Randomized controlled study on the effect of multimodal therapy and drug therapy on children with attention deficit hyperactivity disorder

doi:10.11852/zgetbjzz2019-1488

Abstract

Abstract: Objective To explore the improvement of symptoms and executive dysfunction in children with attention deficit hyperactivity disorder (ADHD) by multimodal therapy and medication alone,so as to provide evidence reference for the treatment of ADHD. Methods A total of 61 children with ADHD from Shanghai Mental Health Center were enrolled in this study from January 2018 to February 2019,and were randomly divided into multimodal group and medication group.The changes of symptoms and executive function were evaluated. Results 1) After treatment,scores of attention deficit,hyperkinetic and oppositional factor in SNAP-IV in the multimodal intervention group were significantly lower than those before treatment (t=7.339,5.637,7.211,P<0.001).The accuracy of Stroop Test B after treatment was significantly higher than that before treatment (t=-3.036,P<0.001).And the number of persistent errors (t=5.961,P<0.001) was lower than that before treatment.The scores of classification,conceptualization and sustained response were significantly higher than those before and after treatment (t=-2.465,-5.585,-3.524,P<0.05).2) After treatment,attention deficit,hyperkinetic,and oppositional factors in SNAP-IV in multimodal therapy group were significantly lower than those in drug treatment group (F=8.270,6.818,10.786, P<0.05).There were significant differences on Stroop color-word Test A between the two groups (F=11.125,P=0.001).And the sustained errors of WCST were significantly lower in the Stroop test group than in the drug treatment group (F=5.567,P<0.05).The level of conceptualization and the number of sustained response were significantly higher than those in the drug treatment group (F=5.775,4.436,P<0.05). Conclusionss Multimodal therapy can improve the core symptoms and executive dysfunction of ADHD children,which can be the priority for ADHD treatment.

Key words: attention deficit hyperactivity disorder, multimodal therapy, parent-child group therapy

摘要： 目的分析综合干预治疗和单纯药物治疗对注意缺陷多动障碍(ADHD)患儿症状及执行功能缺陷的改善情况,为ADHD诊疗参考。方法将上海市精神卫生中心2018年1月-2019年2月儿少科门诊就诊的61例ADHD患儿随机分为综合干预组与药物治疗组,评估其症状及执行功能指标的变化。结果 1)综合干预组治疗后SNAP-Ⅳ评分中注意缺陷、多动、对立性因子均低于治疗前,差异均有统计学意义(t=7.339、5.637、7.211,P<0.001);Stroop测试乙表正确率高于治疗前,差异有统计学意义(t=-3.036,P<0.001);WCST持续错误数低于治疗前,分类完成数、概念化水平、持续应答数均高于治疗前,差异均有统计学意义(t=5.961、-2.465、-5.585、-3.524,P<0.05)。2)治疗后综合干预组SNAP-Ⅳ评分中注意缺陷、多动、对立性因子均明显低于药物治疗组,差异有统计学意义(F=8.270、6.818、10.786,P<0.05或<0.001);Stroop色-词测试甲表正确率高于药物治疗组,差异有统计学意义(F=11.125,P=0.001);WCST持续错误数明显低于药物治疗组,概念化水平、持续应答数明显高于药物治疗组,差异有统计学意义(F=5.567、5.775、4.436,P<0.05)。结论综合干预治疗可以改善ADHD患儿的核心症状和执行功能缺陷,是治疗ADHD的优化治疗选择。

关键词: 注意缺陷多动障碍, 综合干预治疗, 亲子团体治疗, 神经发育障碍

CLC Number:

R749.94

QIAN Yun, LIU Yue, JIANG Wen-qing, ZHAO Zhi-min, LI Yan, CHEN Jing, DU Ya-song. Randomized controlled study on the effect of multimodal therapy and drug therapy on children with attention deficit hyperactivity disorder[J]. journal1, 2020, 28(4): 395-398.

钱昀, 刘乐, 江文庆, 赵志民, 李焱, 陈静, 杜亚松. 综合干预治疗与单纯药物治疗对注意缺陷多动障碍患儿疗效的随机对照研究[J]. 中国儿童保健杂志, 2020, 28(4): 395-398.

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