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儿童变应性鼻炎治疗对注意缺陷多动障碍的影响。

Effect of Chronic Rhinitis Treatment in Children with Attention-Deficit/Hyperactivity Disorder.

机构信息

Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis, Thailand.

出版信息

J Dev Behav Pediatr. 2023;44(8):e511-e518. doi: 10.1097/DBP.0000000000001206. Epub 2023 Aug 8.

Abstract

OBJECTIVE

The purpose of this study is to examine the effect of chronic rhinitis treatment on attention-deficit/hyperactivity disorder (ADHD) symptoms in children with ADHD.

METHODS

Children and adolescents with ADHD were screened for chronic rhinitis symptoms. Participants with positive chronic rhinitis screening underwent the skin prick test and received rhinitis treatment for 3 months. All participants were evaluated using the parent's and teacher's Vanderbilt ADHD rating scales, total nasal symptom score, and Quality of Life Questionnaire (OSA-18) for pediatric obstructive sleep apnea at pretreatment and posttreatment.

RESULTS

Overall, 140 children and adolescents with ADHD were enrolled and screened for chronic rhinitis. Fifty-four children and adolescents with positive screening results underwent the skin prick test and received rhinitis treatment. After 3 months of treatment, inattentive, hyperactive/impulsive, and total ADHD symptom scores were significantly decreased as reported by parents ( p = 0.031 to <0.001) and teachers ( p = 0.001 to <0.001) compared with those before treatment. A subgroup analysis also showed improvement in ADHD symptoms as reported by parents and teachers in the allergic and nonallergic rhinitis groups. Pearson's correlation coefficient analyses showed positive correlations between improvement in the ADHD symptom scores reported by parents and improvement in the quality of life related to sleep problems from the OSA-18 questionnaire (r = 0.377-0.387).

CONCLUSION

Treating chronic rhinitis can improve ADHD symptoms in children and adolescents with ADHD. Pediatricians should be aware of and treat chronic rhinitis to maximize ADHD symptom control.

摘要

目的

本研究旨在探讨慢性鼻炎治疗对伴有注意缺陷多动障碍(ADHD)儿童 ADHD 症状的影响。

方法

对患有 ADHD 的儿童和青少年进行慢性鼻炎症状筛查。有阳性慢性鼻炎筛查结果的参与者进行皮肤点刺试验,并接受为期 3 个月的鼻炎治疗。所有参与者在治疗前和治疗后分别使用父母和教师 Vanderbilt ADHD 评定量表、总鼻症状评分和儿童阻塞性睡眠呼吸暂停质量生活问卷(OSA-18)进行评估。

结果

共有 140 名患有 ADHD 的儿童和青少年接受了筛查和慢性鼻炎筛查。54 名筛查阳性的儿童和青少年接受了皮肤点刺试验和鼻炎治疗。治疗 3 个月后,父母(p = 0.031 至 <0.001)和教师(p = 0.001 至 <0.001)报告的注意力不集中、多动/冲动和总 ADHD 症状评分均显著降低。亚组分析还显示,在过敏性和非过敏性鼻炎组中,父母和教师报告的 ADHD 症状也有所改善。Pearson 相关系数分析显示,父母报告的 ADHD 症状改善程度与 OSA-18 问卷中与睡眠问题相关的生活质量改善程度呈正相关(r = 0.377-0.387)。

结论

治疗慢性鼻炎可以改善患有 ADHD 的儿童和青少年的 ADHD 症状。儿科医生应该意识到并治疗慢性鼻炎,以最大限度地控制 ADHD 症状。

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