哌甲酯控释片联合认知行为治疗对儿童注意缺陷多动障碍疗效的对照研究  

A randomized controlled study for concerta combined with cognitive-behavioral therapy on attention deficit hyperactivity disorder in children

作　　者：费春华[1] 杜昊[1] 卫霞[1] 张平[1] 卞慧莲 褚叶青 朱群花 钱斌[1] 

机构地区：[1]上海市奉贤区精神卫生中心,201418

出　　处：《临床精神医学杂志》2017年第3期188-190,共3页Journal of Clinical Psychiatry

基　　金：奉贤区科委课题(20131308)

摘　　要：目的:探讨哌甲酯控释片联合认知行为治疗(CBT)对儿童注意缺陷多动障碍(ADHD)的疗效。方法:41例ADHD患者被随机分为研究组21例和对照组20例,两组均给予哌甲酯控释片口服12周。在此基础上,研究组联合每周1次的CBT,共12次。分别在基线、治疗后4、8、12周末对患者进行焦虑自评量表(SAS)、Conners简明症状问卷(ASQ)、ADHD筛查量表(SNAP-IV)-父母版的评估。结果:治疗后两组SNAP-IV总分、注意力因子分、多动冲动因子分均较基线显著下降(F=125.14,70.58,126.44;P均<0.001);两组比较,研究组明显低于对照组(F=42.18,32.72,43.75;P均<0.01)。治疗后各时间点两组SAS及ASQ评分均较基线时显著下降(P均<0.01);治疗12周时研究组SAS评分及ASQ评分均显著低于对照组(P均<0.01)。结论:哌甲酯控释片联合CBT较单一哌甲酯控释片能更有效地改善ADHD症状。Objective：To investigate the efficacy of concerta combined with cognitive-behavioral therapy in children with attention deficit hyperactivity disorder（ADHD）.Method：Forty one children with attention deficit hyperactivity disorder（ADHD） were randomly divided into study group treated with concerta combined with cognitive-behavioral therapy（CBT） and control group treated with concerta.The ADHD were assessed by self-rating anxiety scale（SAS）,Conners abbrebiated symptom questinnaire（ASQ）,Swan-son nolan and pelhamIV scale-parent form（SNAP-IV） at the baseline and end of fourth,eighth,twelfth weeks after treatment.Results：Compared with baseline,SNAP-IV attention factor,hyperactivity impulse factor,total scores reduced significantly at the end of fourth,eighth and twelfth week after treatment in both groups.However,the scores at each time point in study group was significantly lower than those in control group（all P〈0.01）.The SAS and ASQ scores were reduced gradually within 12-week treated period in study group（all P〈0.01）.the ASQ score at the end of twelfth week after treatment were significantly lower than those at the baseline,and SAS scores at the end of fourth,eighth and twelfth week after treatment was significantly lower than those at the baseline in control group.At the end of twelfth weeks after treatment,SAS reduced scores of study group was significantly higher than control group（all P〈0.01）.At the end of eighth,twelfth weeks after treatment,ASQ reduced scores of study group was significantly higher than control group（all P〈0.01）.Conclusion：Compared with concerta,concerta combined with CBT may have better effect than concerta monotherapy in treatment ADHD.

关 键 词：注意缺陷多动障碍 认知行为治疗 哌甲酯控释片 

分 类 号：R749.94[医药卫生—神经病学与精神病学]