药物联合心理干预对儿童注意缺陷多动障碍认知功能影响的研究

摘要

Objective To study the effect of drugs combined psychological treatment for cognitive function in children with attention deficit hyperactivity disorder(ADHD). And to explore the best intervention model. Methods 102 cases of ADHD were divided into psychological intervention group, single medication group and comprehensive treatment group randomly, then they were respectively treated for three months with psychotherapy, drugs and combination treatment. The cognitive functions were judged by the Continuous Performance Task(CPT) and Chinese Wechsler Intelligence Scale for Children(C-WISC). The side effects were judged by Treatment Emergent Symptom Scale(TESS). Results 85 patients completed the therapies. After treatment for three months,the CPT and the freedom from distractibility factor of C-WISC in three groups were all improved (P < 0.05). Three months after the intervention,CPT and the freedom from distractibility factor of C-WISC in three groups had descendent tendency. The comprehensive treatment had the best effect ( P < 0.05 ), and there were no significant difference between psychotherapy and drugs( P >0. 05). The side effects of psychotherapy group were significantly lower than those of the other groups( P <0. 05) ,but there was no significant difference between drugs and comprehensive treatment groups(P > 0. 05). Conclusion It is indicated that comprehensive therapy can improve cognitive function in children with ADHD, the therapy is superior to psychotherapy or drugs,its safety is higher and it is an ideal intervention mode of ADHD.%目的 研究药物联合心理治疗的干预模式对注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患者认知功能的影响,探讨最佳干预模式.方法 将102例ADHD患儿随机分为心理干预组、药物干预组及综合干预组,分别应用心理治疗、药物治疗和药物联合心理治疗的方法进行干预,疗程3个月.使用持续注意测验、韦氏儿童智力量表对患者的认知功能进行评估,使用不良反应量表评估治疗过程中的不良反应.结果 共85例患者完成治疗；干预3个月后3组患者持续注意测验及C因子得分较干预前有所改善(P＜0.05),干预结束后3个月,3组患者持续注意测验及C因子得分较干预后成绩有所回落(P＜0.05)；综合干预模式对患者认知功能改善作用优于其他两组(P＜0.05),心理治疗与药物治疗对认知功能改善作用相当(P＞0.05)；心理干预组患者不良反应发生率较其他两组低(P＜0.05),药物干预组和综合干预组两组患者不良反应发生率差异无统计学意义(P＞0.05).结论 药物联合心理治疗的干预模式对ADHD患者的认知功能改善效果优于单纯的心理治疗及药物治疗,安全性较高,是理想的ADHD干预模式.