整合心理行为干预对多动症患儿认知功能及P300的影响  

Effect of integrated psychological and behavioral intervention on cognitive function and P300 in children with attention-deficit/hyperactivity disorder

作　　者：张倩 刘广华 何月敏 谢晓颖 徐乐瑶 Zhang Qian;Liu Guanghua;He Yuemin;Xie Xiaoying;Xu Leyao(Social and Psychological Service Center of Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China;Department of Traditional Chinese Medicine,Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China;Psychological Evaluation and Treatment Room,Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China)

机构地区：[1]绍兴市第七人民医院社会心理服务中心,绍兴312000 [2]绍兴市第七人民医院中医科,绍兴312000 [3]绍兴市第七人民医院心理测量与治疗室,绍兴312000

出　　处：《中国基层医药》2024年第6期885-889,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨整合心理行为干预对多动症患儿认知功能及P300的影响。方法采取随机对照研究,选取绍兴市第七人民医院2022年3月至2023年9月收治的多动症患儿112例,按照随机数字表法分为A组(n=56)、B组(n=56),A组采用常规药物治疗,B组采用常规药物治疗联合整合心理行为干预,两组治疗3个月。观察两组治疗前后去甲肾上腺素(NE)、多巴胺(DA)、视听整合连续执行测试评分、脑电θ/β比值、P300(潜伏期、波幅)的变化及临床疗效。结果治疗后,B组NE、DA分别为(340.83±43.22)ng/L、(1.12±0.25)ng/L,均低于A组的(416.15±48.37)ng/L、(1.30±0.31)ng/L,差异均有统计学意义(t=8.69、3.38,均P<0.05);B组综合注意力商数、综合反应控制商数评分分别为(82.52±14.15)分、(96.34±13.95)分,均高于A组的(75.20±13.83)分、(90.62±15.16)分,差异均有统计学意义(t=-2.77、-2.08,均P<0.05);B组脑电θ/β比值低于A组,差异有统计学意义(t=3.22,P<0.05);B组P300 Cz区、Fz区潜伏期分别为(346.21±40.52)ms、(344.65±39.52)ms,均短于A组的(376.16±43.04)ms、(369.35±42.16)ms,波幅分别为(7.73±1.80)μV、(7.22±1.73)μV,均大于A组的(5.90±1.15)μV、(5.76±1.12)μV,差异均有统计学意义(t=3.79、3.20、-6.41、-5.30,均P<0.05)。B组总有效率为94.6%(53/56),高于A组的82.1%(46/56),差异有统计学意义(χ^(2)=4.26,P<0.05)。结论整合心理行为干预在多动症患儿中的实施效果良好,可降低患儿的NE、DA水平,提高认知功能,改善脑电θ/β比值、P300。Objective To investigate the effect of integrated psychological and behavioral intervention on cognitive function and P300 in children with attention-deficit/hyperactivity disorder(ADHD).Methods A randomized controlled study was conducted on 112 children with ADHD admitted to the Shaoxing 7th People's Hospital from March 2022 to September 2023.These children were randomly divided into two groups:Group A(n=56)and Group B(n=56),using a random number table method.Group A received conventional drug treatment,whereas Group B received conventional drug treatment and an integrated psychological and behavioral intervention.The treatment lasted for 3 months.Before and after treatment,the levels of norepinephrine(NE)and dopamine(DA),scores on the Integrated Visual and Auditory Continuous Performance Test,electroencephalogramθ/βratio,and P300(latency and amplitude)were determined in each group.The clinical efficacy of the treatment was evaluated in both groups.Results After treatment,the NE and DA levels in Group B were(340.83±43.22)ng/L and(1.12±0.25)ng/L,respectively.These levels were significantly lower than those in Group A[(416.15±48.37)ng/L,(1.30±0.31)ng/L,t=8.69,3.38,both P<0.05].The full scale attention quotient and full scale response control quotient in Group B were(82.52±14.15)points and(96.34±13.95)points,respectively.These values were significantly higher than those in Group A[(75.20±13.83)points,(90.62±15.16)points,t=-2.77,-2.08,both P<0.05].The electroencephalogramθ/βratio was significantly lower in Group B than in Group A(t=3.22,P<0.05).The latencies of P300 in the Cz and Fz regions in Group B were(346.21±40.52)ms and(344.65±39.52)ms,respectively.The latencies were significantly shorter than those in Group A[(376.16±43.04)ms,(369.35±42.16)ms,t=3.79,3.20,both P<0.05].Similarly,the amplitudes of P300 in the Cz and Fz regions were significantly greater in Group B[(7.73±1.80)μV,(7.22±1.73)μV]than in Group A[(5.90±1.15)μV and(5.76±1.12)μV](t=-6.41,-5.30,both P<0.05).The total response rate

关 键 词：注意力缺陷障碍伴多动 行为医学 心理疗法 认知疗法 认知 去甲肾上腺素 多巴胺 脑电描记术 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]