前庭功能训练联合重复经颅磁刺激对注意缺陷多动障碍患儿核心症状、感觉统合能力及执行功能的改善作用  

Improvement effects of vestibular function training combined with repetitive transcranial magnetic stimulation on core symptoms,sensory integration abilities,and executive function in children with attention deficit and hyperactive disorder

作　　者：朱育辉 龙耀斌[1] 施冬柳 罗水明 宋美宁 邓雅宸 ZHU Yuhui;LONG Yaobin;SHI Dongliu;LUO Shuiming;SONG Meining;DENG Yachen(Department of Rehabilitation Medicine,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,Guangxi,China)

机构地区：[1]广西医科大学第二附属医院康复医学科,广西南宁市530007

出　　处：《广西医学》2023年第20期2425-2429,2435,共6页Guangxi Medical Journal

基　　金：广西壮族自治区医疗卫生重点(培育)学科(自治区级)项目(桂卫科教发[2022]4号)。

摘　　要：目的探讨前庭功能训练联合重复经颅磁刺激(rTMS)对注意缺陷多动障碍(ADHD)患儿核心症状、感觉统合能力及执行功能的改善作用。方法将98例ADHD患儿随机分为训练组(n=30)、rTMS组(n=32)和联合组(n=36),分别接受单纯前庭功能训练、单纯rTMS、前庭功能训练联合rTMS。比较3组患儿治疗前和治疗6周后的斯旺森-诺兰-佩勒姆量表Ⅳ(SNAP-Ⅳ)、韦氏儿童智力量表第4版(WISC-Ⅳ)及感觉统合评定量表得分。结果治疗6周后,联合组SNAP-Ⅳ各因子、WISC-Ⅳ4项测试、感觉统合评定量表得分优于治疗前,且SNAP-Ⅳ各因子、WISC-Ⅳ的算数测验和顺背数字广度测验、感觉统合评定量表的触觉防御维度得分优于其他两组,WISC-Ⅳ的倒背数字广度测验和译码测验、感觉统合评定量表的前庭平衡维度和本体感维度得分优于训练组(P<0.05)。结论前庭功能训练联合rTMS可有效缓解ADHD患儿对立违抗、注意缺陷及多动/冲动的核心症状,提升其前庭平衡、本体感能力和部分执行功能,且效果优于单纯前庭功能训练或rTMS。Objective To explore the improvement effects of vestibular function training combined with repetitive transcranial magnetic stimulation(rTMS)on core symptoms,sensory integration abilities,and executive function in children with attention deficit and hyperactive disorder(ADHD).Methods A total of 98 ADHD children were randomly divided into training group(n=30),rTMS group(n=32),or combination group(n=36),and they received simple vestibular function training,simple rTMS,and vestibular function training combined with rTMS,respectively.The pre-treatment and 6-week post-treatment scores of Swanson,Nolan,and Pelham Scale in VersionⅣ(SNAP-Ⅳ),Wechsler Intelligence Scale for Children-Fourth Edition(WISC-Ⅳ),and sensory integration assessment scale were compared between children of the three groups.Results After 6 weeks of treatment,the combination group exhibited superior scores of various factors of SNAP-Ⅳ,4 tests of WISC-Ⅳ,and of sensory integration assessment scale to compared with before treatment,as well as superior scores of various factors of SNAP-Ⅳ,reckoning test and orderly recited digit span test of WISC-Ⅳ,and tactile defense dimension of sensory integration assessment scale to compare with the remaining two groups;furthermore,the combination group yielded superior scores of reversely orderly recited digit span test and decoding test of WISC-Ⅳ,as well as vestibular balance dimension and proprioceptive dimension of sensory integration assessment scale to compare with the training group(P<0.05).Conclusion Vestibular function training combined with rTMS can effectively alleviate ADHD children′s core symptoms of oppositional defiance,attention deficit,and hyperactivity/impulse,etc.,improve their vestibular balance,proprioceptive ability,partial executive functions,and the effects are superior to simple vestibular function training or rTMS.

关 键 词：注意缺陷多动障碍 前庭功能训练 重复经颅磁刺激 核心症状 感觉统合能力 执行功能 

分 类 号：R749.94[医药卫生—神经病学与精神病学]