欢迎访问《中国循证儿科杂志》官方网站，今天是
English Version
中国循证儿科杂志

中国循证儿科杂志 ›› 2022, Vol. 17 ›› Issue (6): 457-462.DOI: 10.3969/j.issn.1673-5501.2022.06.010

• 论著 • 上一篇    下一篇

医校家结合方案治疗注意力缺陷多动障碍的非随机对照试验

李瑜1,李梦瑶1,王胤2,徐贇佳1,吴芷蘅1,朱大倩1
  

  1. 复旦大学附属儿科医院 上海，201102；1 心理科，2 儿科研究院临床试验中心
  • 收稿日期:2022-07-20 修回日期:2022-08-30 出版日期:2022-12-25 发布日期:2022-12-25
  • 通讯作者: 朱大倩
  • 作者简介:zhudaqian2003@163.com

The medicalfamilyschool cooperation model for children with attention deficit hyperactivity disorder：A nonrandomized controlled trial

LI Yu1, LI Mengyao1,  WANG Yin2, XU Yunjia1,  WU Zhiheng1, ZHU Daqian1   

  1. Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China; 1 Department of Psychology, 2 Clinical Test Center of Pediatrics Research Institute
  • Received:2022-07-20 Revised:2022-08-30 Online:2022-12-25 Published:2022-12-25
  • Contact: ZHU Daqia

PDF

458

补充材料

1

摘要： 背景 注意力缺陷多动障碍（ADHD）的治疗强调多模式治疗，我国缺乏医校家结合的分工合作、可操作化强的长效综合干预方式。 目的 探讨医校家结合模式对ADHD患儿注意力核心症状和家校学习生活功能的影响。 设计 非随机对照试验。 方法 干预组实施医校家联合训练方案，基于ADHD医校家长效管理模式及信息平台筛选阳性者并确诊的6~10岁的ADHD患儿；对照组为心理科门诊常规ADHD干预病例，与干预组纳入病例按1∶2进行匹配。2组干预持续4个月，干预期间药物治疗不受限制。 主要结局指标 中文SNAP-Ⅳ父母版量表评分（注意缺陷、多动／冲动和对立违拗）的变化情况。 结果 干预组（n=27）和对照组（n=54）ADHD患儿，年龄、干预前使用药物比例、父母年龄、母亲文化程度、家庭收入差异均无统计学意义，智商差异有统计学意义。干预组干预前后SNAP-Ⅳ 3个分量表评分均降低≥2分，对照组干预前后SNAP-Ⅳ注意力和多动/冲动分量表评分均降低≥2分；干预组较对照组干预前后对立违拗评分减分值差异有统计学意义。2组干预前后WEISS功能缺陷父母版量表（WFIRS-P）全部6个分量表减分值差异均无统计学意义，其中生活技能分量表评分有更明显改善趋势。干预组用药亚组（11例）与未用药亚组（10例）SNAP-Ⅳ 3个分量表评分均降低≥2分，但2个亚组评分降低差异无统计学意义；2组未用药亚组WFIRS-P评分均有下降，干预组未用药亚组较对照组未用药亚组“学习/学校”分量表评分改善明显，差异有统计学意义。干预组除转换因子外，干预后较前执行功能均有提升，差异有统计学意义。 结论 医校家结合方案有助于ADHD患儿核心症状和执行功能的改善。

关键词: 注意力缺陷多动障碍, 医家校结合模式, 干预

Abstract: Background The treatment of attention deficit hyperactivity disorder （ADHD） emphasizes multi-model treatment. For now there is no long-term comprehensive intervention method with the medical-family-school cooperation model in China. Objective To evaluate the improvement effects of the medical-school-family cooperation model on core symptoms and learning and life function at home and school of ADHD patients. Design Non-randomized controlled study. Methods Children with ADHD attending medical-family-school cooperation project (age range 6-10) were selected as the intervention group. The control group matched by the ratio of 1:2 consisted of ADHD outpatients from the Department of Psychology in Children's Hospital of Fudan University. During the 4-month duration of the program, all patients were allowed to receive treatment as usual at their own clinics. Main outcome measures Changes in the scores of Chinese version of SNAP-Ⅳ scale-parent (inattention, hyperactivity/impulsivity and oppositional score). Results Children with ADHD (n=27) in the medical-school-family treatment group did not differ from those in the control group (n=54) in age, pre-intervention drug using rate, parental age, education level of mother, family income, SNAP and WFIRS-P scores before treatment, but diffrences were significant in intelligence quotient. The scores of three subdomain of SNAP-Ⅳ scale decreased by 2 points at least from baseline to the end of treatment in medical-family-school cooperative model intervention group. After the intervention in control group, SNAP-Ⅳ inattention and hyperactivity/impulsivity scores declined by two points at least. Statistically significant differences were obtained in oppositional and total scores. There was no significant difference in the Weiss scores between the two groups before and after treatment, and the difference is close to significance in life skill scores. The scores of three subdomains of SNAP-Ⅳ scale declined by two points at least both in medical-school-family treatment subgroups of no-medication (n=10) and medication (n=11). There was no significant difference in the reduced scores between two subgroups. WFIRS-P scores decreased in the subgroup of no-medication in both two groups, and there was a statistically significant difference between them in the school domain. The medical-family-school cooperation model intervention group showed improved executive functions except shift function with a statistically significant difference. Conclusion The medical-family-school cooperation model could reduce ADHD core symptoms, and improve executive functions.

Key words: Attention deficit hyperactivity disorder, The medical-family-school cooperative model, Intervention