目的 探索音乐治疗的方式对注意缺陷多动障碍(ADHD)患儿的治疗作用,为ADHD的治疗提供新思路。方法 将上海市精神卫生中心儿少科门诊2017年 1月-2019年 1月首次确诊的ADHD患儿随机分为三组:音乐治疗组(n=47)、盐酸哌甲酯缓释片治疗(n=46)和综合治疗(音乐治疗结合药物治疗)(n=43),评估和比较三组治疗前后临床症状及执行功能的改善情况。结果 1)音乐治疗组治疗后Conners量表品行问题、学习问题、多动冲动及多动指数得分较治疗前差异具有统计学意义(t=2.242~3.687,P<0.05);在Stroop测验的乙表正确率,WCST测试中的持续错误数、概念化水平、持续应答数的差异有统计学意义(t=2.312~4.695,P<0.05)。2)单因素协方差分析显示,在控制基线水平后,三组在PSQ的冲动多动和焦虑因子和WCST测试中的持续错误数、分类完成数、概念化水平和持续应答数的得分差异具有统计学意义(F=3.432~6.610,P<0.05)。结论 音乐治疗能改善ADHD儿童的临床症状和执行功能,而联合治疗疗效更为突出。
Abstract
Objective To explore the effect of music therapy on children with attention deficit hyperactivity disorder (ADHD),in order to provide new ideas for the treatment of ADHD. Methods Children with ADHD first diagnosed from January 2017 to January 2019 at the children′s clinic of Shanghai Mental Health Center were randomly divided into three groups,including music therapy group(n=47),drug therapy(n=46) and combined therapy group(n=43).The improvement of clinical symptoms and executive function among the three groups were evaluated and compared before and after intervention. Results 1) After music therapy,the scores of conduct question,learning question,hyperactive impulse and hyperactive index of Conners Scale in music therapy group were significantly different(t=2.242-3.687,P<0.05).There were significant differences on the number of sustained errors,the level of conceptualization and the number of sustained responses in WCST(t=2.312-4.695,P<0.05).2) Univariate analysis indicated that there were significant differences on the number of persistent errors,the number of complete classification,the level of conceptualization and the number of persistent responses in WCST(F=3.432-6.610,P<0.05). Conclusionss Music therapy is effective in improving the clinical symptoms and executive function of ADHD children,and the effect of combined intervention is better than single intervention.
关键词
注意缺陷多动障碍 /
音乐治疗 /
发育神经障碍
Key words
attention deficit hyperactivity disorder /
music therapy /
neurodevelopmental disorder
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基金
重大慢性非传染性疾病防控研究(2016YFC1306102);上海市卫计委课题(201640286);国家自然科学基金面上项目(81771477);上海市卫生计生委智慧医疗专项研究项目(2018ZHYL0210);上海市精神卫生中心院级课题(2018-YJ-14)
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