目的 探討地牡寧神口服液聯(lián)合阿立哌唑片治療兒童注意力缺陷多動(dòng)障礙的臨床療效。方法 選取河南省兒童醫(yī)院鄭州兒童醫(yī)院在2021年6月—2024年6月收治注意力缺陷多動(dòng)障礙患兒共計(jì)80例。按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各40例。對(duì)照組口服阿立哌唑片，1次/d，初始劑量每次2 mg,2 d后增至5 mg，持續(xù)2周后調(diào)整劑量，維持劑量2片/d，分2次服用。治療組患兒在對(duì)照組的基礎(chǔ)上口服地牡寧神口服液，3～5歲劑量5 mL/次，6～14歲，劑量10 mL/次，15歲以上劑量15 mL/次，3次/d。兩組持續(xù)治療8周。比較兩組患兒的治療效果、多動(dòng)癥狀、注意力功能和血清指標(biāo)。結(jié)果 治療組患兒總有效率為92.50%，明顯高于對(duì)照組的總有效率75.00%，組間差異顯著（P<0.05）。治療后，兩組注意力缺陷評(píng)分、沖動(dòng)–多動(dòng)評(píng)分、對(duì)立違抗評(píng)分均降低（P<0.05），治療組相較于對(duì)照組的注意缺陷多動(dòng)障礙量表（SNAP-Ⅳ）各領(lǐng)域評(píng)分更低（P<0.05）。治療后，兩組的視聽持續(xù)性操作測(cè)試系統(tǒng)（IVA-CPT）注意力商數(shù)、反應(yīng)控制力商數(shù)、視覺商數(shù)均增加（P<0.05），治療組的注意力商數(shù)、反應(yīng)控制力商數(shù)、視覺商數(shù)均大于對(duì)照組（P<0.05）。治療后，兩組的血清腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）、膠質(zhì)細(xì)胞源性神經(jīng)營(yíng)養(yǎng)因子（GDNF）水平升高，血清神經(jīng)元特異性烯醇化酶（NSE）水平降低（P<0.05）；治療組的血清BDNF、GDNF水平高于對(duì)照組，血清NSE水平低于對(duì)照組（P<0.05）。結(jié)論 地牡寧神口服液聯(lián)合阿立哌唑片可提高兒童注意力缺陷多動(dòng)障礙的臨床療效，減輕患兒多動(dòng)癥狀，改善注意力，促進(jìn)神經(jīng)修復(fù)。

Objective To explore the therapeutic effect of Dimu Ningshen Oral Liquid combined with Aripiprazole Tablets in treatment of attention deficit hyperactivity disorder in children. Methods 80 Children with attention deficit hyperactivity disorder admitted to Henan Children’s Hospital, Zhengzhou Children’s Hospital from June 2021 to June 2024, and were divided into control group and treatment group according to the random number table method, with 40 in each group. Children in the control group were po administered with Aripiprazole Tablets, once daily, the initial dose was 2 mg each time, and increased to 5 mg after 2 d. After 2 weeks,the dose was adjusted, and the maintenance dose was 2 tablets daily, which was taken twice. Children in the treatment group were po administered with Dimu Ningshen Oral Liquid on the basis of the control group, with a dose of 5 mL/time for ages 3 — 5, 10 mL/time for ages 6 — 14, and 15 mL/time for ages 15 and above, 3 times daily. Two groups received continuous treatment for 8 weeks. The treatment efficacy, hyperactivity symptoms, attention function, and serum indicators between two groups of children were compared.Results The total effective rate of the treatment group（92.50%） was significantly higher than 75.00% of the control group, with a significant difference between the groups（P＜0.05）. After treatment, the attention deficit score, impulse hyperactivity score, and oppositional defiant score in both groups were decreased（P＜0.05）, and the treatment group had lower Attention Deficit Hyperactivity Disorder Scale（SNAP-IV） scores in various fields（P＜0.05）. After treatment, the attention quotient, reaction control quotient, and visual quotient of the audio-visual continuous operation testing system（IVA-CPT） were increased in both groups（P＜0.05）, and the attention quotient, response control quotient, and visual quotient of the treatment group were all higher than those of the control group（P＜0.05）. After treatment, the levels of serum BDNF and GDNF were increased in both groups, but the levels of serum NSE were decreased（P＜0.05）. The serum levels of BDNF and GDNF in the treatment group were higher than those in the control group, but the serum levels of NSE were lower than those in the control group（P＜0.05）. Conclusion The combination of Dimu Ningshen Oral Liquid and Aripiprazole Tablets can improve the clinical efficacy of attention deficit hyperactivity disorder in children, alleviate hyperactivity symptoms, improve attention, and promote nerve repair.

R971

河南省醫(yī)學(xué)科技攻關(guān)項(xiàng)目(LHGJ2020021837)