Lv Ying-Bo, Cheng Wei, Wang Meng-Hui, Wang Xiao-Min, Hu Yan-Li, Lv Lan-Qiu
Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China.
World J Clin Cases. 2023 Jun 26;11(18):4267-4276. doi: 10.12998/wjcc.v11.i18.4267.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders in child and adolescent psychiatry, with a prevalence of more than 5%. Despite extensive research on ADHD in the last 10 to 20 years, effective treat-ments are still lacking. Instead, the concept of ADHD seems to have become broader and more heterogeneous. Therefore, the diagnosis and treatment of ADHD remains challenging for clinicians.
To investigate the effects of a multimodal integrated intervention for children with ADHD.
Between March 2019 and September 2020, a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility, two of whom revoked their consent. A case-control study was conducted in which the children were equally assigned, using a randomized number table, to either a medication group (methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets) or a multimodal integrated intervention group (medication + parent training + behavior modification + sensory integration therapy + sand tray therapy), with 49 patients in each group. The clinical endpoint was the efficacy of the different intervention modalities.
The two groups of children with ADHD had comparable patient characteristics ( > 0.05). Multimodal integrated intervention resulted in a significantly higher treatment efficacy (91.84%) than medication alone (75.51%) ( < 0.05). Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone ( < 0.05). The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group ( < 0.05). Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone ( < 0.05).
Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children. It enhanced their memory and attention with high safety and parental satisfaction, demonstrating good potential for clinical promotion.
注意力缺陷多动障碍（ADHD）是儿童和青少年精神病学中最常见的疾病之一，患病率超过5%。尽管在过去10到20年里对ADHD进行了广泛研究，但仍缺乏有效的治疗方法。相反，ADHD的概念似乎变得更加宽泛和多样化。因此，ADHD的诊断和治疗对临床医生来说仍然具有挑战性。
探讨多模式综合干预对ADHD儿童的影响。
2019年3月至2020年9月，对我院诊断并治疗的100例ADHD儿童进行资格评估，其中2例撤销同意。进行病例对照研究，使用随机数字表将儿童平均分为药物治疗组（盐酸哌甲酯缓释片和盐酸托莫西汀片）或多模式综合干预组（药物治疗+家长培训+行为矫正+感觉统合治疗+沙盘治疗），每组49例。临床终点是不同干预方式的疗效。
两组ADHD儿童的患者特征具有可比性（P>0.05）。多模式综合干预的治疗有效率（91.84%）显著高于单纯药物治疗（75.51%）（P<0.05）。接受多模式综合干预的儿童在康纳斯父母症状问卷和韦斯功能损害评定量表中的得分低于单纯药物治疗的儿童（P<0.05）。多模式综合干预组儿童的感觉统合量表得分高于药物治疗组儿童（P<0.05）。接受多模式综合干预的儿童比单纯药物治疗的儿童依从性更高、家庭满意度更高且不良事件发生率更低（P<0.05）。
多模式综合干预有效缓解了儿童ADHD相关症状。它以高安全性和家长满意度提高了儿童的记忆力和注意力，显示出良好的临床推广潜力。
