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L-肌肽作为注意缺陷多动障碍儿童和青少年辅助治疗的随机双盲安慰剂对照临床试验

l-Carnosine as Adjunctive Therapy in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

作者信息

Ghajar Alireza, Aghajan-Nashtaei Farinaz, Afarideh Mohsen, Mohammadi Mohammad-Reza, Akhondzadeh Shahin

机构信息

Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran .

出版信息

J Child Adolesc Psychopharmacol. 2018 Jun;28(5):331-338. doi: 10.1089/cap.2017.0157. Epub 2018 Feb 22.

Abstract

OBJECTIVES

This study aimed to investigate the efficacy and tolerability of l-carnosine as an add-on to methylphenidate in management of children with attention-deficit/hyperactivity disorder (ADHD).

METHODS

This was an 8-week, randomized, double-blind placebo-controlled study. Fifty-six drug-free children and adolescents aged 6-17 years old with a diagnosis of ADHD entered the study. The patients were randomly assigned to l-carnosine (800 mg/d in two divided doses) or placebo plus methylphenidate (0.5-1.5 mg/kg/d) for 8 weeks. Children were assessed using the Teacher and Parent ADHD Rating Scale-IV (ADHD-RS-IV) at baseline and at weeks 4 and 8 postbaseline.

RESULTS

Fifty patients completed the study, and all had two postbaseline measurements. Using the general linear model repeated measures, significant effect was observed for time × treatment interaction on total and inattention subscales of the Parent ADHD-RS (Greenhouse-Geisser corrected: F = 3.783, df = 1.444, p = 0.041 and F = 4.032, df = 1.600, p = 0.030). Improvements in the Teacher ADHD-RS were not significantly different between the two groups in total (Greenhouse-Geisser corrected: F = 0.200, df = 1.218, p = 0.705), as well as inattention and hyperactivity subscale scores (p = 0.956 and 0.281, respectively). The frequency of side effects was not significantly different between the two treatment arms.

CONCLUSIONS

l-carnosine, as a supplementary medication, might be beneficial in treatment of children with ADHD. However, further investigations and different doses of l-carnosine are required to replicate these findings in children with ADHD.

摘要

目的

本研究旨在探讨左旋肌肽作为哌甲酯辅助药物治疗注意力缺陷多动障碍(ADHD)患儿的疗效和耐受性。

方法

这是一项为期8周的随机双盲安慰剂对照研究。56名年龄在6至17岁、诊断为ADHD的未服用过药物的儿童和青少年进入该研究。患者被随机分配接受左旋肌肽(800毫克/天,分两次服用)或安慰剂加哌甲酯(0.5 - 1.5毫克/千克/天)治疗8周。在基线以及基线后第4周和第8周,使用教师和家长ADHD评定量表第四版(ADHD-RS-IV)对儿童进行评估。

结果

50名患者完成了研究,且所有人都有两次基线后测量数据。使用一般线性模型重复测量,观察到时间×治疗交互作用对家长ADHD-RS总分和注意力不集中分量表有显著影响(经Greenhouse-Geisser校正:F = 3.783,自由度 = 1.444,p = 0.041;F = 4.032,自由度 = 1.600,p = 0.030)。两组在教师ADHD-RS总分(经Greenhouse-Geisser校正:F = 0.200,自由度 = 1.218,p = 0.705)以及注意力不集中和多动分量表得分(分别为p = 0.956和0.281)方面的改善无显著差异。两个治疗组的副作用发生率无显著差异。

结论

左旋肌肽作为一种辅助药物,可能对ADHD患儿的治疗有益。然而,需要进一步研究以及不同剂量的左旋肌肽来在ADHD患儿中重复这些发现。

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