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针刺与心理干预联合应用对注意缺陷多动障碍患儿注意力、反应抑制及脑血流的影响

[Effect of combination of acupuncture and psychological intervention on attention, response inhibition and cerebral blood flow in children with attention deficit hyperactivity disorder].

作者信息

Zhang Hai-Jun, Dong Xiao-Lei, Zhang Yong-Fa, Fang You-Fu, Zhang Hong-Yu

机构信息

Department of Pediatrics, Weifang Municipal Yidu Central Hospital of Shandong Province, Qingzhou 262500, China.

Department of Pediatrics, Qingzhou Municipal Chinese Medicine Hospital of Shandong Province.

出版信息

Zhongguo Zhen Jiu. 2021 Apr 12;41(4):400-4. doi: 10.13703/j.0255-2930.20200424-k0004.

Abstract

OBJECTIVE

To observe the clinical curative effect on attention deficit hyperactivity disorder (ADHD) and explore the relevant mechanism of acupuncture in treatment.

METHODS

A total of 100 ADHD children were randomized into an observation group (50 cases, 2 cases dropped off) and a control group (50 cases, 1 case dropped off). In the control group, the routine psychological intervention was used. In the observation group, on the base of the treatment as the control group, acupuncture was applied to Taichong (LR 3), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Baihui (GV 20), Sishencong (EX-HN 1), etc., once daily, for 3 months. The Cambridge neuropsychological tests automated battery (CANTAB) was adopted to evaluate attention and response inhibition in two groups before and after treatment. Digi-Lite color transcranial Doppler was used to measure cerebral arterial blood velocity. The therapeutic effect was compared between the two groups.

RESULTS

Regarding evaluation of attention, the mean delay time in the observation group after treatment was shorter than that before treatment and that in the control group separately (<0.05), and rapid visual information processing A' statistics (RVP A') value was higher than that before treatment and that in the control group separately (<0.05). For evaluation of response inhibition, the number of Go signal error, the time of stop signal response and the number of stop Go signal error after treatment were all reduced as compared with those before treatment in the two groups (<0.05). The number of stop signal error was also reduced after treatment as compared with that before treatment in the observation group (<0.05). The number of Go signal error and the number of stop signal error in the observation were lower than those in the control group (<0.05). After treatment, the average flow velocity of bilateral posterior cerebral artery (PCA) was increased than that before treatment in the two groups (<0.05). The average flow velocity of the left middle cerebral artery (MCA-L) and bilateral anterior cerebral artery (ACA) after treatment was increased than that before treatment in the observation group (<0.05), and the average flow velocity of left PCA, MCA-L and bilateral ACA in the observation group was faster than that in the control group (<0.05). The total effective rate was 90.5% (19/21) in the observation group, remarkably higher than 50.0% (11/22) in the control group in children with attention deficit (<0.05). The total effective rate was 83.3% (40/48) in the observation group, also higher than 63.3% (31/49) in the control group (<0.05).

CONCLUSION

Acupuncture combined with psychological intervention may improve attention and response inhibition in ADHD children, which is possibly related to the regulation of cerebral blood flow.

摘要

目的

观察针刺治疗注意力缺陷多动障碍(ADHD)的临床疗效,探讨针刺治疗的相关机制。

方法

将100例ADHD患儿随机分为观察组(50例,脱落2例)和对照组(50例,脱落1例)。对照组采用常规心理干预。观察组在对照组治疗基础上,针刺太冲(LR 3)、内关(PC 6)、神门(HT 7)、三阴交(SP 6)、百会(GV 20)、四神聪(EX-HN 1)等穴位,每日1次,治疗3个月。采用剑桥神经心理测试自动成套系统(CANTAB)评估两组治疗前后的注意力和反应抑制能力。使用Digi-Lite彩色经颅多普勒测量脑动脉血流速度。比较两组的治疗效果。

结果

在注意力评估方面,观察组治疗后的平均延迟时间分别短于治疗前及对照组(<0.05),快速视觉信息处理A'统计量(RVP A')值分别高于治疗前及对照组(<0.05)。在反应抑制评估方面,两组治疗后的Go信号错误数、停止信号反应时间及停止Go信号错误数均较治疗前减少(<0.05)。观察组治疗后的停止信号错误数较治疗前也减少(<0.05)。观察组的Go信号错误数和停止信号错误数低于对照组(<0.05)。治疗后,两组双侧大脑后动脉(PCA)的平均血流速度均较治疗前增加(<0.05)。观察组治疗后左侧大脑中动脉(MCA-L)及双侧大脑前动脉(ACA)的平均血流速度较治疗前增加(<0.05),且观察组左侧PCA、MCA-L及双侧ACA的平均血流速度快于对照组(<0.05)。观察组中注意力缺陷患儿的总有效率为90.5%(19/21),显著高于对照组的50.0%(11/22)(<0.05)。观察组的总有效率为83.3%(40/48),也高于对照组的63.3%(31/49)(<0.05)。

结论

针刺联合心理干预可改善ADHD患儿的注意力和反应抑制能力,可能与调节脑血流有关。

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