随机对照研究电针结合行为疗法治疗学龄前儿童注意缺陷多动障碍
Randomized-controlled study of treating attention deficit hyperactivity disorder of preschool children with combined electro-acupuncture and behavior therapy.
机构信息
Department of Rehabilitation Medicine, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
出版信息
Complement Ther Med. 2010 Oct;18(5):175-83. doi: 10.1016/j.ctim.2010.08.002. Epub 2010 Aug 30.
OBJECTIVE
To study the effectiveness of electro-acupuncture with behavior therapy on preschool children with attention deficit hyperactivity disorder (ADHD).
METHODS
180 preschool children with ADHD diagnosed by DSM-IV were classified into three subtypes: predominantly inattentive subtype (PI subtype, 60 cases), predominantly hyperactive-impulsive subtype (HI subtype, 60 cases) and combined subtype (CT subtype, 60 cases). In each subtype, the patients were recruited randomly into experimental group, which received electro-acupuncture and behavior therapy; and control group, which received sham electro-acupuncture and behavior therapy. The treatment efficacy was evaluated by measuring the change in core symptoms of ADHD according to the standard enacted by the national traditional Chinese medicine committee after 12 courses of treatment (lasted 12 weeks) and relapse rate was evaluated after a half-year follow up.
RESULTS
(1) In PI subtype, 11 cases showed effectiveness with treatment and 12 cases showed improvement with treatment among experimental group, while five cases showed effectiveness and 12 cases showed improvement among control group; in HI subtype, 10 cases showed effectiveness and 17 cases showed improvement among experimental group, while four cases showed effectiveness and 14 cases showed improvement among control group; in CI subtype, 12 cases showed effectiveness and 12 cases showed improvement among experimental group, while five cases showed effectiveness and 12 cases showed improvement among control group; The overall comparison manifested that the efficacy of experimental group was better than that of control group (p<0.05). (2) The core symptoms of experimental group were significantly decreased than that of control group at half-year follow up (p<0.05).
CONCLUSION
The treatment of ADHD in preschool children with electro-acupuncture combining behavior therapy has positive effect in reducing symptoms of ADHD. Adverse events are mild to patients. It is recommendable for this combined therapy, while multi-center RCT needs to be further studied.
目的
研究电针结合行为疗法治疗学龄前儿童注意缺陷多动障碍（ADHD）的疗效。
方法
采用 DSM-IV 诊断的 ADHD 学龄前儿童 180 例，分为注意缺陷为主型（PI 型，60 例）、多动冲动为主型（HI 型，60 例）和混合型（CT 型，60 例）。各亚型随机分为电针结合行为疗法治疗组和电针结合假穴位刺激行为疗法对照组，每组 60 例。疗程 12 周，共 12 个疗程。治疗结束后，根据国家中医药管理局颁布的 ADHD 疗效评定标准，评定核心症状变化，半年后随访复发率。
结果
（1）PI 型：治疗组显效 11 例，有效 12 例，进步 12 例；对照组显效 5 例，有效 12 例，进步 14 例。HI 型：治疗组显效 10 例，有效 17 例，进步 17 例；对照组显效 4 例，有效 14 例，进步 14 例。CT 型：治疗组显效 12 例，有效 12 例，进步 12 例；对照组显效 5 例，有效 12 例，进步 12 例。总有效率治疗组优于对照组（p<0.05）。（2）半年后随访，治疗组核心症状较对照组明显减少（p<0.05）。
结论
电针结合行为疗法治疗学龄前儿童 ADHD 疗效确切，能显著改善 ADHD 核心症状，不良反应轻，值得临床推广应用，尚需多中心 RCT 进一步研究。
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