目的 比较盐酸哌甲酯缓释片(MPH)与盐酸托莫西汀(ATX)对注意缺陷多动障碍(ADHD)患儿症状及执行功能的改善效果,为临床干预提供更多依据。方法 选取2017—2019年上海交通大学医学院附属精神卫生中心儿少门诊未曾用药的ADHD患儿为研究对象。对建议服用药物的64名患儿,根据用药情况分为MPH组与ATX组。在基线、用药4周末、8周末及24周末评估症状得分及执行功能指标变化。采用斯诺佩量表(SNAP-Ⅳ)、Conners父母症状问卷(PSQ)对症状评估;Stroop测试、威斯康辛卡片分类测试、数字广度测试进行执行功能评估。结果 24周末两组ADHD患儿的症状得分及执行功能多个核心指标明显改善(P<0.05);两组患儿在基线、4周、8周及24周末的SNAP-Ⅳ量表评分、PSQ因子分、Stroop测验结果、WCST指标及背数的组间得分差异均无统计学意义(P>0.05)。结论 MPH与ATX均能持续改善ADHD的症状,提高执行功能表现。
Abstract
Objective To compare the improvement of symptoms and executive function of children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate hydrochloride (MPH) prolonged-release tablets and atomoxetine (ATX), in order to provide more reference for clinical intervention. Methods From 2017 to 2019,children with ADHD who had not been medicated in the Pediatric and Juvenile Outpatient Clinic of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine were selected into the study, then 64 ADHD Children were divided into MPH group and ATX group according to medication treatment strategy. Changes in symptom scores and executive function indicators were assessed at baseline, at the end of 4, 8, and 24 weeks of medication. Swanson, Nolan, and Pelham Rating Scale-Ⅳ (SNAP-Ⅳ) and Conners Parents Symptom Questionnaire (PSQ) were used to evaluate symptoms. Executive function was evaluated by Stroop color-word test, Wisconsin card classification test and Digital Span test. Results Symptom scores and several core indicators of executive function improved significantly in both groups of ADHD children at the end of the 24th weekend (P<0.05). There were no significant differences in SNAP-Ⅳ scale scores, PSQ scores, Stroop test, as well as the scores of WCST and Digital Span between the two groups at baseline, at the end of 4th week, 8th week and 24th week (P>0.05). Conclusion Both MPH and ATX can continuously improve behavioral symptoms and executive function performance of ADHD children.
关键词
注意缺陷多动障碍 /
行为症状 /
执行功能 /
药物干预
Key words
attention deficit hyperactivity disorder /
behavioral symptoms /
executive function /
medication intervention
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参考文献
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基金
上海市公共卫生体系建设三年行动计划(2020-2022年)重点学科建设计划项目(GWV-10.1-XK19);国家自然科学基金青年项目(18901386);上海市老龄化和妇儿健康研究专项(2020YJZX0201);国家自然科学基金面上项目(81771477)
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