心理行为干预联合生物反馈对学龄前注意缺陷多动障碍患儿的疗效分析

黄欣欣; 欧萍; 钱沁芳; 黄艳; 杨式薇; 王艳霞; 黄姗; 王章琼; 谢燕钦

doi:10.7499/j.issn.1008-8830.2019.03.008

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中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (3) : 229-233. DOI: 10.7499/j.issn.1008-8830.2019.03.008

论著·临床研究

心理行为干预联合生物反馈对学龄前注意缺陷多动障碍患儿的疗效分析

黄欣欣¹, 欧萍¹, 钱沁芳², 黄艳², 杨式薇², 王艳霞², 黄姗², 王章琼², 谢燕钦²

作者信息 +

Clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention defcit hyperactivity disorder

HUANG Xin-Xin¹, OU Ping¹, QIAN Qin-Fang², HUANG Yan², YANG Shi-Wei², WANG Yan-Xia², HUANG Shan², WANG Zhang-Qiong², XIE Yan-Qin²

Author information +

文章历史 +

摘要

目的探讨心理行为干预联合生物反馈治疗对学龄前注意缺陷多动障碍（ADHD）患儿的疗效。方法选择注意力缺陷型、多动-冲动型及复合型学龄前ADHD患儿各60例作为研究对象。按照干预措施前瞻性随机分为对照组、心理行为组、生物反馈组和综合组，治疗4个月后评估注意力集中时间及Conners父母量表（PSQ量表）的冲动-多动、多动指数评分。结果治疗后心理行为组、生物反馈组和综合组中，三种类型患儿注意力集中时间均明显增加（P < 0.05）。对于三种类型的患儿，采用生物反馈及综合治疗均可降低冲动-多动评分（P < 0.05）；注意力缺陷型及复合型患儿采用心理行为及综合治疗可降低多动指数评分，多动-冲动型患儿采用心理行为、生物反馈及综合治疗均可降低多动指数评分（均P < 0.05）。结论心理行为干预联合生物反馈治疗可提高ADHD患儿注意力集中水平，改善冲动-多动及多动的行为症状，不同ADHD类型患儿治疗效果略有不同。

Abstract

Objective To study the clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention deficit hyperactivity disorder (ADHD). Methods Sixty children each with inattentive, hyperactive/impulsive or combined type ADHD were enrolled. According to the intervention measure, they were randomly divided into 4 groups:control, psychological and behavioral intervention, biofeedback treatment and comprehensive treatment (psychological and behavioral intervention + biofeedback). Attention concentration time and impulse/hyperactivity and hyperactivity index scores of the Conners Parent Symptom Questionnaire (PSQ) were evaluated after 4 months of treatment. Results The attention concentration time increased in all types children with ADHD after psychological and behavioral intervention, biofeedback treatment or comprehensive treatment (P < 0.05). In children with inattentive ADHD, hyperactive/impulsive ADHD or combined-type ADHD, biofeedback or comprehensive treatment reduced the impulse/hyperactivity index score (P < 0.05). In children with inattentive or combined-type ADHD, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P < 0.05). In children with hyperactive/impulsive ADHD, biofeedback treatment, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P < 0.05). Conclusions In children with ADHD, psychological and behavioral intervention combined with biofeedback treatment can improve the attention concentration and impulsive/hyperactive and hyperactive symptoms. The treatment strategies are slightly different for children with different types of ADHD.

导出引用

黄欣欣, 欧萍, 钱沁芳, 黄艳, 杨式薇, 王艳霞, 黄姗, 王章琼, 谢燕钦. 心理行为干预联合生物反馈对学龄前注意缺陷多动障碍患儿的疗效分析[J]. 中国当代儿科杂志. 2019, 21(3): 229-233 https://doi.org/10.7499/j.issn.1008-8830.2019.03.008

HUANG Xin-Xin, OU Ping, QIAN Qin-Fang, HUANG Yan, YANG Shi-Wei, WANG Yan-Xia, HUANG Shan, WANG Zhang-Qiong, XIE Yan-Qin. Clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention defcit hyperactivity disorder[J]. Chinese Journal of Contemporary Pediatrics. 2019, 21(3): 229-233 https://doi.org/10.7499/j.issn.1008-8830.2019.03.008

参考文献

[1] Catalá-López F, Hutton B, Núñez-Beltrán A, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents:protocol for a systematic review and network meta-analysis of randomized controlled trials[J]. Syst Rev, 2015, 4:19.
[2] 美国精神医学学会. 精神障碍诊断与统计手册[M]. 第5 版. 张道龙, 译. 北京:北京大学出版社, 2014:25-29.
[3] 童连, 史慧静, 臧嘉捷. 中国儿童ADHD流行状况Meta分析[J]. 中国公共卫生, 2013, 29(9):1279-1283.
[4] Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China:a systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1):32.
[5] Sonuga-Barke E J, Brandeis D, Cortese S, et al. Nonpharmacological interventions for ADHD:systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments[J]. Am J Psychiatry, 2013, 170(3):275-289.
[6] Khajehpiri Z, Mahmoudi-Gharaei J, Faghihi T, et al. Adverse reactions of methylphenidate in children with attention defcithyperactivity disorder:report from a referral center[J]. J Res Pharm Pract, 2014, 3(4):130-136.
[7] 刘靖, 郑毅. 中国注意缺陷多动障碍防治指南第2 版解读[J]. 中华精神科杂志, 2016, 49(3):132-135.
[8] 靳彦琴, 姚梅玲, 段桂琴, 等. 脑电生物反馈治疗注意缺陷多动障碍患儿疗效分析[J]. 兰州大学学报(医学版), 2015, 41(1):68-70, 74.
[9] 张慧凤, 张劲松, 帅澜, 等. 学龄前儿童中文版SNAP-IV评定量表父母版的信效度检验[J]. 中国儿童保健杂志, 2016, 24(12):1253-1256.
[10] American Academy of Pediatrics. Subcommittee on AttentionDeficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline:treatment of the school-aged child with attention-defcit/hyperactivity disorder[J]. Pediatrics, 2001, 108(4):1033-1044.
[11] 郑毅, 刘靖. 中国注意缺陷多动障碍防治指南[M]. 第2 版. 北京:中华医学电子音像出版社, 2015.
[12] 王亚. 不同气质类型儿童多动症的相关因素和心理行为干预评估[D]. 安徽:安徽医科大学, 2015.
[13] 陈静. 学龄前儿童注意缺陷多动障碍的行为干预效果观察[J]. 保健医学研究与实践, 2017, 14(5):93-95.
[14] Moreno-García I, Meneres-Sancho S, Camacho-Vara de Rey C, et al. A randomized controlled trial to examine the posttreatment effcacy of neurofeedback, behavior therapy, and pharmacology on ADHD measures[J]. J Atten Disord, 2019, 23(4):374-383.
[15] Daley D, van der Oord S, Ferrin M, et al. Behavioral interventions in attention-defcit/hyperactivity disorder:a metaanalysis of randomized controlled trials across multiple outcome domains[J]. J Am Acad Child Adolesc Psychiatry, 2014, 53(8):835-847.
[16] 高霞, 石元洪, 童萍, 等. 结构式心理行为干预对ADHD学龄儿注意力和多动行为的影响[J]. 齐鲁护理杂志, 2018, 24(9):18-20.
[17] 朱莎, 钟燕, 陈宇, 等. 脑电生物反馈治疗儿童注意缺陷多动障碍87例临床研究[J]. 中国医师杂志, 2016, 18(4):609-611.
[18] 郭洁. 不同治疗方法对儿童注意力缺陷多动障碍疗效的循证评价[J]. 吉林医学, 2015, 36(8):1574.
[19] 赵红伟, 李洁. 行为矫正八步法护理干预在注意缺陷多动障碍患儿中的应用效果[J]. 中国当代医药, 2018, 25(25):189-191, 195.