饮食干预对孤独症儿童相关症状改善的影响

摘要

目的 探讨饮食干预对孤独症谱系障碍儿童核心症状、 胃肠道症状和变态反应等的影响.方法 采用前瞻性非随机方法,于2014年10月-2015年7月在北京市海淀区阳光友谊儿童康复训练中心纳入孤独症谱系障碍儿童受试者47例,患者均在北京大学第六医院和北京市儿童医院确诊.将受试者分配至禁食组32例和对照组15例,禁食组患儿在常规行为康复训练的基础上接受3个月不耐受食物(主要包括麸质、 蛋、 奶及其他检测出的不耐受食物)禁食,对照组儿童仅接受同等的常规行为康复训练.采用儿童孤独症评定量表(CARS)、 临床语言功能问卷(CLSQ)及其他症状评估问卷调查法比较干预前后各组患儿在孤独症核心症状及胃肠道、 变态反应、 挑食、 兴奋及睡眠障碍症状的改善情况.结果 禁食组患儿干预后3个月CARS评分为29.3±5.2,明显低于干预前的34.4±6.3;禁食组患儿干预后3个月CLSQ表达评分为6.8±2.9,认知评分为7.4±1.9,分别高于干预前的4.2±3.0和5.7±2.4,差异均有统计学意义(均P<0.05);干预前后对照组患儿上述评分差异均无统计学意义(均P>0.05).干预后3个月禁食组患儿胃肠道、 兴奋、 挑食症状的改善例数明显高于对照组,差异均有统计学意义(均P<0.05);干预前后两组间患儿变态反应症状和睡眠障碍的改善例数差异无统计学意义(均P>0.05).结论 禁食不耐受食物可一定程度地缓解孤独症谱系障碍儿童的相关症状,改善患儿的胃肠道、 兴奋、 挑食症状.%Objective To explore the effect of dietary intervention on autistic core symptoms, gastroin-testinal dysfunction, and allergy as well as other related symptoms in children with autism spectrum disorders ( ASD) . Methods A total of 47 ASD children were recruited in this study, with 32 in the dietary intervention group and 15 in the control group. Children in the dietary intervention group received behavior rehabilitation training and were restricted on intolerant food ( including gluten, eggs, milk, and other intolerant food as detected) for three months, while children in the control group only received behavior rehabilitation training. Childhood Autism Rating Scale ( CARS) , Clinical Language State Questionnaire ( CLSQ) and other symptom assessing questionnaires were used to assess the symptom alleviation after the 3-month intervention, including autistic core symptoms, gastrointestinal dysfunction, allergy, choosy in food dysfunction, agitation and sleep disorder. Results CARS scores were significantly lower (34. 4±6. 3 vs. 29. 3±5. 2) and CLSQ expression and cognition scores were significantly higher (4. 2±3. 0 vs. 6. 8±2. 9, 5. 7±2. 4 vs. 7. 4±1. 9) in children in the dietary intervention group, while no statistically significant difference was observed in these scores in the control group. Additionally, as compared to the control group, children in the dietary intervention group showed better improvement in gastrointestinal dysfunction, agitation, and choosy in food. Alleviation of allergy and sleep disorder was not different between these two groups. Conclusion Restricting intolerant food intake could alleviate the core symptoms of ASD and other related symptoms such as gastrointestinal dysfunction, agitation, and choosy in food in ASD children.