哌甲酯及托莫西汀联合脑电生物反馈与单纯脑电生物反馈治疗儿童注意缺陷多动障碍的疗效对比观察  

Comparison and observation on curative effects of methylphenidate,tomoxetine combined with electroencephalographic biofeedback therapy and simple electroencephalographic biofeedback therapy in treatment of children with attention deficit hyperactivity diso

作　　者：刘文龙 王真真 张娟[1] 王娟 LIU Wen-Long;WANG Zhen-Zhen;ZHANG Juan(Xiamen Municipal Maternal and Child Health Care Hospital,Affiliated Women and Children's Hospital of Xiamen Univer-sity,Xiamen,Fujian361003,China)

机构地区：[1]厦门大学附属妇女儿童医院厦门市妇幼保健院,福建厦门361003 [2]厦门医学院,福建厦门361000

出　　处：《中国妇幼保健》2020年第4期657-660,共4页Maternal and Child Health Care of China

基　　金：福建省中青年教师教育科研项目(JAT160582);厦门医学院博士启动基金(K2016-11);厦门市科技计划项目(3502Z20159004);福建省卫生计生面向农村和城市社区推广适宜技术项目(2017028)

摘　　要：目的 探讨哌甲酯(MPH)及托莫西汀(ATX)联合脑电生物反馈(EEG-B)与单纯EEG-B治疗儿童注意缺陷多动障碍(ADHD)的疗效,为临床治疗提供参考依据。方法 64例ADHD儿童随机分成A、B、C 3组,A组予MPH,B组予ATX,同时联合EEG-B,C组仅予EEG-B,以整合视听持续性操作测试(IVA-CPT)、SNAP-IV问卷为评价工具,比较疗效差异。结果 3组在综合控制力商数和多动/冲动量表得分上均有改善,治疗前后比较差异有统计学意义(均P<0.05);在综合注意力商数和注意力量表得分上均有改善,仅A、B组差异有统计学意义(均P<0.05);两两比较,除多动/冲动量表外,其余结果显示A、B两组差异无统计学意义(均P>0.05),但与C组差异有统计学意义(均P<0.05)。结论 MPH及ATX联合EEG-B可以改善ADHD患儿的核心症状,两者疗效相当,且较单纯的EEG-B治疗更有优势;单纯EEG-B改善ADHD患儿的多动/冲动症状优于注意缺陷症状。Objective To explore the curative effects of methylphenidate(MPH),tomoxetine(ATX)combined with electroencephalographic biofeedback therapy(EEG-B)and simple EEG-B in treatment of children with attention deficit hyperactivity disorder(ADHD),provide a reference basis for clinical treatment of ADHD.Methods Sixty-four children with ADHD were selected and randomly divided into A group,B group,and C group.The children in A group were treated by MPH,the children in B group were treated by ATX and EEG-B,the children in C group were treated by EEG-B.Intermediate visual and auditory continuous performance test(IVA-CPT)and SNAP-IV questionnaire were used to evaluate and compare the curative effects.Results Comprehensive reaction control quotients and the scores of impulsivity/hyperactivity scale in the three groups were improved,there were statistically significant differences between before and after treatment(P<0.05).Comprehensive attention quotients and the scores of attention scale in the three groups were improved,but there were statistically significant differences between before and after treatment in A group and B group(P<0.05).There was no statistically significant difference between A group and B group excluding the score of impulsivity/hyperactivity scale(P>0.05),but there were statistically significant differences compared with C group(P<0.05).Conclusion MPH,ATX combined with EEG-B can improve the core symptoms of ADHD children,the curative effects of these two methods are similar,which are better than that of simple EEG-B.The improvement effect of simple EEG-B on impulsivity/hyperactivity is superior to attention deficit.

关 键 词：注意缺陷多动障碍 儿童 哌甲酯 托莫西汀 脑电生物反馈 疗效 

分 类 号：R748[医药卫生—神经病学与精神病学]