （ADHD）. METHODS： （1）Forty-four ADHD children without any previous treatment, who were treated at Department of Child Health Care, Xinhua Hospital, were randomly assigned to EEG BF group A and MPH group. （2）Twenty ADHD children without obvious effects by MPH treatment which lasted＇for at least 3 months were considered as EEG BF group B. The two EEG BF groups received the treatments of reinforcing 16-20 Hz β wave and suppressing 4-8 Hz θ wave, which were divided into 5 stages： First stage was to detectthe base level and ensure the training objective; Other 4 stages were to perform BF treatment for 5 minutes, 3-5 times per week continuously for 3 months, totally 35-40 times. The follow-up was ineffective if treated for less than 20 times. The children of MPH group were treated with MPH administration in every morning, and the dose started from 5 mg and increased gradually with the patients＇conditions Until the effects were satisfied without any adverse effect. The course was 3 months, and less than one month was considered ineffective. The Conners Parent Rating Scale was utilized to assess the behavioral changes （The scale included 48 items and 6 factors of conduct problem, learning problem, psychosomatic disorder, impulsive-hyperactive, anxiety and hyperactive index. The subjects were scored by 4 grades from 1 to 3 according to the symptom existence and expression level. The scores of factors were obtained by dividing item scores by item number）. The children in EEG BF group A and MPH group were evaluated during treatment （BF treatment for 20 times, MPH treatment for 1.5 months）, at pretreatment, post-treatment and 1,3,6 months ot follow-ups, while the follow-up and evaluations were performed in EEG BF group B at 3 and 6 months of ibllow-ups. RESULT

关 键 词：注意力缺陷障碍伴多动 生物反馈 行为 情绪 

分 类 号：R74[医药卫生—神经病学与精神病学]