丁一芸 王雅璇 周义山 王俊宏

摘要 目的：观察并对比中药及中药联合脑电生物反馈治疗注意力缺陷多动障碍患儿的临床疗效。方法：选取2015年7月至2017年3月在北京中医药大学东直门医院儿科就诊的注意力缺陷多动障碍（ADHD）患儿50例，随机分为中药组和中药+生物反馈组，每组各25例，最终完成临床观察37例。治疗前后进行数字划消、SNAP-IV量表评分、脑电生理检测以及多动指数测试。结果：治疗后，2组在SNAP-IV量表评分、数字划消测试、脑电波频率变化方面均有改善（P<0.05）;多动指数无明显改善。结论：中药+脑电生物反馈、中药治疗2种方案对ADHD治疗均是有效的，其中综合疗法在疾病总体症状较中药单一疗效更佳。

关键词 注意力缺陷多动障碍;静宁颗粒;兴奋剂;脑电生物反馈;疗效机制;认知功能;大脑功能;综合疗法

Clinical Study on Jingning Granules Combined with EEG Biofeedback in the Treatment

of Attention Deficit Hyperactivity Disorder

Ding Yiyun1， Wang Yaxuan2， Zhou Yishan1， Wang Junhong1

（1 Dongzhimen Hospital， Beijing University of Chinese Medicine， Beijing 100700， China; 2 Beijing First Hospital

of Integrated Chinese and Western Medicine， Beijing 100034， China）

Abstract Objective：To observe and compare clinical efficacy of Chinese herbal medicine combined with EEG biofeedback in the treatment of Attention Deficit Hyperactivity Disorder （ADHD）， and to evaluate its efficacy objectively and explore its mechanism. Methods：A total of 50 cases of ADHD children were collected in July 2015 to March 2017 in Dongzhimen hospital of Beijing university of Chinese medicine. Cases were randomly divided into Chinese herbal medicine group and Chinese herbal medicine+EEG biofeedback groups， with 25 cases in each group. Finally， a total of 37 cases were observed clinically. The outcome was evaluated with Number Cancellation Test， Snap-IV scale score Test， Brain Electrophysiological Test and Conners Index of Hyperactivity Test before and after treatment. Results：After treatment， both groups improved in the Snap-IV scale score Test， the Number Cancellation Test and the frequency variation of the brainwave （P<0.05）. The hyperactivity index did not improve significantly. Conclusion：Both groups are effective for ADHD treatment， and the comprehensive treatment is better in the overall symptoms than Chinese herbal medicine.

Key Words Attention deficit hyperactivity disorder （ADHD）; JingNing Granules; EEG biofeedback; Therapeutic mechanism， Cognitive function， Cerebral function， Combining therapy

中圖分类号：R289.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.023

注意力缺陷多动障碍（Attention-deficit Hyperactivity Disorder，ADHD）是一种儿童高发的神经发育障碍性疾病，其特征是与年龄不符的注意力不集中、过度活跃以及情绪冲动。神经认知功能受损被认为是该病的核心功能障碍[1]。主要反映在各种神经认知功能的缺陷中，包括注意力、抑制和工作记忆等方面[2]。神经兴奋剂是目前普遍用于治疗该病的药物，可减少患儿的行为症状，同时改善其认知功能[3]。然而，兴奋剂的应用也存在药物的不良反应，包括睡眠问题、食欲下降、头痛等。此外，对于兴奋性药物的长期疗效也始终存疑。中医辨证治疗该病，以中药治法丰富、疗效确实、不良反应小的优势在ADHD的治疗上受到越来越多家长及患儿的支持。此外，脑电生物反馈是目前国内外推荐的治疗儿童ADHD的非药物治疗方法，研究证实该疗法可以改善其注意力、冲动性、反应速度及稳定性，改善大脑功能[4]。……