目的 探討多動(dòng)寧膠囊聯(lián)合托莫西汀治療兒童注意力缺陷多動(dòng)癥的臨床研究。方法 選取2019年4月—2021年4月在駐馬店市中心醫(yī)院婦女兒童醫(yī)院診治的134例注意力缺陷多動(dòng)癥患兒，根據(jù)隨機(jī)數(shù)字表法分為對照組和治療組，每組各67例。對照組患兒口服鹽酸托莫西汀膠囊，0.5 mg/（kg·d），1次/d。治療組患兒在對照組基礎(chǔ)上口服多動(dòng)寧膠囊，3粒/次，3次/d。兩組患兒連續(xù)用藥20 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀好轉(zhuǎn)時(shí)間，血清皮質(zhì)醇（COR）和促腎上腺皮質(zhì)激素（ACTH）水平，Conner簡明癥狀量表（ASQ）評分和斯若佩評估量表（SNAP-IV）評分及不良反應(yīng)情況。結(jié)果 治療后，治療組總有效率明顯高于對照組（P<0.05）。治療后，治療組患兒癥狀好轉(zhuǎn)時(shí)間均早于對照組（P<0.05）。治療后，兩組患兒血清COR、ACTH水平明顯升高（P<0.05），且治療組患兒COR、ACTH水平明顯高于對照組（P<0.05）。治療后，兩組患兒ASQ和SNAP-IV評分明顯下降（P<0.05），且治療組患兒ASQ和SNAP-IV評分明顯低于對照組（P<0.05）。治療期間，治療組不良反應(yīng)發(fā)生率明顯低于對照組（P<0.05）。結(jié)論 多動(dòng)寧膠囊與托莫西汀聯(lián)合治療兒童注意力缺陷多動(dòng)癥可有效改善臨床癥狀，改善注意力和控制力，不良反應(yīng)較小。

Objective To explore the clinical study of Duodongning Capsules combined with atomoxetine in treatment of children with attention deficit hyperactivity disorder. Methods Children (134 cases) with attention deficit hyperactivity disorder in Zhumadian Central Hospital from April 2019 to April 2021 were divided into control and treatment group according to random number table method, and each group had 67 cases. Children in the control group were po administered with Atomoxetine Hydrochloride Capsules, 0.5 mg/(kg·d), once daily. Children in the treatment group were po administered with Duodongning Capsules on the basis of the control group, 3 grains/time, three times daily. Children in two groups were treated for 20 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the levels of serum COR and ACTH, the scores of ASQ and SNAP-Ⅳ and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of serum COR and ACTH in two groups were significantly increased (P < 0.05), and which in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the scores of ASQ and SNAP-IV in two groups were significantly decreased (P < 0.05), and the scores of ASQ and SNAP-IV in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Duodongning Capsules combined with atomoxetine in treatment of children with attention deficit hyperactivity disorder can effectively improve clinical symptoms, ability of attention and control with less side effects.

R985

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201702312）