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哌甲酯与右旋苯丙胺治疗儿童注意力缺陷多动障碍的双盲交叉试验

Methylphenidate versus dexamphetamine in children with attention deficit hyperactivity disorder: A double-blind, crossover trial.

作者信息

Efron D, Jarman F, Barker M

机构信息

Centre for Community Child Health and Ambulatory Paediatrics, Royal Children's Hospital, Melbourne, Australia.

出版信息

Pediatrics. 1997 Dec;100(6):E6. doi: 10.1542/peds.100.6.e6.

Abstract

OBJECTIVE

To compare methylphenidate (MPH) and dexamphetamine (DEX) in a sample of children with attention deficit hyperactivity disorder (ADHD).

METHOD

A total of 125 children with ADHD received both MPH (0.3 mg/kg twice daily) and DEX (0.15 mg/kg twice daily) for 2 weeks a double-blind, crossover study. Outcome measures were Conners' Parent Rating Scale-Revised, Conners' Teacher Rating Scale-Revised, a Parent Global Perceptions questionnaire, the Continuous Performance Test, and the Barkley Side Effects Rating Scale.

RESULTS

There were significant group mean improvements from baseline score on all measures for both stimulants. On the Conners' Teacher Rating Scale-Revised, response was greater on MPH than DEX on the conduct problems and hyperactivity factors, as well as on the hyperactivity index. On the Conners' Parent Rating Scale-Revised, anxiety was the only factor to differ significantly, in favor of MPH. Parents rated 73% of subjects as globally improved on MPH and 69% improved on DEX, compared with baseline. Overall, 46% of parents chose MPH as the preferred drug, compared with 37% who chose DEX. On the Continuous Performance Test, there was no difference in the number of correct responses or errors between the two drugs.

CONCLUSIONS

Most children with ADHD improve significantly on both MPH and DEX. There was a slight advantage to MPH on most measures.

摘要

目的

在患有注意力缺陷多动障碍(ADHD)的儿童样本中比较哌甲酯(MPH)和右旋苯丙胺(DEX)。

方法

总共125名患有ADHD的儿童接受了MPH(0.3毫克/千克,每日两次)和DEX(0.15毫克/千克,每日两次)治疗,为期2周,这是一项双盲交叉研究。结果测量指标包括康纳斯父母评定量表修订版、康纳斯教师评定量表修订版、家长总体感知问卷、连续操作测试以及巴克利副作用评定量表。

结果

两种兴奋剂在所有测量指标上的组均值均较基线得分有显著改善。在康纳斯教师评定量表修订版中,MPH在品行问题、多动因素以及多动指数方面的反应比DEX更大。在康纳斯父母评定量表修订版中,焦虑是唯一有显著差异的因素,有利于MPH。与基线相比,家长将73%的受试者评定为使用MPH后总体改善,69%评定为使用DEX后改善。总体而言,46%的家长选择MPH作为首选药物,而选择DEX的家长为37%。在连续操作测试中,两种药物在正确反应数量或错误数量上没有差异。

结论

大多数患有ADHD的儿童使用MPH和DEX后均有显著改善。在大多数测量指标上MPH略有优势。

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