论文部分内容阅读
目的观察中枢神经兴奋剂盐酸哌甲酯控释片对儿童注意缺陷多动障碍(ADHD)的临床疗效。方法 2005年6月-2008年12月在本科儿童多动症门诊就诊的ADHD患儿113例。男87例,女26例;年龄(8.1±2.7)岁,其中盐酸哌甲酯控释片治疗组(控释组)86例,速释哌甲酯片治疗组(速释组)27例。分别观察用药后2周及6个月患儿注意力和行为改善情况,以及用药的依从性。分别于治疗前、治疗1个月和6个月随访时对患儿进行视听连续整合测试(IVA-CPT)、Conner′s儿童行为量表、韦氏智力量表进行疗效评价。结果控释组和速释组用药2周内注意力和行为改善分别为91.9%、88.9%,6个月注意力和行为改善分别为96.5%、59.3%;控释组的依从性显著高于速释组。2组治疗1个月综合反应控制商数(FRCQ)、综合注意力商数(FAQ)较治疗前均明显改善(Pa<0.01),控释组6个月随访时FRCQ和FAQ仍保持较高水平。2组治疗1个月Conner′s儿童行为量表6个因子得分较治疗前均明显降低(Pa<0.01),控释组治疗6个月6个因子得分均显著低于速释组(Pa<0.05)。2组治疗6个月韦氏智力评定全量表IQ、言语量表IQ、操作量表IQ均明显上升(Pa<0.01)。2组不良反应均较轻微。结论哌甲酯控释治疗可有效改善ADHD核心症状,长期提高患儿的认知功能和注意力,依从性显著高于速释哌甲酯治疗,药物不良反应轻微。
Objective To observe the clinical effect of central nervous system stimulant methylphenidate controlled release tablets on children with attention deficit hyperactivity disorder (ADHD). Methods From June 2005 to December 2008, 113 ADHD children were admitted to undergraduate ADHD clinics. There were 87 males and 26 females with a mean age of 8.1 ± 2.7 years. Among them, 86 cases were treated with methylphenidate controlled-release tablets (controlled-release group) and 27 cases were treated with immediate-release methylphenidate tablets (immediate release group). Observed two weeks and six months after treatment in children with attention and behavioral improvement, and medication compliance. The therapeutic effects of IVA-CPT, Conner’s Children’s Behavior Scale and Webster’s Intelligence Scale were evaluated before treatment, 1 month and 6 months respectively. Results The improvement of attention and behavior in controlled release group and immediate release group were 91.9% and 88.9% in 2 weeks, respectively, and the improvement of attention and behavior at 6 months were 96.5% and 59.3% respectively. The compliance of controlled release group was significantly higher than that of controlled release group Quick release group. FRCQ and the integrated attention quotient (FAQ) of two groups were significantly improved (P <0.01), the FRCQ and FAQ remained high at 6 months of follow-up in the controlled release group Level. The score of 6 factors in Conner’s Child Behavior Inventory decreased significantly (P <0.01) 6 months after treatment in both groups, and 6 factors in Controlled Release Group were significantly lower than those in immediate release group (Pa < 0.05). The scores of IQ, scale IQ and scale IQ of the two groups were significantly increased (Pa <0.01) after 6 months of treatment. 2 adverse reactions were mild. Conclusion The controlled release of methylphenidate can effectively improve the core symptoms of ADHD, long-term improvement in children’s cognitive function and attention, compliance was significantly higher than the immediate release of methylphenidate treatment, minor adverse drug reactions.