听觉统合训练联合重复经颅磁刺激对孤独症谱系障碍患儿疗效的观察  

Effects of auditory integration training combined with repetitive transcranial magnetic stimulation on behavioral symptoms in children with autism spectrum disorder

作　　者：左晓晓 杜宝媛 王阔 冉欣 李健 Zuo Xiaoxiao;Du Baoyuan;Wang Kuo(Department of Child Rehabilitation,Henan University of Science and Technology Affiliated Yellow River Hospital,Sanmenxia 472000,China)

机构地区：[1]河南科技大学附属黄河医院儿童康复科,河南三门峡472000 [2]河南科技大学附属黄河医院儿童心理与行为发展科,河南三门峡472000

出　　处：《中国康复》2024年第10期599-603,共5页Chinese Journal of Rehabilitation

基　　金：中国水利水电第十一工程局有限公司科技项目(2021-217-23)。

摘　　要：目的:探讨听觉统合训练(AIT)联合重复经颅磁刺激(rTMS)对孤独症谱系障碍(ASD)患儿行为学症状的影响。方法:选择ASD患儿98例,随机分为对照组和研究组各49例。对照组接受常规康复训练和rTMS治疗,研究组在对照组基础上给予AIT。最终对照组47例、研究组46例完成研究。于干预前、干预12周后采用孤独症行为评定量表(ABC)和ASD儿童心理教育量表第3版(PEP-3)对患儿进行评定,记录事件相关电位(ERP)并检测脑源性神经营养因子(BDNF)水平。比较2组患儿的行为学症状、功能与行为状况、ERP及BDNF水平。结果:干预12周后,2组患儿ABC量表中5项评分均低于干预前(P<0.01),研究组5项评分均低于对照组(P<0.01);2组患儿PEP-3中2项评分、P300波幅及血清BDNF水平均高于干预前(P<0.01),且研究组均高于对照组(P<0.01,0.05);2组患儿P300潜伏期均短于干预前(P<0.01),且研究组P300潜伏期短于对照组(P<0.05)。结论:对ASD患儿开展AIT联合rTMS,可显著改善行为学症状、功能和行为状况,明显提高血清BDNF水平,有效调节P300电位。Objective:To explore the effect of auditory integration training(AIT)combined with repetitive transcranial magnetic stimulation(rTMS)on behavioral symptoms in children with autism spectrum disorder(ASD).Methods:This study was conducted on 98 children with ASD admitted to our hospital from July 2022 to December 2023.In this study,1 case was excluded and 1 case was dislodged from the control group;2 cases were excluded and 1 case was dislodged from the study group,resulting in the inclusion of 93 children with ASD.The children were randomly divided into 2 groups,47 in the control group and 46 in the study group.The control group received conventional rehabilitation training and rTMS treatment,while the study group was given AIT on the basis of the control group,using the autism behavioral rating scale(ABC)and the psychoeducational scale for children with ASD,3rd edition(PEP-3),and the event-related potentials(ERPs)and the brain-derived neurotrophic factor(BDNF)test were observed.Behavioral symptoms,functional and behavioral status,ERP and BDNF levels were compared between the 2 groups before and after 12 weeks of intervention.Results:After 12 weeks of intervention,the scores of 5 items in ABC in both groups were lower than before intervention(P<0.01),and 5 scores in the study group were lower than in the rTMS group(P<0.01).After 12 weeks of intervention,the scores of two items in PEP-3,P300 amplitude,and serum level of BDNF in the two groups were higher than before intervention(P<0.05),and those in the study group were higher than in the rTMS group(P<0.01).After 12 weeks of intervention,the P300 latency in both groups were shorter than before intervention(P<0.01,0.05),and the incubation period of P300 in the study group was shorter than in the rTMS group(P<0.01).Conclusion:AIT combined with rTMS can obviously increase serum BDNF level,effectively regulate P300 potential,and obviously improve behavioral symptoms,function,and behavioral status in children with ASD.

关 键 词：听觉统合训练 重复经颅磁刺激 孤独症谱系障碍 行为学症状 

分 类 号：R49[医药卫生—康复医学] R749.94[医药卫生—临床医学]