益智口服液对智能迟缓儿童智力结构的影响

摘要

背景:儿童智能迟缓是由分类智商中操作智商、言语智商等项目组成总智商的智力结构的低下,一些研究证实中药的某些复方组合成份对其有较好的干预效应.目的:观察益智口服液对智能迟缓儿童智力结构的影响.设计:以患儿为研究对象的同期对照研究.单位:一所省级的中医学院儿科教研室,一所省级康复中心.对象:病例选择2002-01/07,在甘肃省康复中心医院和甘肃中医学院附属医院门诊,以CCMD-Ⅱ-R提出的智能迟缓诊断标准确诊为智能迟缓者的6～16岁兰州市城关区辅读学校学生,能够接受药物及训练治疗,非先天遗传性染色体疾病者74例,男47例,女27例.分为治疗组33例,对照组20例,单纯教育训练组21例.方法:治疗组33例均服益智口服液,小于10岁每次服15 mL,10～14岁每次20 mL,14岁服以上者每次服25 mL,3次/d,接受特殊教育训练.对照组20例患儿均口服乙-吡咯烷酮乙酰胺,0.4g/次,3次/d,接受特殊教育训练,单纯教育训练组21例患儿只接受与治疗组、对照组患儿相同的特殊教育.3个月为一疗程.采用中国-韦氏儿童智力量表(C-WISC)及专用工具评估3组治疗前后总智商及分类智商中操作智商、言语智商智力测试,进行组间对照比较.主要观察指标:3组总智商改善情况及言语及操作智商提高值.结果:74例入选,无脱落.①总智商改善情况:治疗组治疗前后(44.7±9.8,51.8±11.5)t=2.701,P＜0.01.对照组治疗前后(43.8±14.0,51.0±13.6)t=1.680,P＞0.05.单纯教育训练组治疗前后(41.6±7.8,45.2±10.6)t=1.561,P＞0.05.②言语智商提高值:治疗组8.1±5.5,对照组5 3±3 9及单纯教育训练组4.8±4.8,与治疗组比较,P＜0.05.③操作智商提高值:治疗组4.0±3.6与对照组及单纯教育训练组1.7±2 2比较,P＜0.05.④治疗组言语智商提高程度8.1±5.5与操作智商提高4.0±3.6相比,P＜0.01.结论:益智口服液能明显改善及提高智能迟缓儿总智商,对分类智商中的言语智商提高程度优于操作智商.%BACKGROUND: The intelligence retardation in children refers to hypo-intelligence structure of full intelligence quotient(FIQ) composed of performance intelligence quotient(PIQ) and verbal intelligence quotient (VIQ) . It is verified in some researches that some of compound formulas provide better intervention on it.OBJECTIVE: To observe the effect of yizhi koufuye on intelligence structure in children with intelligence retardation.DESIGN: Homochronous controlled study based on children.SETTING: Pediatric department in a provincial college of traditional Chinese medicine and one provincial rehabilitation center.PARTICIPANTS: The cases were selected in Rehabilitative Central Hospital in Gansu Province and Clinic of the Hospital Affiliated to Gansu College of Traditional Chinese Medicine from January to July 2002. They were 74 students in Fudu Schools in Chenguan District, Lanzhou City, aged varied from 6 to 16 years, diagnosed as intelligence retardation according to CCMD-Ⅱ-R proposed Intelligence Retardation Diagnostic Standards, and they were able to accept medical and training treatment and were absent of congenital hereditary chromosome disorders. Of those, 47 cases were males and 27 cases females. They were divided into treatment group of 33 cases,the control of 20 cases and simple educational training group of 21 cases.METHODS: In treatment group of 33 cases, yizhi koufuye was administrated and was taken 15 mL each time for children younger than 10 years old, 20 mL for those between 10 to 14 years old and 25 mL for those over 14years old. In addition, the special educational training was applied. In the control of 20 cases, oral application of piracetam was prescribed, 0.4 g per time, 3 times a day and the special educational training was applied additionally. In simple educational training group of 21 cases, the children only received special education same as those in treatment group and the control. Three months made one session. Chinese-Wechsler Intelligence Scale for Children (C-WISC) and specific devices were used to assess FIQ and PIQ and VIQ in classified IQ in 3 groups before and after treatments, and the control comparisons were carried on among groups.MAIN OUTCOME MEASURES: Improvement of FIQ and improved values of VIQ and PIQ in 3 groups.RESULTS: Totally 74 cases were selected and no one lost. Improvement of FIQ: In treatment group, there were 44.7±9.8 and 51.8 ± 11.5 before and after treatment respectively, t = 2. 701, P ＜ 0.01; In the control, there were 43.8 ± 14.0 and 51.0 ± 13.6 before and after treatment respectively, t = 1. 680, P ＞ 0. 05; In simple educational training group, there were 41.6 ± 7.8 and 45.2 ± 10.6 before and after treatment respectively, t = 1. 561 and P ＞ 0.05. Improved values of VIQ: It was 8.1 ± 5.5 in treatment group, 5.3 ± 3.9 in the control and 4. 8 ± 4. 8 in simple educational training group. P ＜ 0.05 compared with the results in treatment group. Improved values of PIQ: It was 4.0 ± 3.6 in treatment group and P ＜ 0. 05 compared with 1.7± 2. 2 in the control and simple educational training group. Improving extent of VIQ was 8. 1 ± 5. 5 and of PIQ was 4.0 ± 3.6 in treatment group, P ＜ 0. 01.CONCLUSION: Yizhi koufuye improves markedly FIQ of children with intelligence retardation and for the classified IQ, the improving extent of VIQ is superior to that of PIQ.