ADHD儿童不同干预方案的疗效对比

目的探讨ADHD患儿不同干预之间的疗效对比研究。方法对符合DSM—IV诊断标准的120例ADHD患儿随机分为三组，分别采用感觉统合治疗、脑电生物反馈治疗、中枢兴奋性药物（专注达）治疗，治疗前后分别采用视听整合连续性测试IVA—CPT测试。瑞文推理测试、ADHD—RS临床疗效评估患儿的总体疗效，比较三组治疗之间以及组间不同阶段的疗效差异。结果感觉统合治疗组对综合反应控制商数（FRCQ）总分提高明显，对多动型ADHD的疗效要优于脑电生物反馈治疗组（P〈0．01），脑电生物反馈治疗组对综合注意力商数（FAQ）总分提高明显，对注意缺陷型ADHD的疗效要优于感觉统合治疗组（P〈0．01），中枢兴奋性药物治疗在治疗1个月综合反应控制商数（FRCQ）、综合注意力商数（FAQ）、ADHD—RS评分减分率较其他组有明显改善（P〈0．01），6个月随访时FRCQ和FAQ仍保持较高水平。对混合型ADHD的疗效要优于感觉统合治疗组和脑电生物反馈治疗组，差异有统计学意义（P〈0．01）。干预六个月后三组的瑞文推理测试得分各自比干预前自身均有明显提高，差异比较有统计学意义。结论感觉统合训练和脑电生物反馈训练以及药物治疗都能帮助改善ADHD患儿的核心症状，药物治疗作用更加迅速、有效，且疗效持久。

To observe the different efficacy of three kinds of treatments for children with attention deficit hyperactivity disorder(ADHD)

Objective To observe the different efficacy of three kinds of treatments for children with attention deficit hyperactivity disorder(ADHD).Methods We diagnosed 120 children who presented hyperactivity,attention problem,in our clinic as ADHD according to DSM-Ⅳ.They were randomly divided into three groups and treated respectively with Sense Ingredient Therapy(SIT),EEG Biofeedbake(EEGB) and Control-Released Methylphenidate Hydrochloride(CRMH).The effectiveness was evaluated before,1-month after treatment and 6-month follow-up with Integrated Visual and Auditory Continuous Performance Test(IVA-CPT),Raven’s Progressive Matrices(RPM) and ADHD-RS.Results 1 Children in SIT group raised significantly in FRCQ total scores.And SIT was more effeciant than EEGB for hyperactivity/impulse type ADHD(P < 0.01).2 Children in EEGB group raised significantly in FAQ total scores.And EEGB was more effeciant than SIT for attention deficit type ADHD.(P < 0.01).3 Children in CRMH group improved significantly in FRCQ,FAQ and ADHD-RS 1-month after treatment.(P < 0.01).And their FRCQ and FAQ total scores remained in high level 6-month follow-up.CAMH was more effeciant than other two kinds of treatment significantly for mixed type ADHD(P < 0.01).In all three groups,Raven Progressive Matrices Test(RPMT)scores enhanced significantly after 6-month treatment.Conclusion Sense Ingredient Therapy(SIT),EEG Biofeedbake(EEGB) and Control-Released Methylphenidate Hydrochloride(CRMH) can all effectively improving core symptoms of ADHD.Among three treatments medical treatment is the fastest,the most effective and last-long one.