摘要
目的评价盐酸托莫西汀治疗注意缺陷多动障碍（ADHD）共病Tourette综合征（TS）的疗效。方去对首诊符合美国精神病学会精神障碍诊断和统计手册第4版（DSM-Ⅳ）的ADHD和Ts诊断标准的26例氢儿均采用盐酸托莫西汀治疗，用ADHD父母评定量表和耶鲁综合抽动严重程度量表评估治疗前及治疗第2、l、6、8周的症状评分改善情况，并观察其治疗过程中的不良反应。结果1．治疗前后比较。经盐酸托莫西汀台疗后，注意缺陷评分：第6、8周差异有统计学意义（t=8．41、9．97，P均〈0．05）；多动／冲动评分：第4、6、8周差异均有统计学意义（Z=-4．39、-4．47、-4．46，P均〈0．05）。运动抽动评分：第4、6、8周差异均有统计学意义（t=18．30、18．67、20．32，P均〈0．05）。而发声抽动评分：第2周开始即显示差异有统计学意义（t=5．45，P〈0．05）；功能受损评分：第6、8周差异均有统计学意义（Z=-3．95、-3．94，P均〈0．05）。2．ADHD与Ts比凌。治疗第2周，ADHD和TS的有效率分别为7．69％、15．38％，二者疗效比较差异无统计学意义（X^2=0．188，P〉0．05）。但在第4周评定时，二者疗效分别为19．23％、46．15％。疗效比较差异有统计学意义（X^2=3．923，P〈0．05）。第6、8周二者有效率比较差异均无统计学意义（X^2=0．083、0．103，P均〉0．05）。3．治疗期间，所有病例未出现严重不良反应。结论盐酸托莫西汀对ADHD共病TS有较好疗效，且无明显不良反应。在治疗ADHD方面，多动／冲动起效优于注意力缺陷。在治疗TS方面，发声抽动起效优于运动抽动。ADHD与TS比菠，TS症状改善较ADHD快。但最终疗效相当。
Objective To evaluate the therapeutic efficacy of atomoxetine hydrochloride for attention deficit hyperactivity disorder （ADHD） combined with Tourette syndrome （TS）. Methods Twenty-six cases of children with ADHD combined with TS were firstly diagnosed American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders fourth edition （ DSM-1V ） of ADHD and TS were treated with atomoxetine. The symptoms were improved and conditions were assessed based on the fourth version of ADHD parent rating scale and the severity of Yale comprehensive pumping quantity during pre-treatment,the 2^nd ,4^th ,6^th and the 8^th week of therapeutic courses, respectively. The adverse reaction was observed. Results 1. Compared with pre-treatment, attention deficit scores after treatment were statistically different （ t = 8.41,9.97, all P 〈 0.05 ） in the 6^th ,8^th week of therapeutic courses ; hyperactivity / impulsivity scores were statistically different （ Z = - 4.39, - 4.47, - 4.46, all P 〈 0.05 ） in the 4^th, 6^th, 8^th week ; Motor tics scores were statistically different （t = 18.30,18.67,20.32,all P 〈0.05） in the 4^th ,6^th ,8^th week; The vocal tic score：the second weeks already had statistically different（ t = 5.45, P 〈 0.05 ） ; And the impaired function score were statistical significance （ Z = - 3.95, - 3.94, all P 〈 0.05 ） at the 6^th and 8^th week. 2. The effective rate of ADHD and TS was 7.69% and 15.38% , respectively in the 2^th week. The curative effect had no statistical significance （X^2 = 0. 188,P 〉 0.05 ）. But at the fourth week of assessment, and the rates of curative effect were respectively 19.23% and 46.15%. It had statistical significance （X^2 = 3. 923, P 〈 0.05 ）. In the 6^th, 8^th weeks, there was no significant difference between the 2 efficiency （X^2 =0. 083,0. 103 ,all P 〉0.05 ）. 3. During the treatment,no severe adverse reaction had appeared. Conclusions Atomoxetine in ADHD comorbid TS had exact curative effect and no obvious
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第21期1665-1667,共3页
Chinese Journal of Applied Clinical Pediatrics
