综合干预治疗对7~14岁注意缺陷与多动障碍患儿执行功能缺陷疗效

刘雪琴; 胡春华; 罗叶; 张萍萍; 黄常荣; 纪惠梅

doi:10.16835/j.cnki.1000-9817.2023.05.022

综合干预治疗对7~14岁注意缺陷与多动障碍患儿执行功能缺陷疗效

doi: 10.16835/j.cnki.1000-9817.2023.05.022

江西省赣州市第三人民医院儿少精神心理科，341000

基金项目:

江西省卫生健康委科技计划项目 SKJP220202952

详细信息

作者简介:
刘雪琴(1988-)，女，江西宜春人，硕士，主治医师，主要研究方向为儿童青少年常见发育障碍、精神心理疾病

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-24
- 修回日期: 2023-02-16
- 网络出版日期: 2023-05-25
- 刊出日期: 2023-05-25

Effect of comprehensive intervention on executive dysfunction in children with attention deficit and hyperactivity disorder aged 7-14 years

Department of Pediatric Psychiatry, the Third People's Hospital of Ganzhou, Ganzhou(341000), Jiangxi Province, China

摘要

摘要: 目的分析综合干预治疗和单纯药物治疗对7~14岁注意缺陷多动障碍(ADHD)患儿执行功能的改善情况，为改善ADHD的干预研究提供基础依据。方法将2021年1月—2022年6月在赣州市第三人民医院就诊的80例ADHD患儿采用随机数字对照法分为研究组和对照组，研究组采用药物和综合干预治疗，对患儿进行每周1次，每次60~90 min，持续12周的感觉统合训练，并对照顾者、学校教师进行相关训练；对照组仅采用药物治疗。干预12周后，应用stroop色-词关联测验、威斯康辛卡片分类测试(WCST)评估患儿执行功能的变化情况。结果研究组患儿干预后，Stroop色-词关联测验三类结果为(3.25±0.98，4.92±1.40，10.17±1.28)个，干预前为(6.47±1.92，8.35±1.25，16.55±1.57)个，差异均有统计学意义(t值分别为12.94，15.36，26.34，P值均 < 0.01)；对照组干预后为(3.95±1.01，5.45±1.15，12.35±0.86)个，干预前为(6.17±1.87，8.10±1.03，16.02±1.38)个，差异均有统计学意义(t值分别为6.76，15.01，16.15，P值均 < 0.01)。研究组干预前，WCST中持续性错误数、非持续性错误数、完成分类数为(47.77±4.50，35.50±2.37，3.97±1.07)个，干预后分别为(31.42±2.01，24.75±2.05，5.05±1.13)个；对照组干预前为(46.45±7.34，34.87±2.29，3.70±1.11)个，干预后为(32.82±2.57，25.55±1.04，4.25±1.48)个，干预前后差异均有统计学意义(t值分别为21.93，22.27，-10.37；10.84，26.81，-6.90，P值均 < 0.01)。在Stroop色-词关联测验错误数和WCST中持续性错误数、非持续性错误数方面，综合干预组较单纯药物治疗组改善更为明显，差异均有统计学意义(t值分别为-2.94，2.29，-9.07，-2.35，-2.06，P值均 < 0.05)。结论对患儿进行训练以及采用综合干预治疗模式，一定程度上可以改善患儿的执行功能。
- 注意力缺陷障碍伴多动 /
- 执行功能 /
- 健康促进 /
- 干预性研究 /
- 儿童
Abstract: Objective To analyze the improvement of executive function in children with attention deficit hyperactivity disorder (ADHD) aged 7-14 years with comprehensive intervention and drug therapy alone, to provide a basis for intervention research to improve ADHD. Methods A total of 80 children with ADHD treated in the Third People's Hospital of Ganzhou from January 2021 to June 2022 were randomly divided into intervention group and control group. The intervention group received drug and comprehensive intervention therapy, and sensory integration training once a week for 60 to 90 min each for 12 weeks, and conduct related training for caregivers and school teachers, the control group received only drug therapy. The changes of executive function were assessed by the stroop color-word association test and the Wisconsin Card Sorting Test (WCST) after 12 weeks of intervention. Results After intervention, the results of the Stroop color-word test in the intervention group (3.25±0.98, 4.92±1.40, 10.17±1.28) showed statistically significant differences (t=12.94, 15.36, 26.34, P < 0.01) compared with those before intervention (6.47±1.92, 8.35±1.25, 16.55±1.57). There were also statistically significant differences (t=6.76, 15.01, 16.15, P < 0.01) in the control group (3.95±1.01, 5.45±1.15, 12.35±0.86) compared to those before intervention (6.17±1.87, 8.10±1.03, 16.02±1.38). Before intervention, the number of perseverative errors, non-perseverative errors, and completed categories by WCST in the intervention group were (47.77±4.50, 35.50±2.37, 3.97±1.07), and in the control group were (46.45±7.34, 34.87±2.29, 3.70±1.11). After intervention, those of the intervention group and control group were (31.42±2.01, 24.75±2.05, 5.05±1.13) and (32.82±2.57, 25.55±1.04, 4.25±1.48), respectively. There were significant differences in the two groups before and after intervention (t=21.93, 22.27, -10.37; 10.84, 26.81, -6.90, P < 0.01). After intervention, there were significant differences in the number of Stroop color-word test errors, perseverative errors and non-perseverative errors in WCST between the two groups (t=-2.94, 2.29, -9.07, -2.35, -2.06, P < 0.05). Conclusion Through training for children and the therapy model of comprehensive intervention could significantly improve the executive function of children for a certain extent.
- Attention deficit disorder with hyperactivity /
- Executive function /
- Health promotion /
- Intervention studies /
- Child
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表 1 研究组和对照组患儿干预前后执行功能比较(x ±s)

Table 1. Comparison of executive function between the research group and the control group before and after intervention(x ±s)

组别	干预前后	人数	统计值	Stroop			WCST
组别	干预前后	人数	统计值	测试一	测试二	测试三	持续性错误数	非持续性错误数	完成分类数
研究组	干预前	40		6.47±1.92	8.35±1.25	16.55±1.57	47.77±4.50	35.50±2.37	3.97±1.07
	干预后	40		3.25±0.98	4.92±1.40	10.17±1.28	31.42±2.01	24.75±2.05	5.05±1.13
			t值	12.94	15.36	26.34	21.93	22.27	-10.37
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
对照组	干预前	40		6.17±1.87	8.10±1.03	16.02±1.38	46.45±7.34	34.87±2.29	3.70±1.11
	干预后	40		3.95±1.01	5.45±1.15	12.35±0.86	32.82±2.57	25.55±1.04	4.25±1.48
			t值	6.76	15.01	16.15	10.84	26.81	-6.90
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01

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