盐酸托莫西汀治疗儿童多动症合并短暂性抽动障碍的临床效果

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摘要目的观察儿童注意缺陷多动障碍（ADHD）合并短暂性抽动障碍应用盐酸托莫西汀治疗的临床研究。方法采集2016年7月~2018年7月内蒙古自治区精神卫生中心门诊治疗的128例ADHD合并短暂性抽动障碍患儿，按不同治疗方案分为两组，每组64例。对照组服用盐酸哌甲酯治疗，观察组服用盐酸托莫西汀。比较两组疗效、认知功能及不良反应等多项指标。结果治疗2个月后，观察组总有效率高于对照组（P < 0.05）；治疗前两组各项Cormer因子评分比较，差异无统计学意义（P ＞ 0.05），治疗后两组各项Cormer因子评分均较治疗前明显降低（P < 0.05），且观察组学习、行为、焦虑等因子评分低于对照组（P < 0.05）；治疗前两组运动抽动、发声抽动评分比较，差异无统计学意义（P ＞ 0.05），治疗后两组运动抽动、发声抽动评分均较治疗前降低（P < 0.05），且观察组低于对照组（P < 0.05）；治疗前两组认知功能各项因子评分比较，差异无统计学意义（P ＞ 0.05）；治疗后两组认知功能各项因子评分均较治疗前升高（P < 0.05），且观察组算数、编码、数字广度、C因子均高于对照组（P < 0.05）；观察组不良反应总发生率低于对照组（P < 0.05）。结论 ADHD合并短暂性抽动障碍应用盐酸托莫西汀治疗效果显著，能有效改善ADHD，减轻抽动障碍，并纠正患儿认知功能，提高临床疗效，且不良反应少，安全有效。

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	景兰王毅张文静田乐▲

关键词 ：儿童多动性障碍, 短暂性抽动障碍, 盐酸托莫西汀, 盐酸哌甲酯, C-WISC评分

Abstract：Objective To observe the clinical treatment of children with attention deficit hyperactivity disorder (ADHD) complicated by transient tic disorder treated by Tomoxetine Hydrochloride. Methods The clinical data of 128 children with ADHD complicated by transient tic disorder who had received treatment in the Outpatient Service of Inner Mongolia Mental Health Center from July 2016 to July 2018 were enrolled in the study, and they were divided into two groups according to the different treatment options, with 64 cases in each group. The control group was treated with Methylphenidate Hydrochloride, whereas the observation group was treated with Tomoxetine Hydrochloride. The efficacy, cognitive function, adverse reactions and other indicators were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group after 2 months of treatment (P < 0.05). There were no statistical differences in the Cormer factor scores between the two groups before treatment (P > 0.05), however, these scores were lower than before treatment in both groups (P < 0.05). The scores of learning, behavior, anxiety and other factors in the observation group were lower than those in the control group (P < 0.05). Before treatment, there was no statistical difference between the two groups in the scores of exercise twitch and vocal twitch (P > 0.05), these scores were reduced in both groups after treatment (P < 0.05), and these scores in the observation group were lower than those in the control group (P < 0.05). There were no statistical differences in the scores of cognitive function between the two groups before treatment (P > 0.05); after treatment, however, the scores were increased than before treatment in both groups (P < 0.05). The counting, coding, digital breadth, and C factor in the observation group were higher than those in the control group (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion For children with ADHD complicated by transient tic disorder, Tomoxetine Hydrochloride is safe, effective and with significant curative effect, which can help improve ADHD, reduce tic disorder, correct cognitive function and enhance clinical efficacy, yet incurring fewer adverse reactions.

Key words： Children with ADHD Transient tic disorder Atomoxetine Hydrochloride Methylphenidate Hydrochloride C-WISC score

基金资助:内蒙古自治区卫生和计划生育委员会科研计划项目（201703074）。

通讯作者: ▲通讯作者

引用本文:

景兰王毅张文静田乐▲. 盐酸托莫西汀治疗儿童多动症合并短暂性抽动障碍的临床效果[J]. 中国医药导报, 2019, 16(17): 54-58.
JIN Lan WANG Yi ZHANG Wenjing TIAN Le▲. Clinical effect of Tomoxetine Hydrochloride for children with ADHD complicated by transient tic disorder. 中国医药导报, 2019, 16(17): 54-58.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I17/54

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