中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (11): 1209-1213.DOI: 10.11852/zgetbjzz2020-0166

• 科研论著 • 上一篇    下一篇

低频度执行功能计算机训练对注意缺陷多动障碍患儿干预效果的研究

宋蕊1,2, 江文庆1, 樊宁1, 汪作为2, 杜亚松1   

  1. 1 上海交通大学医学院附属精神卫生中心,上海 200030;
    2 上海市虹口区精神卫生中心,上海 200083
  • 收稿日期:2020-02-24 修回日期:2020-03-25 发布日期:2020-11-10 出版日期:2020-11-10
  • 通讯作者: 杜亚松,E-mail:yasongdu@163.com.cn
  • 作者简介:宋蕊 (1983-),女,山东人,主治医师,在读硕士,主要研究方向为儿童精神病与精神卫生学。
  • 基金资助:
    国家自然科学基金面上项目(81771477);上海市虹口区临床医学优秀青年人才培养计划(HKYQ2018-19);青年科学基金项目(81901386);上海市医学重点专科建设计划(ZK2019A06);上海市精神卫生中心院课题(2018-YJ-14)

Study on the efficacy of low frequency computerized executive function training in children with attention deficit hyperacivity disorder

SONG Rui1,2, JIANG Wen-qing1, FAN Ning1, WANG Zuo-wei2, DU Ya-song1   

  1. 1 Mental Health Center Affiliated to Medical School of Shanghai Jiao Tong University,Shanghai 200030,China;
    2 Shanghai Hongkou District Mental Health Center,Shanghai 200083,China
  • Received:2020-02-24 Revised:2020-03-25 Online:2020-11-10 Published:2020-11-10
  • Contact: DU Ya-song,E-mail:yasongdu@163.com

摘要: 目的 评估对注意缺陷多动障碍(ADHD)儿童进行低频度计算机执行功能训练的可行性,为ADHD的临床治疗提供依据。方法 于2017年10月-2018年5月选取44例儿少门诊就诊符合DSM-5诊断标准的6~12岁ADHD儿童,按照家长意愿分为训练组和药物组,以患儿治疗前后症状和执行功能改善情况、对治疗方案的接受程度作为可行性分析指标。采用SNAP-Ⅳ量表对症状进行评估;Stroop色词关联测试、威斯康辛卡片分类测试(WCST)、WISC-Ⅳ的数字广度测试、译码测验进行执行功能评估。结果 低频度执行功能训练结束后患儿的ADHD症状改善,SNAP-Ⅳ的对立性、注意缺陷、多动冲动分量表得分差异均有统计学意义(t=3.386、2.976,Z=-2.026,P<0.05或<0.01);部分执行功能指标改善,患儿Stroop甲表正确数、乙表错误数、乙表时间差异均有统计学意义(t/Z=-2.727、2.368、-2.987,P<0.05或<0.01);WCST持续错误数、概念化水平差异有统计学意义(t=2.375、-2.614,P<0.05);WISC-Ⅳ顺背数字得分和译码得分差异有统计学意义(t=-3.093、-2.723,P<0.05)。患儿对训练的接受程度较高,脱落率低。药物组患儿8周末,SNAP-Ⅳ对立性和注意缺陷因子得分降低,治疗前后的差异均有统计学意义(P<0.01);Stroop 乙表正确数增加,乙表时间减少,差异均有统计学意义(t=4.833、3.360,P<0.001)。结论 低频度的计算机执行功能训练有效、可行,可改善ADHD患儿的症状和部分执行功能,患儿接受程度高,可在医疗机构临床上广泛推广。

关键词: 注意缺陷多动障碍, 执行功能, 计算机执行功能训练

Abstract: Objective To evaluate the feasibility of low-frequency computerized executive function training for attention deficit hyperacivity disorder (ADHD) children. Methods Totaly 44 ADHD children aged 6-12 years who met the DSM-5 diagnostic criteria were selected from the outpatient clinic from October 2017 to May 2018,and were divided into the training group and the drug group according to their parents' wishes.The improvement of symptoms and executive function before and after treatment,as well as the acceptance degree of the treatment plan,were taken as the feasibility analysis indicators.Children's symptoms were assessed by SNAP-Ⅳ scale.The executive functions of ADHD children were assessed by digit span test and coding tests of Stroop color-word test,WISC-Ⅳ, Wisconsin Card Sorting Test (WCST). Results The ADHD symptoms of the children improved after the low-frequency executive function training,and the scores of SNAP-Ⅳ subscale of oppositions,attention deficit and hyperactivity were different significantly(t=3.386,2.976,Z=-2.026,P<0.05 or<0.01).Some indicators of executive function were improved,including the correct number of Stoop test A,the wrong number of test B,and the time of test B(t/Z=-2.727,2.368,-2.987,P<0.05 or<0.01).WCST persistent error number and conceptualization level were significantly different after training (t=2.375,-2.614,P<0.05).There were statistically significant differences on the digit span test score and coding test score of WISC-Ⅳ (t=-3.093,-2.723,P<0.05).The children received a higher acceptance of low-frequency training and the drop-out rate was lower.At the end of 8 weeks, the scores of SNAP-Ⅳ oppositions and attention deficit factor in the drug group were decreased,and the difference before and after treatment was highly significant(P<0.01).The correct number in Stroop test B was increased while the time in Stroop test B were decreased,and the difference was statistically significant(t=-4.833,3.360,P<0.01)。 Conclusions Low-frequency computerized executive function training is effective and feasible that can improve the symptoms and partial executive function of ADHD children.Moreover,children's acceptance for computerized executive function training is high,so it can be widely promoted in clinical practice.

Key words: attention deficit hyperactivity disorder, executive function, computerized executive function training

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