针灸结合综合康复训练治疗儿童孤独症谱系障碍的临床疗效分析

目的将针灸结合综合康复训练治疗用于儿童孤独症谱系障碍治疗中,探究其临床疗效。方法对我院收治的150例孤独症患儿分组研究,随机分成观察组与参照组各75例,参照组行综合康复训练治疗,观察组在此基础上辅助针灸治疗,评价两组治疗效果。结果治疗前,两组患者ABC各项评分比较,差异不显著(P0.05);治疗后,两组各项ABC评分均明显降低,且观察组各项评分低于参照组,差异有统计学意义(P0.05);治疗前,两组CARS、社会生活能力评分比较,差异不显著(P0.05);治疗后,观察组CARS低于参照组,社会生活能力评分高于参照组,差异有统计学意义(P0.05)。结论对孤独症谱系障碍患儿应用综合康复训练结合针灸治疗的疗效满意,对患儿语言、感觉、交往能力等方面改善显著,值得临床推广应用。     

孤独症谱系障碍儿童的综合干预模式

孤独症谱系障碍（Autism Spectrum Disorders , ASD）是一类以社交沟通缺陷以及刻板行为为主要表现的发育性疾病群,患病率超过1％［1］。目前,关于孤独症的干预方法主要有定向干预和综合干预模式（Comprehensive Treatment Models ,CTMs）两类［2］。ASD患者一旦确诊应尽早接受综合干预。本研究对综合干预模式的定义、具体确定标准、目标、分类等进行综述,以期为国内的相关研究和实践提供借鉴。     

中医推拿干预孤独症谱系障碍患儿的临床观察

目的:观察中医推拿结合行为干预对孤独症谱系障碍(Autism Spectrum Disorder,ASD)患儿干预的临床疗效。方法:选择长沙市星学园教育发展中心符合入选标准的孤独症谱系障碍患儿44例,随机分为观察组(22例),对照组(22例),对照组予以行为干预,观察组在行为干预的基础上采用中医推拿。以30次为1个周期,共进行1个周期干预,以儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)和儿童孤独症行为量表(Autism Behavior Checklist,ABC)进行疗效判定。结果:干预后,观察组与对照组的CARS、ABC均较干预前下降(P<0.05),观察组优于对照组(P<0.05),观察组总有效率95.45%,对照组总有效率72.72%。结论:推拿干预孤独症谱系障碍或仅进行行为干预均能改善ASD患儿的临床症状,但是中医推拿结合行为干预的临床疗效优于单纯的行为干预。     

孤独症谱系障碍患儿父母心理弹性现状调查

目的:调查孤独症谱系障碍患儿父母心理弹性现状,以期为促进患儿父母心理健康,提高其对患儿的照护能力提供参考。方法:2021年1月—2021年11月对医院康复科收治的204名孤独症谱系障碍患儿父母进行调查。结果:孤独症患儿父母心理弹性得分为(58.42±9.36)分,影响因素包括同病人关系、受教育程度、居住地以及益处发现水平。结论:孤独症患儿父母心理弹性得分较低,且受居住地、文化程度、与患儿关系以及益处发现水平等多种因素影响,护理人员应引起关注。     

针刺改善孤独症谱系障碍患儿核心症状的临床观察

目的:探讨针刺改善儿童孤独症谱系障碍(ASD)核心症状的临床效果。方法:选取2016年7月—2018年8月我院收治的86例ASD患儿,采取简单随机数字表法将其随机分成观察组(n=43)与对照组(n=43)。对照组采取常规康复训练,而观察组在对照组基础上加用针刺疗法治疗,所有患儿均治疗6个月。比较两组临床疗效,治疗前后分别对两组患儿进行孤独症儿童行为量表(ABC)、儿童孤独症评定量表(CARS)、孤独症疗效评估量表(ATEC)、孤独症儿童心理教育评核(第三版)(PEP-3)及韦氏学龄前及初小儿童智力量表(WPPSI)测评,并统计针刺相关副反应发生情况。结果:观察组总有效率为88.37%(38/43),与对照组的67.44%(29/43)相比显著上升(P<0.05)。两组治疗后ABC和CARS评分均较治疗前显著降低(P<0.05),但观察组下降更显著(P<0.05);两组治疗后ATEC中各分量表(言语、感知觉、社交、行为)评分及其总分均较治疗前显著降低(P<0.05),但观察组下降更显著(P<0.05)。两组治疗后PEP-3中各部分包括认知(语言/语前)、语言...     

孤独症谱系障碍流行病学研究现状

儿童孤独症是一类起病于3岁以前的神经系统发育障碍,属于广泛性发育障碍的一个亚型。精神障碍诊断与统计手册第五版(DSM-Ⅴ)已将其归类为孤独症谱系障碍(ASD)。1980年以前,孤独症被认为是一种罕见性疾病,而近些年有关孤独症及ASD的流行病学研究表明,其发病率日趋上升,2014年美国疾病控制与预防中心对11个州8岁儿童的监测数据发现,ASD患病率高达14.7/1 000,即相当于68例儿童中即有1例为ASD患儿,本文综述了目前ASD流行病学研究现状,并分析患儿性别、种族、智力、地域间的差异,为ASD的早期发现与早期干预提供理论依据。     

孤独症谱系障碍的病因学研究进展

孤独症谱系障碍(ASD)是一个表型宽广的疾病群体,病因复杂,包括遗传及环境因素的共同作用。本文就ASD病因学研究进展进行综述。     

针刺治疗孤独症谱系障碍儿童便秘的效果

目的 观察针刺对孤独症谱系障碍(ASD)儿童便秘问题及核心症状的治疗效果。方法 2019年1月至2020年11月,黑龙江中医药大学附属第二医院康复中心收治50例ASD并发便秘患儿,随机分为针康组(n = 25)和药康组(n = 25)。针康组采用头针、体针结合康复训练法;药康组采用口服益生菌结合康复训练法;两组均进行便秘和核心症状的康复训练。便秘治疗8周,核心症状治疗12周。治疗前,治疗8周、12周后进行便秘疗效判定和便秘主症评分,并采用孤独症儿童行为量表(ABC)和孤独症治疗评估表(ATEC)对核心症状进行评估。结果 治疗前两组便秘主症评分、ABC评分和ATEC总分比较均无显著性差异(P > 0.05)。治疗8周,两组主症评分均显著降低(t > 5.473, P < 0.001);治疗12周,针康组便秘疗效和主症评分均优于药康组(Z = 2.848, t = -2.139, P < 0.05)。治疗8周后,两组ABC评分和ATEC总分均较治疗前显著降低(t > 7.139, P < 0.001),两组间比较均无显著性差异(P > 0.05);针康组ATEC行为评分明显降低(t = 3.849, P < 0.01),优于药康组(t = -2.643, P < 0.05),两组间其他项评分无显著性差异(P > 0.05);治疗12周,针康组ABC评分、ATEC总分及各项评分均低于药康组(|t| > 2.156, P < 0.05)。结论 针刺结合康复训练法可改善ASD儿童便秘问题,疗效较持久,也可改善孤独症的核心症状,均优于药物结合康复训练法。     

犬辅助干预对孤独症家庭功能的影响

目的 系统评价犬辅助干预对孤独症家庭功能的影响。方法 检索建库至2021年2月Cochrane Library、PubMed、Web of Science、CNKI、中国生物医学文献数据库(CBM)、维普(VIP)、万方数据库关于犬辅助干预治疗孤独症的随机对照试验(RCT)研究。采用家庭评估量表(FAM-III-GS)评估家庭功能;采用儿童抑郁量表第二版(CDI-2)和Spence儿童焦虑量表(Spence Children's Anxiety Scale, SCAS)评估心理行为。根据Cochrane系统评价标准和澳大利亚循证护理中心(JBI)标准对纳入文献进行质量评估。应用RevMan 5.4软件进行Meta分析。结果 纳入4项RCT研究,共190例受试者。各项指标文献不足,不能进行Meta分析。两项研究显示,犬辅助干预有助于改善FAM-III-GS评分。结论 犬辅助干预可以改善孤独症家庭功能。     

Effect of L1-79 on Core Symptoms of Autism Spectrum Disorder: A Case Series

PurposeThis study examines the effects of the tyrosine hydroxylase inhibitor L1-79, a racemic formulation of α-methylparatyrosine, in patients with autism spectrum disorder (ASD) in a prospective case series. The l-isomer formulation of α-methylparatyrosine, metyrosine, is approved for the management of patients with pheochromocytoma.MethodsSix male and 2 female patients aged 2.75 to 24 years with ASD were treated for 8 weeks at L1-79 doses ranging from 90 to 400 mg thrice daily. Assessments at weekly intervals included the Aberrant Behavior Checklist–Community (ABC-C), Connor's Parent Rating Scale (CPRS), and Clinical Global Impressions (CGI) scale. The Autism Diagnostic Observation Schedule (ADOS) was administered at baseline and week 10.FindingsThe ABC-C and CPRS scores improved between baseline and end of study for 7 of 8 participants; most participants' assessment scores decreased. At week 8, the CGI efficacy index was 05 for 6 of 8 participants, indicating modest improvement with at least partial resolution of symptoms and no medication adverse effects, and 09 for 2 participants, indicating minimal improvement and no change in status or care needs, without adverse effects. The mean ADOS scores improved by ≥31% for 4 of the 6 participants tested, with 1 patient experiencing a 47% improvement. Seven of the 8 participants previously taking psychotropic medications were stable without their legacy medications while receiving L1-79, and 1 patient resumed a single legacy medication at a lower dose. Three adverse events were reported; symptoms were mild and resolved without change in therapy.ImplicationsThese results suggest L1-79 may be a tolerable and effective treatment for the core symptoms of ASD, which must be confirmed with double-blind studies.     

Autism Spectrum Disorder Screening and Early Action

Since its diagnostic inception, autism has garnered stigma and fear, often to the exclusion of action. Early detection and treatment of autism spectrum disorders have become crucial priorities of the National Institutes of Health. The primary care provider is the point of entry to the health care system for infants/children showing risk factors for autism spectrum disorders and/or symptoms of the disorder. Despite the existence of low-cost, well-tested developmental screening tools, many primary care providers rely solely on clinical judgment to ascertain developmental status. Current best screening practices were determined by a review of the literature. Key recommendations are highlighted.     

Effects of Exercise Interventions on Stereotypic Behaviours in Children with Autism Spectrum Disorder

Purpose:

The purpose of this systematic review was to synthesize evidence from studies examining the effect of exercise interventions on stereotypic behaviours in children with autism spectrum disorder (ASD).

Methods:

Only exercise-related physical therapy (PT) interventions were included. A multifaceted search strategy identified studies published between 1980 and 2007. Quality was assessed using the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale, the Clinical Relevance Tool for Case Studies, and the Quality, Rigour or Evaluative Criteria tool.

Results:

Seven studies (1982–2003) met our inclusion criteria; four of these used single-subject research designs, two were group studies, and one was a case study. Ages and behavioural characteristics of the children (N = 25) varied among the studies. Levels of evidence ranged from II to V (of a possible I–V). Study quality scores ranged from 2 to 5 (range: 0 to 7); mean = 3.9, mode = 5. Few studies in this area of PT practice have been published, and those identified scored low levels of rigour on the AACPDM criteria.

Conclusions:

Research suggests that exercise provides short-term reductions of stereotypic behaviours in children with ASD. Future research with stronger evidence levels, greater rigour, and longer-term outcome assessment is required to determine specific exercise parameters.