摘要
目的 探讨脑电反馈治疗注意缺陷多动障碍 (ADHD)的有效性及特点。方法 将符合美国精神障碍诊断与统计手册第 3版修订本标准的 5 7例ADHD患儿 ,按就诊序号的奇偶数分为脑电反馈治疗 (反馈组 ,2 8例 )和哌甲酯 (以下简称利他林 )治疗 (利他林组 ,2 9例 ) ,疗程为 3～ 4个月 ,随访1～ 3个月 ;采用行为问卷、副作用量表、韦氏智力测查、注意变量检测 (TOVA)、定量脑电图等工具于治疗前、中、后及随访时进行疗效评定。结果 经过治疗两组行为问卷评分均明显减少 (P <0 0 5 )。其中利他林组减分更多 ,但停药后分值上升 ;反馈组为持续减分 (治疗前、后及随访时的多动指数 ,利他林组分别为 16 14± 4 6 4,4 2 3± 1 45 ,13 5 2± 5 0 8;反馈组分别为 16 0 4± 6 31,9 2 6± 3 0 9,8 76±3 79。TOVA亦有类似改变。利他林组的副作用出现率高 (82 % ) ,而反馈组未发现明显副反应。随访时反馈组韦氏智测中C因子分增加 [治疗前为 (93 7± 13 3)分 ,随访时为 (10 6 3± 14 1)分 ,P <0 0 1],额区和右侧半球α波增多 ,δ波减少 ;利他林组尚无此现象。结论 脑电反馈治疗ADHD的疗效肯定 ,与利他林治疗相比 ,虽起效较慢但作用相对持久 ,且无副作用 。
Objective To explore the effectiveness and the characteristics of EEG biofeedback treatment on attention deficit hyperactivity disorder (ADHD) Methods Fifty seven children with ADHD diagnosed according to the DSM Ⅲ R criteria were enrolled in the study They were randomly assigned to the EEG biofeedback treatment (EEG) group (28 cases) and the Ritalin (MED) treatment group (29 cases) They were evaluated before, during, and after treatment with Conner′s behavior rating scale, side effects scale, Wechsler Intelligence Scale, TOVA, and Quantitative EEG All the subjects were followed up in one to three months after treatment Results (1) The score of Conner′s Rating Scale decreased significantly in both groups The MED group showed a relatively more decrease of scores in the behavior scale, but rebounded when the treatment stopped (hyperactivity index score for example: pretreatment 16 14±4 64,post treatment 4 23±1 45,follow up 13 52±5 08), while the EEG group showed a continual improvement (hyperactivity index: pretreatment 16 04±6 31, post treatment 9 26± 3 09, follow up 8 76±3 79) Side effects emerged more frequently (82%) in MED group but none in EEG group (2) Both groups improved significantly on the Omission and Commission level of TOVA ( P <0 05), the MED group made a significant improvement on Variability of Response to medicine ( P <0 01) In follow up, the advantage was replaced and became even worse on Omission compared to pretreatment The EEG group improved continuously (3) The EEG group gained a significant increase in score of the Free from Distractibility Factor of Wechsler Intelligence Scale (pretreatment 93 7±13 3,follow up 106 3±14 1, P <0 01) (4) A significant increase of relative power of 8 13 Hz waves and decrease of 0 4 Hz waves was found in EEG group through the Quantitative EEG No such results were found in MED group Conclusion The effectiveness of EEG biofeedback is affirmed Compared to the psycho stimulant Ritalin, it shows slower but relatively permanent effects, and a special effect on improving of attention and the EEG spectrum
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2001年第3期168-171,共4页
Chinese Journal of Psychiatry
基金
国家杰出青年基金资助项目 ( 3972 5 0 10 )
科学技术部攀登计划资助项目 ( 95 专 0 9)
