目的 探討地牡寧神口服液聯(lián)合托莫西汀治療兒童注意力缺陷多動(dòng)障礙的臨床療效。方法 回顧性分析2018年2月—2020年11月在南陽市中心醫(yī)院進(jìn)行治療的94例注意力缺陷多動(dòng)障礙患兒的臨床資料，根據(jù)用藥差別分為對(duì)照組和治療組，每組各47例。對(duì)照組口服鹽酸托莫西汀膠囊，體質(zhì)量在70 kg下的患兒每日初始劑量為0.5 mg/kg，3 d后增加至1.2 mg/kg，單次服藥，每日總劑量不可超過1.4 mg/kg；體質(zhì)量大于70 kg的患兒每日初始總劑量為40 mg，3 d后可增加至目標(biāo)劑量80 mg/d，單次服藥，每日總劑量不可超過100 mg。治療組在對(duì)照組基礎(chǔ)上口服地牡寧神口服液，3～5歲5 mL/次，6～14歲10 mL/次，15歲以上15 mL/次，3次/d。兩組均經(jīng)12周治療。觀察兩組的臨床療效，比較兩組中醫(yī)癥候改善時(shí)間和相關(guān)評(píng)分。結(jié)果 治療后，治療組的總有效率是97.87%，顯著高于對(duì)照組的82.98%（P<0.05）。經(jīng)治療，治療組在多動(dòng)不寧、注意力不集中、少眠多夢(mèng)、手足心熱、盜汗改善時(shí)間上均顯著短于對(duì)照組（P<0.05）。經(jīng)治療，兩組SNAP-Ⅳ評(píng)分、多動(dòng)指數(shù)、CGI評(píng)分均較治療前顯著降低，但劃消測(cè)驗(yàn)顯著升高（P<0.05）；治療后，治療組相關(guān)量表積分改善優(yōu)于對(duì)照組（P<0.05）。結(jié)論 地牡寧神口服液聯(lián)合鹽酸托莫西汀膠囊治療兒童注意力缺陷多動(dòng)障礙可有效改善患兒相關(guān)癥候，有利于改善患兒沖動(dòng)、多動(dòng)的行為癥狀和認(rèn)知能力，有著良好的臨床應(yīng)用價(jià)值。

Objective To investigate the effect of Dimu Ningshen Oral Liquid combined with tomoxetine in treatment of attention deficit hyperactivity disorder in children. Methods A retrospective analysis was performed on the clinical data of 94 children with ADHD treated in Nanyang Central Hospital from February 2018 to November 2020, and they were divided into control group and treatment group according to medication difference, with 47 cases in each group. Patients in the control group were po administered with Atomoxetine Hydrochloride Capsules, for children with body weight of 70 kg, the initial daily dosage was 0.5 mg/kg and increased to 1.2 mg/kg after 3 d. The total daily dosage should not exceed 1.4 mg/kg for a single dosage. For children with body weight greater than 70 kg, the initial daily total dosage was 40 mg/d, which could be increased to the target dosage of 80 mg/d after 3 d. The total daily dosage should not exceed 100 mg for a single dosage. Patients in the treatment group were po administered with Dimu Ningshen Oral Liquid on the basis of the control group, 3 — 5 years old, 5 mL/time, 6 — 14 years old, 10 mL/time, 15 mL/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time and correlation score of TCM symptoms were compared between the two groups. Results After treatment, the total effective rate of treatment group was 97.87%, significantly higher than that of control group 82.98% (P<0.05). After treatment, the treatment group was significantly shorter than the control group in the improvement time of Chinese medicine symptoms such as hyperrestlessness, inattention, less sleep and more dreams, hand, foot and heart heat, night sweat (P<0.05). After treatment, SNAP-Ⅳ score, hyperactivity index, and CGI score in two groups were significantly decreased compared with before treatment, but exclusion test was significantly increased (P<0.05). After treatment, the improvement of relevant scale score in the treatment group was better than that in the control group (P<0.05). Conclusion Dimu Ningshen Oral Liquid combined with Atomoxetine Hydrochloride Capsules in the treatment of attention deficit hyperactivity disorder in children can effectively improve the related symptoms of children, and is beneficial to improve the behavioral symptoms and cognitive ability of impulsive, hyperactive children, which has a good clinical application value.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（LHGJ20200667）