经颅磁刺激结合前庭康复训练对ADHD患儿注意力缺陷的影响及临床机制  

Effect of transcranial magnetic stimulation combined with vestibular rehabilitation training on attention deficit in children with ADHD and its clinical mechanism

作　　者：邓艳媚 龙耀斌[1] 李鑫[1] 莫丽华[1] Yanmei Deng;Yaobin Long;Xin Li;Lihua Mo(Department of Rehabilitation Medicine,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530000,China)

机构地区：[1]广西医科大学第二附属医院康复医学科,广西南宁530000

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第1期34-38,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2019010);广西壮族自治区医疗卫生重点学科建设项目(桂卫科教发[2022]4号)。

摘　　要：目的重复经颅磁刺激(rTMS)联合前庭康复训练方案对注意缺陷多动障碍(ADHD)患儿注意力缺陷症状的影响,并分析其临床机制。方法选取广西医科大学第二附属医院康复医学科自2020年1月至2021年7月收治的74例ADHD患儿,按照随机数字表法分为对照组和rTMS组,每组37例。对照组予以前庭训练模式与rTMS伪刺激治疗,rTMS组予以前庭训练模式与rTMS治疗。比较2组患者视听整合测试(IVA-CPT)评分、Conner’s多动指数量表(ASQ)评分、25-羟维生素D[25-(OH)-D]和多肽蛋白激素(PRL)指标值。结果2组患儿治疗后的IVA-CPT评分均较治疗前升高,且rTMS组高于对照组,差异具有统计学意义(P<0.05)。2组患儿治疗后ASQ评分均较治疗前降低,且rTMS组低于对照组,差异具有统计学意义(P<0.05)。2组患儿治疗后体内25-(OH)-D和PRL指标水平较治疗前呈上升趋势,且rTMS组高于对照组,差异具有统计学意义(P<0.05)。结论rTMS技术结合前庭康复训练方式疗效好、安全性高,对减轻患儿多动症状具有明显效果,对患儿注意力缺陷症状的改善具备积极影响。Objective To analyze the effect of repetitive transcranial magnetic stimulation(rTMS)combined with vestibular rehabilitation training on attention deficit symptoms in children with attention deficit hyperactivity disorder(ADHD)and its clinical mechanism.Methods Seventy-four children with ADHD admitted to the Rehabilitation Medicine Department of the Second Affiliated Hospital of Guangxi Medical University from January 2020 to July 2021 were randomly divided into the control group and the rTMS group,with 37 cases in each group.The control group was treated with vestibular training mode and rTMS pseudo-stimulation,while the rTMS group was treated with vestibular training mode and rTMS.The audio-visual Integration test(IVA-CPT)scores,Conner's Hyperactivity index(ASQ)scores,25-hydroxyvitamin D[25-(OH)-D]and polypeptide protein hormone(PRL)index values between two groups were compared.Results Compared with before treatment,the IVA-CPT scores of the two groups increased,and the rTMS group was higher than the control group,with a statistically significant difference(P<0.05).After treatment,the ASQ scores of both groups of children decreased compared to before treatment,and the rTMS group was lower than the control group,with a statistically significant difference(P<0.05).After the treatment,the 25-(OH)-D and PRL index levels of the two groups were higher than before treatment,and the rTMS group was higher than the control group,with a statistically significant difference(P<0.05).Conclusion rTMS technology combined with vestibular rehabilitation training has higher efficacy and safety,has obvious effect on reducing ADHD symptoms in children,and has a positive impact on the improvement of attention deficit symptoms in children.

关 键 词：注意缺陷多动障碍 重复经颅磁刺激 前庭训练 25-羟维生素D 注意力缺陷 

分 类 号：R651.1[医药卫生—外科学]