孤独症谱系障碍实验动物模型研究进展

孤独症谱系障碍(ASD)的发生是遗传和环境相互作用的结果。建立不同因素诱发的ASD动物模型,并探讨其行为学、神经环路与分子信号机制,对于揭示ASD的发生机制,开发新型临床干预与治疗策略具有重要参考价值。本文围绕目前国际上常用的ASD实验动物模型及其构建方法进行了系统梳理与总结,以期为深入开展ASD发生机制的基础研究与临床诊疗方案研发提供线索和依据。     

神经免疫相关疾病孤独症谱系障碍的药物治疗与免疫疗法的研究进展

孤独症谱系障碍（autism spectrum disorder, ASD）又称孤独症或自闭症。ASD 患病率的逐年上升,给患者的家庭和社会带来了沉重负担。迄今为止 ASD 的发病机制尚不明确,并且尚无有效的治疗药物。全球已有很多关于 ASD 成因的报道,如遗传因素、免疫因素和环境因素等。其中免疫因素在神经发育、突触形成等过程中发挥重要作用。有很多研究表明在 ASD 中存在着多种免疫异常,如自身抗体的出现、免疫细胞及细胞因子的异常和神经-免疫信号传递异常等,这些异常通常与 ASD 患者的核心症状有关。综述了ASD 的药物治疗及免疫治疗研究的最新进展,以期为 ASD 的治疗研究提供思路。     

高压氧治疗10例儿童孤独症谱系障碍的临床观察

目的探讨高压氧治疗孤独症谱系障碍的临床疗效。方法我院2013年7月至2014年7月10例孤独症谱系障碍(ASD)患者在常规训练的基础上,配合高压氧治疗,10 d为1个疗程,每天1次,2个疗程之间间隔10 d。每个患儿3~5个疗程,高压氧治疗前及治疗后均做孤独症行为评定量表(ABC)及儿童孤独症评定量表(CARS),降低10分以上者为显效,降低5~10分为有效,降低5分以下者为无效。结果 1例显效,4例有效,5例无效。结论 ASD症状越轻,干预的年龄越小,治疗时间越长,效果越好。高压氧治疗孤独症谱系障碍(ASD)确实有一定的临床疗效。     

近10年中医药治疗儿童孤独症谱系障碍综述

通过对近10年来中医药治疗儿童孤独症谱系障碍(ASD)的相关文献进行检索和分析,从病因病机、辨证论治2个方面阐述中医药治疗儿童ASD的研究现状.现有研究证实中医药治疗ASD具有显著疗效,但存在中药的基础实验研究较少、临床循证医学研究缺乏、患儿配合度较低等不足,今后需进一步改进和加强研究,为中医药治疗本病提供科学的理论基...     

孤独症谱系障碍儿童照顾者家庭抗逆力的研究进展

孤独症谱系障碍（ASD）是一种严重的儿童精神发育障碍疾病,预后差,致残率高,需全周期生命支持。长期的康复治疗使孤独症患者家庭长期处于困境中,许多家庭因不能有效应对,导致家庭解体,给个人、家庭和社会带来了沉重负担。家庭成员能否有效应对危机,家庭抗逆力在其中发挥重要作用。家庭抗逆力是指个人或家庭在逆境中积极应对并获得成长和发展的过程。本文从ASD儿童照顾者家庭抗逆力相关内容进行综述,旨在了解国内外ASD儿童照顾者家庭抗逆力的研究现状及影响因素,从而为提高照顾者家庭抗逆力有效干预措施提供参考。     

耳穴埋针联合托莫西汀治疗孤独症谱系障碍儿童注意缺陷多动障碍的临床效果

目的 探究耳穴埋针联合托莫西汀治疗孤独症谱系障碍儿童注意缺陷多动障碍的临床应用价值。方法 选取2021年7月至2022年7月赣州市妇幼保健院儿童神经康复科收治的300例孤独症谱系障碍共病注意缺陷多动障碍患儿为研究对象,按照随机数字表法将其分为A组（100例）、B组（100例）、C组（100例）,A组采用埋针联合口服托莫西汀治疗,B组采用耳穴埋针治疗,C组采用口服托莫西汀治疗。比较三组患儿治疗前后的Conners父母症状问卷评分、Weiss功能性缺陷量表评分,并记录不良反应。结果 三组患儿治疗后的Conners父母症状问卷及Weiss功能性缺陷量表评分均低于本组治疗前,差异有统计学意义（P<0.05）。A组和C组患儿治疗后的Conners父母症状问卷及Weiss功能性缺陷量表评分均低于B组,差异有统计学意义（P<0.05）;A组与C组治疗后的Conners父母症状问卷及Weiss功能性缺陷量表评分比较,差异无统计学意义（P>0.05）。A组发生不良反应14例,C组30例,B组无不良反应发生,三组间比较,差异有统计学意义（P<0.05）。A组患儿托莫西汀平均口服剂量...     

近5年针刺治疗儿童孤独症谱系障碍临床研究进展

回顾近5年针刺治疗儿童孤独症谱系障碍(ASD)的相关文献,从病因病机、单一针刺疗法、综合针刺疗法3个方面进行综述,为ASD患儿提供更为可行的治疗方案。同时指出目前存在的问题,如临床研究的样本量偏少、基础研究较少、有效的实验机制研究不足、远期疗效不确切等,今后需进一步完善对儿童ASD的研究,从而为其提供更为系统的疗效评价标准。     

临床常用药物难治性不良反应的治疗方法

药物不良反应防治措施，近年来已成为临床医务工作者共同关注的课题，也是提高疾病药疗水平的重要步骤之一．现将临床常用药物在应用过程中出现的难治性不良反应防治方法作一概述．1氯氟平所致道居定王氏等[1]对于服用氯氟平所致遗尿症患者，应用甲氛芬酯0．1gtid连用7～10d后改01gqn维持，全部5例均有效，开始起效时间为用药后2～d（平均3d，用药期间患者氯氮平量仍按常现给药。胡氏对于治疗期间服用氯氮平连续出现边尿3次（排除器质性病变者），即服六味地费九1丸bid，3～6周1疗程，共治疗8例，治愈7例。2抗征神病药所致国坐不能彭氏等‘…     

90年代精神分裂症的药物治疗

本文扼要介绍了现今精神分裂症的药物治疗，并综述了抗精神病药发展的最新进展。优化治疗的第一步是增强优化意识和补充已有的治疗标准。佐替平、利培酮、奥氮平和舍吲哚等均是在氯氮平启示下开发的较新药物，它们产生锥体外系副作用较轻。长期维持给药对预防复发是重要的，同时要连续监视伴发的副作用。     

Aripiprazole for treating irritability associated with autism spectrum disorders

ABSTRACT

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a reported prevalence of 1 in 59 people. Its core features are persistent deficits in social communication and restricted, repetitive patterns of behavior or interests. Individuals with ASD have a high incidence of secondary problems with mood lability, tantrums, self-injurious behavior and aggressiveness toward others. Collectively, these behaviors are often referred to as irritability. Many medications have been used to treat irritability in autism, with aripiprazole one of only two medications approved in the USA for this purpose.

Areas covered: Herein, the authors review the evidence supporting the use of aripiprazole for treating irritability in autism, including the pivotal trials leading to regulatory approval and long-term studies conducted post-approval. They utilized PubMed, searching all English language publications since 2000, using the terms aripiprazole, autism, autism spectrum disorder, pervasive developmental disorder, Asperger’s disorder, and irritability, and focused on clinical trials and review articles.

Expert opinion: Multiple studies have shown the clear benefit of aripiprazole in the treatment of irritability in autism disorders compared to placebo. Often underemphasized are the metabolic effects, the proper monitoring for these effects, and the need for periodic reassessment to determine if ongoing treatment is needed.     

The status of pharmacotherapy for autism spectrum disorders

The use of pharmacologic agents as a component of treatment for children and adults with autism spectrum disorders is common and a substantial body of literature describing controlled and open-label clinical trials now exists to guide clinical practice. Empiric evidence of efficacy of risperidone, methylphenidate and some selective serotonin re-uptake inhibitors for maladaptive behaviors commonly associated with autism spectrum disorders has increased substantially in recent years. Preliminary controlled trials of valproate, atomoxetine, α-2 adrenergic agonists and olanzapine are promising. In addition to traditional psychotropic medications, investigators have examined the potential role of a variety of agents with glutamatergic or cholinergic mechanisms, and the results warrant further investigation. Although psychotropic medications are effective in treating some important associated behaviors, evidence of significant impact on the core features of autism spectrum disorders is very limited.     

The status of pharmacotherapy for autism spectrum disorders

The use of pharmacologic agents as a component of treatment for children and adults with autism spectrum disorders is common and a substantial body of literature describing controlled and open-label clinical trials now exists to guide clinical practice. Empiric evidence of efficacy of risperidone, methylphenidate and some selective serotonin re-uptake inhibitors for maladaptive behaviors commonly associated with autism spectrum disorders has increased substantially in recent years. Preliminary controlled trials of valproate, atomoxetine, alpha-2 adrenergic agonists and olanzapine are promising. In addition to traditional psychotropic medications, investigators have examined the potential role of a variety of agents with glutamatergic or cholinergic mechanisms, and the results warrant further investigation. Although psychotropic medications are effective in treating some important associated behaviors, evidence of significant impact on the core features of autism spectrum disorders is very limited.     

Mirror system based therapy for autism spectrum disorders

This paper reviews the present theories and empirical research of autisms’ cognitive research and mirror systems and introduces a new hypothesis about the causes of autism spectrum disorders (ASD): autistic mirror neuron dysfunction hypothesis. ASD subjects show obvious lack of the activation of the mirror system during the task of observation or emotional cognition. It is significant to investigate the mirror system for revealing the causes of autism and it is also helpful for developing new ways to diagnose or treat this disorder.     

干细胞治疗自闭症研究进展

自闭症是一类异质性神经发育障碍,其特征是广泛的认知、情感和神经行为异常、社交和沟通障碍、兴趣受限、重复和刻板的言语和非言语行为。世界范围内每1 000名儿童12例自闭症患者,尽管其发病率不断上升,但目前仍无法治愈。细胞疗法可通过促进组织损伤修复、合成并分泌抗炎细胞因子和抑制凋亡细胞因子、迁移并定植如神经系统替换损伤细胞等机制在自闭症治疗过程中发挥积极作用,其中干细胞的旁分泌机制对自闭症的调节作用最受关注。     

Lurasidone for the treatment of irritability and anger in autism spectrum disorders

Introduction: Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by deficits in social interaction and communication as well as restricted patterns of behaviors and interests. Irritability marked by tantrums, self-injury and aggression occurs frequently in youth with ASD, causing significant parent and caregiver distress. Atypical antipsychotics have been the most studied drug class targeting irritability in ASD. Risperidone and aripiprazole are Food and Drug Administration (FDA)-approved atypical antipsychotics for treatment of irritability in youth with ASD. However, other atypical antipsychotics, such as lurasidone, are often considered for off-label use in the treatment of irritability, whether because of tolerability issues with risperidone and aripiprazole or because of the drug-refractory nature of this symptom cluster.

Areas covered: Following a comprehensive review of the literature this article summarizes information on the efficacy and tolerability of lurasidone as a potential off label treatment of irritability in children and adolescents with ASD. Available data included a 6 week randomized, blind, fixed dose, placebo-controlled study and a case study.

Expert opinion: To date the safety and tolerability of lurasidone in treating irritability in youth with ASD has yet to be established with, lurasidone being the only antipsychotic with published negative placebo-controlled results.     

微小核糖核酸与孤独症谱系障碍的研究进展

孤独症谱系障碍(ASD)是一种以社会交往障碍、交流障碍、局限刻板的行为为特征的神经发育障碍疾病。虽然 ASD病因未明,但是已有研究发现遗传因素在其发病中扮演重要作用,其发病涉及与脑功能和发育相关的多个基因。微小核糖核酸(miRNA)是转录后调控因子,在大脑发育、突触形成和突触可塑性以及记忆形成相关基因的微调中起关键作用。因此,越来越多的研究开始关注 miRNA与 ASD病理生理学之间的遗传和分子联系,这些发现显示出了 miRNA作为 ASD的生物标志物和治疗工具的潜力。该文就 miRNA与 ASD的研究进展作一综述。