重复经颅磁刺激联合感觉统合训练对注意缺陷多动障碍儿童的疗效观察  

Observation on the efficacy of repetitive transcranial magnetic stimulation combined with sensory integration training in children with attention deficit hyperactivity disorder

作　　者：梁冠军[1] 李明娣[1] 陈小明 张何威[1] 顾琴[1] Liang Guanjun;Li Mingdi;Chen Xiaoming;Zhang Hewei;Gu Qin(Department of rehabilitation medicine,Children's hospital affiliated to Soochow University,Suzhou,Jiangsu,215004,China;Lehang early intervention center for special children,Wuzhong district of Suzhou,Suzhou,Jiangsu,215128,China)

机构地区：[1]苏州大学附属儿童医院康复医学科,江苏苏州215004 [2]苏州市吴中区乐航特殊儿童早期干预中心,江苏苏州215128

出　　处：《齐齐哈尔医学院学报》2022年第9期846-850,共5页Journal of Qiqihar Medical University

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2021027)。

摘　　要：目的 探讨重复经颅磁刺激联合感觉统合训练治疗注意缺陷多动障碍(ADHD)儿童的临床效果。方法 选择2019年10月—2021年9月本院收治的69例ADHD患儿作为研究对象,采用随机数表法分为感觉统合(SI)组、重复经颅磁刺激(rTMS)组和联合组,每组各23例。SI组给予针对性的感觉统合训练,rTMS组以10Hz高频刺激右侧背外侧前额叶皮质,联合组先进行SI训练,随后以rTMS刺激。三组治疗持续12周。治疗前后以Conners父母用症状问卷(PSQ),中文版斯诺佩第4版评估量表(SNAP-Ⅳ)和视听整合持续操作测试(IVA-CPT)进行疗效评估。结果 治疗12周后,三组患儿PSQ评分和SNAP-Ⅳ评分各因子分较治疗前均显著下降,差异有统计学意义(P<0.05),联合组各因子分均优于SI组和rTMS组,差异有统计学意义(P<0.05),而SI组和rTMS组间比较,差异无统计学意义(P>0.05)。IVA-CPT评分较治疗前显著提升,联合组各因子分均优于SI组和rTMS组,差异有统计学意义(P<0.05)。SI组和rTMS组间比较,差异无统计学意义(P>0.05)。结论 重复经颅磁刺激联合感觉统合训练可显著改善ADHD儿童的核心症状,提高抑制控制能力,增强注意力水平,且效果优于单一疗法。Objective To explore the clinical effect of repetitive transcranial magnetic stimulation(rTMS)combined with sensory integration(SI)training in treating behavioral problems in attention deficit hyperactivity disorder(ADHD)children.Methods A total of 69 children suffered with ADHD those were admitted to the hospital were selected as the study objects,the were divided into SI group,rTMS group and joint group according to the random number table method,with 23 cases in each group.The SI group was given targeted sensory integration training,the rTMS group stimulated the right dorsolateral prefrontal cortex at 10 Hz high frequency,and the combined group underwent SI training followed by rTMS stimulation.The intervention of the three groups continued for 12 weeks.Before and after treatment,conners Parent Symptoms Questionnaire(PSQ),Chinese Version 4 Assessment Scale(SNAP-IV)and integrated visual and auditory continuous performance test(IVA-CPT)were used for evaluation.Results After 12 weeks of treatment,the PSQ and SNAP-IV scores of the three groups decreased significantly(P<0.05),and the scores of combined group were superior to the SI and rTMS groups(P<0.05),however,there was no significant difference between the SI and rTMS group(P>0.05).The IVA-CPT score in the three groups after treatment were significantly higher than those before treatment(P<0.05),the factor score of the combination group was better than those of SI and rTMS group(P<0.05),and there was no significant difference between SI and rTMS group(P>0.05).Conclusions rTMS combined with sensory integration training significantly improves core symptoms in children with ADHD,improves inhibitory control of children and attention levels,and worked better than mono-therapy.

关 键 词：重复经颅磁 感觉统合 ADHD IVA-CPT 

分 类 号：R896.91[医药卫生—法医学]