计算机认知矫正治疗对注意缺陷多动障碍儿童注意功能疗效的随机对照试验  

A randomized controlled trial on effect of computerized cognitive remediation therapy on attentional deficit in patients with attention-deficits/hyperactivity disorder

作　　者：章小彩[1] 李琳[1] 朱小英[1] 

机构地区：[1]杭州市第七人民医院,杭州310013

出　　处：《中国心理卫生杂志》2015年第8期599-605,共7页Chinese Mental Health Journal

基　　金：杭州市科技型中小企业技术创新基金--认知行为治疗对偏执型精神分裂症患者疾病认知和自我管理的效果评估(项目编号:20120533Q16;项目负责人:朱小英)

摘　　要：目的：研究计算机认知矫正治疗（CCRT）对注意缺陷/多动障碍（ADHD）儿童注意功能的影响。方法：选取符合美国精神障碍诊断与统计手册第4版的注意缺陷/多动障碍-注意障碍诊断标准的72~144个月的患者40例,分为盐酸哌甲酯缓释片＋CCRT组（n=20）和盐酸哌甲酯缓释片治疗组（n=20）。从社区选取年龄、智商匹配的正常儿童20例。盐酸哌甲酯缓释片＋CCRT组在接受盐酸哌甲酯缓释片治疗[剂量（25.8±3.7）mg/d]的同时进行为期6个月的CCRT干预。盐酸哌甲酯缓释片治疗组在研究期间只接受盐酸哌甲酯缓释片治疗[剂量（26.5±3.3）mg/d]。正常对照组在研究期间不接受任何干预。治疗前后所有儿童均用注意网络范式评估注意功能。结果：干预前,两组ADHD患者在警戒和执行控制子网络上反应时均长于正常对照组（P〈0.05）。干预后,在警戒子网络上,盐酸哌甲酯缓释片＋CCRT组与盐酸哌甲酯缓释片治疗组反应时均长于对照组（均P〈0.05）;而在执行控制网络上,盐酸哌甲酯缓释片治疗组反应时长于盐酸哌甲酯缓释片＋CCRT组和对照组（均P〈0.05）。干预前后组内比较表明,盐酸哌甲酯缓释片＋CCRT组经过干预,在执行控制子网络上反应时小于干预前（P〈0.05）。结论：盐酸哌甲酯缓释片联合计算机认知矫正治疗治疗可改善ADHD儿童的执行控制网络功能。Objective： To investigate the effect of the training of Computerized Cognitive Remediation Therapy （CCRT） on attentional deficits in patients with attention-deficit/hyperactivity disorder （ADHD）. Methods： Forty children aged 72 - 144 months and diagnosed with ADHD-inattentive subtype according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） criterion were recruited. They were randomly divided into methylphenidate HC1 extended-release tablets combined with CCRT group （n = 20） and methylphenidate HC1 extended-release tablets group （n = 20）. Twenty age-and intelligence -matched normal children were recruited from communities. Patients in the methylphenidate HC1 extended-release tablets combined with CCRT group re-ceived methylphenidate HC1 extended-release tablets treatment and 6 months CCRT training simultaneously. The average dosage was （25.8± 3.7） mg/d. Patients in the methylphenidate HC1 extended-release tablets group only had methylphenidate HC1 extended-release tablets treatment and the average dosage was （ 26.5 ± 3.3） mg/ d. Normal children in the control group didn＇t receive any treatment during the study period. Attention Network Test （ANT） was administered to all participants to measure their attentional function before and after the treatment. After the intervention, severity evaluation according to DSM-IV criterion was administered to patients with ADHD. Results： Before the intervention, ANT test revealed that patients with ADHD had longer reaction time than the normal children on alert and executive networks （P 〈 0. 05）. After the intervention, patients in the methylpheni- date HC1 extended-release tablets combined with CCRT group and methylphenidate HC1 extended-release tablets group both had longer reaction time than the normal children on alert network （Ps 〈 0. 05）. But on the executive network, patients in the methylphenidate HC1 extended-release tablets group had a longer reaction time than those in the meth

关 键 词：注意缺陷多动障碍 计算机认知矫正治疗 注意功能 随机对照试验 

分 类 号：R749.94[医药卫生—神经病学与精神病学]