中药益智宁治疗儿童注意缺陷多动障碍的临床研究  

Clinical Study of Yizhining in Treating Children with Attention Deficit Hyperactivity Disorder

作　　者：刘华[1] 欧阳学认[1] 沈凌[1] 赖东兰[1] 江美容 陈晓刚[1] 李宜瑞[1] LIU Hua;OUYANG Xue-Ren;SHEN Ling;LAI Dong-Lan;JIANG Mei-Rong;CHEN Xiao-Gang;LI Yi-Rui(The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405 Guangdong, China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2018年第4期628-632,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省名老中医药专家传承工作室建设项目[粤中医办函(2017)209号];广州中医药大学李宜瑞名医工作室建设项目[中医一院(2015)87号]

摘　　要：【目的】观察中药益智宁治疗儿童注意缺陷多动障碍(ADHD)的临床疗效。【方法】运用前瞻性病例对照研究方法,将107例患儿分成治疗组62例和对照组45例,分别以益智宁、择思达(盐酸托莫西汀)治疗12周后进行疗效评价,并在治疗前后分别给予ADHD症状量表评分、视听整合反应测试(IVA-CPT)和视空间工作记忆测试(n-back task),以及对药物不良反应等进行临床检测。【结果】(1)治疗12周后,治疗组总有效率为82.26%,对照组为84.44%,2组疗效比较,差异无统计学意义(P>0.05)。(2)ADHD症状量表评分情况:治疗4周、8周、12周后,2组的ADHD症状量表评分均较治疗前改善(P<0.01);组间比较,在治疗4周后,治疗组的ADHD症状量表评分高于对照组(P<0.01),但在治疗8周、12周后,2组间差异无统计学意义(P>0.05)。(3)视听整合反应测试(IVA-CPT)情况:治疗12周后,2组的注意力商数(综合注意力商数、听觉注意力商数、视觉注意力商数)和控制力商数(综合尺度控制商数、听觉反应控制商数、视觉反应控制商数)均较治疗前改善,差异均有统计学意义(P<0.01);但治疗后各指标组间比较,差异均无统计学意义(P>0.05)。(4)视空间工作记忆测试(n-back task)情况:治疗12周后,2组的2-back正确反应次数均较治疗前改善,差异有统计学意义(P<0.01),而2-back正确反应平均时间虽均较治疗前缩短,但差异均无统计学意义(P>0.05);治疗后组间比较,无论是2-back正确反应数,还是2-back正确反应平均时间,差异均无统计学意义(P>0.05)。(5)安全性评价:治疗组的不良反应明显少于对照组。【结论】益智宁能改善ADHD患儿的工作记忆、持续性注意缺陷和冲动控制障碍,其疗效与择思达大致相当,但副作用少,临床应用安全。Objective To observe the clinical curative effect of Yizhining in treating children with attention deficithypertensive disorder（ADHD）. Methods A prospective case-control study was carried out. One hundred andseven cases of children with ADHD were divided into treatment group（N = 62）and control group（N = 45）,andwere given oral use of Chinese medicine Yizhining and Atomoxetine Hydrochloride Capsules,respectively. Thetreatment lasted for 12 weeks. After treatment,the clinical efficacy was evaluated,and ADHD symptom scoring,intermediate visual and auditory continuous performance test（IVA-CPT） and visual-space working memory test（n-back task） were carried out before and after treatment. TESS scale was used for clinical detection of drugadverse reaction. Results（1）After treatment for 12 weeks,the total effective rate was 82.26% in the treatmentgroup,and was 84.44% in the control group. There was no significant difference between the two groups（P〉0.05）.（2）The scores of ADHD symptoms in both groups were significantly improved after treatment for 4,8,12 weeks in comparison of those before treatment（P 〈 0.01）. ADHD symptom scores in the treatment group after treatment for 4 weeks were significantly higher than those in the control group（P〈0.01）, but there was nosignificant difference between the two groups after treatment for 8,12 weeks（P〉0.05）.（3）In respect of IVA-CPT, the attention quotients（including comprehensive attention quotient, auditory attention quotient, visualattention quotient）and control quotients（including comprehensive control quotient, auditory control quotient,visual control quotient）in both groups after treatment for 12 weeks were significantly higher than those beforetreatment（P〈0.01）,but there was no significant difference of the above indexes between the two groups aftertreatment（P〉0.05）.（4）Visual-space working memory test（n-back task）results showed that 2-back correctresponse count in both groups was improved signific

关 键 词：注意缺陷多动障碍 益智宁 视听整合反应测试 视空间工作记忆测试 

分 类 号：R277.7[医药卫生—中医学]