目的 探讨超低频经颅磁刺激(ILF-TMS)联合常规康复训练对孤独症谱系障碍(ASD)合并睡眠障碍儿童的治疗效果,为临床治疗提供科学依据。方法 选择2023年在广州中医药大学附属南海妇产儿童医院就诊的60例ASD合并睡眠障碍儿童为研究对象,采用随机数表法分为研究组与对照组,各30例。对照组接受应用行为分析疗法、感觉统合训练和言语治疗等常规康复训练,研究组加予ILF-TMS,两组均治疗12周,治疗前后采用儿童睡眠习惯问卷(CSHQ)、孤独症行为量表(ABC)和儿童孤独症评定量表(CARS)评估,并对两组各指标进行组内比较及治疗前后差值的组间比较,以观察治疗效果。结果 研究组治疗后在CSHQ评分中睡眠阻抗、睡眠焦虑、睡眠时间、异态睡眠、日间困倦得分及总分较治疗前明显降低(t=2.438、2.261、2.295、2.987、5.954、5.518,P＜0.05),且治疗前后得分差值显著高于对照组,差异有统计学意义(t=2.201、2.218、2.604、3.322、6.668、8.216,P＜0.05);研究组、对照组治疗后CARS、ABC总分均较治疗前显著降低(研究组:t=3.067、3.125;对照组:t=2.098、2.094,P＜0.05),研究组ABC总分治疗前后的差值显著大于对照组,差异有统计学意义(t=3.121,P＜0.05)。结论 ILF-TMS可有效改善ASD儿童的睡眠障碍,并减轻其临床症状,为ILF-TMS在ASD患儿治疗中的应用提供理论依据。
Abstract
Objective To investigate the therapeutic efficacy of infra-low frequency transcranial magnetic stimulation (ILF-TMS) combined with conventional rehabilitation training in children with autism spectrum disorder (ASD) and comorbid sleep disturbances, in order to provide a scientific basis for clinical treatment. Methods A total of 60 children with ASD and sleep disturbances, who were treated at the Nanhai Obstetrics and Gynecology Children′s Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine in 2023, were selected as study participants.They were randomly divided into a study group and a control group using a random number table, with 30 children in each group.The control group received conventional rehabilitation training, including applied behavior analysis therapy, sensory integration training, and speech therapy.The study group received ILF-TMS additionally.Both groups underwent treatment for 12 weeks.The Children′s Sleep Habits Questionnaire (CSHQ), Autism Behavior Checklist (ABC), and Childhood Autism Rating Scale (CARS) were used to assess outcomes before and after treatment.Intra-group comparisons and inter-group comparisons of score changes before and after treatment were conducted to evaluate therapeutic effects. Results In the study group, post-treatment scores for sleep resistance, sleep anxiety, sleep duration, parasomnias, daytime sleepiness, and total CSHQ scores were significantly lower than pre-treatment scores (t=2.438, 2.261, 2.295, 2.987, 5.954, 5.518, P<0.05).Moreover, the differences in the above score changes before and after treatment were significantly greater in the study group compared to the control group, with statistical significance (t=2.201, 2.218, 2.604, 3.322, 6.668, 8.216, P<0.05).Both the study and control groups showed significant reductions in CARS and ABC total scores after treatment (study group: t=3.067, 3.125; control group: t=2.098, 2.094, P<0.05).The difference in ABC total score changes before and after treatment was significantly greater in the study group compared to the control group (t=3.121, P<0.05). Conclusions ILF-TMS can effectively improve sleep disturbances and alleviate clinical symptoms in children with ASD, which provides theoretical support for the application of ILF-TMS in the treatment of children with ASD.
关键词
超低频经颅磁刺激 /
孤独症谱系障碍 /
睡眠障碍
Key words
infra-low frequency transcranial magnetic stimulation /
autism spectrum disorder /
sleep disorder
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基金
佛山市科技局医学类科研攻关项目(2220001004421)
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