维生素D辅助治疗注意缺陷多动障碍疗效研究  

Effect of vitamin D supplementation as adjunctive therapy on attention deficit hyperactivity disorder.

作　　者：王执勇[1] 武婷婷[1] 王辉[1] 郭辉[1] 马保海[1] WANG Zhiyong;WU Tingting;WANG Hui(Weifang Maternal and Child Health Hospital,Weifang 261011,China)

机构地区：[1]潍坊市妇幼保健院,山东潍坊261011

出　　处：《精神医学杂志》2023年第2期146-151,共6页Journal of Psychiatry

基　　金：山东省医药卫生科技发展计划项目(编号:202006041347)。

摘　　要：目的探讨补充维生素D作为辅助治疗注意缺陷多动障碍(ADHD)的疗效。方法选取90例ADHD患儿,随机分为研究组和对照组各45例,两组均口服盐酸哌甲酯缓释片。研究组口服维生素D 8周,对照组口服安慰剂。应用液相色谱-串联质谱法测定基线及治疗后第8周末血清25(OH)D浓度,应用Conners父母症状问卷(PQS)和斯诺佩评估量表(SNAP-Ⅳ)评估基线及治疗后第4、8周末ADHD症状。应用重复测量方差分析比较基线及治疗后第4、8周结局指标变化。结果在控制年龄、性别、智商、25(OH)D、早产、剖宫产、独生子等因素,两组PQS、SNAP-Ⅳ各维度评分在基线及治疗后第4、8周末三个时间点进行重复测量方差分析显示,时间与组别之间的交互作用均有统计学意义(P<0.01)。组内比较显示,两组治疗后第4、8周末PQS和SNAP-Ⅳ各维度评分均较各自治疗前降低(P<0.01)。组间比较显示,治疗后第4周末研究组PQS学习问题、心身问题、冲动多动、焦虑、多动指数和SNAP-Ⅳ注意缺陷、冲动多动评分均低于对照组(P<0.05),治疗后第8周末PQS和SNAP-Ⅳ量表各维度评分均低于对照组(P<0.05)。治疗后第8周末,研究组25(OH)D浓度与基线比较差异有统计学意义(P<0.01),两组25(OH)D浓度比较差异有统计学意义(P<0.01)。结论在维生素D不足的ADHD患儿中,每日补充2000 IU维生素D联合盐酸哌甲酯缓释片能显著改善症状。Objective To explore the clinical efficacy of vitamin D supplementation as an adjuvant treatment for attention deficit hyperactivity disorder(ADHD).Methods A total of 90 children with ADHD were recruited and randomly divided into study group(45 cases)and control group(45 cases).Oral methylphenidate hydrochloride sustained-release tablets were given to children with ADHD in both groups.Oral vitamin D supplementation for 8 weeks was applied to children in study group,and those in control group were given oral placebo.Serum 25(OH)D levels at baseline and the end of the 8 th week were measured by liquid chromatography-tandem mass spectrometry(LC-MS/MS).Clinical symptoms of ADHD at baseline and the ends of the 4 th and 8 th weeks were assessed by Conners Parent Symptom Questionnaire(PQS)and Swanson,Nolan and Pelham Teacher and Parent Rating Scale(SNAP-IV).Changes in the outcomes at baseline and the ends of the 4 th and 8 th weeks were compared by the repeated measures analysis of variance.Results There were significant group-by-time interaction effects on the all factor scores of PQS and SNAP-IV at baseline and the ends of the 4 th and 8 th weeks after adjustment for age,gender,intelligence quotient,25(OH)D,premature birth,cesarean section and singleton(P<0.01).Intra-group comparison showed that all factor scores of PQS and SNAP-IV at the ends of the 4 th and 8 th weeks in both groups were significantly reduced compared with those at baseline(P<0.01).At the end of the 4 th week,the scores of the academic problem,behavioral problem,impulsivity and hyperactivity,anxiousness and hyperactivity index in PQS and those of the attention deficit and impulsivity and hyperactivity in SNAP-IV in study group were significantly lower than those in control group(P<0.05).At the end of the 8 th week,all factor scores of PQS and SNAP-IV in study group were significantly lower than those in control group(P<0.05).At the end of the 8 th week,there was a significant difference in the serum 25(OH)D levels between two groups(P<0.01);there al

关 键 词：注意缺陷多动障碍 维生素D 儿童 重复测量方差 

分 类 号：R749.94[医药卫生—神经病学与精神病学]