哌甲酯联合ω-3多不饱和脂肪酸治疗注意缺陷多动障碍的临床效果

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摘要目的：探讨哌甲酯联合ω-3多不饱和脂肪酸（PUFA）治疗注意缺陷多动障碍（ADHD）的效果。方法：以符合条件的50例ADHD患儿为研究对象，随机分为2组（A组和B组）。采用二阶段交叉设计试验，第一阶段（试验前3个月）A组患者为干预组（哌甲酯联合ω-3PUFA），B组为对照组（哌甲酯联合安慰剂）；第二阶段（试验后3个月）A组为对照组，B组为干预组。于每个阶段开始、结束时应用SNAP-IV父母等级评定量表评估治疗效果并记录不良反应事件。结果：2组接受哌甲酯联合ω-3PUFA干预后，均表现为注意缺陷评分、多动/冲动评分显著降低，差异均有统计学意义（P＜0.05），而对立违抗评分与对照组比差异无统计学意义（P＞0.05）。二阶段交叉设计的方差分析显示，哌甲酯联合ω-3PUFA和哌甲酯联合安慰剂对注意缺陷评分、多动/冲动评分的影响差异有统计学意义（P＜0.05）。2个阶段中，干预组和对照组的不良事件发生率差异无统计学意义（P＞0.05）。结论：ω-3PUFA是可用于辅助治疗ADHD的有效、安全的方法。

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	金伟敏
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关键词 ： &omega, -3多不饱和脂肪酸；哌甲酯；注意缺陷多动障碍

Abstract：Objective: To explore the effect of combination of methylphenidate and ω-3 polyunsaturated fatty acid (PUFA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Fifty ADHD patients according with the conditions were randomly divided into two groups: group A and group B. Cross-design of two stages (I, II) was used during observation. Group A received methylphenidate and ω-3 PUFA as an intervention group for ahead of 3 months (I stage), while group B as a control group (methylphenidate and placebo). Group B was given ω-3PUFA and methylphenidate in late 3 months (II stage), while Group A as control group. Chinese version of Swanson Nolan and Pelham, Version IV Scale—parent form (SNAP-IV) were used to assess the treatment effect at the beginning and end of each stage. Adverse events were recorded. Results: The two groups both showed a reduction of attention deficit score and hyperactive/impulsive score after receiving methylphenidate and ω-3PUFA intervention (P<0.05), while oppositional defiant score showed no significant difference (P>0.05). Two-period crossover design analysis of variance showed that there was significant difference effect on attention deficit score and hyperactive/impulsive score between combination of methylphenidate and ω-3PUFA and combination of methylphenidate and placebo (P<0.05). In both two phases, the incidence of adverse events had no significant difference between the intervention group and the control group (P>0.05). Conclusion: ω-3PUFA is a safe and effective adjuvant treatment for ADHD children.

Key words： ω-3 polyunsaturated fatty acids methylphenidate attention deficit hyperactivity disorder

收稿日期: 2016-05-03

通讯作者: 金国信，主任医师，Email：zg88776589@163.com。

作者简介: 金伟敏（1982-），男，浙江温州人，主治医师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I2/119

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