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儿童注意缺陷多动障碍伴情绪问题中西医协同诊治方案的专家建议

Expert advice on an integrated diagnosis and treatment plan using both traditional Chinese and Western medicine for children with attention deficit and hyperactivity disorder accompanied by emotional problems

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【作者】 张劲松赵欣薛征和婧伟孙锦华王瑜沈毅韵张欣邱美慧夏卫萍吴敏

【Author】 ZHANG Jinsong;ZHAO Xin;XUE Zheng;HE Jingwei;SUN Jinhua;WANG Yu;SHEN Yiyun;ZHANG Xin;QIU Meihui;XIA Weiping;WU Min;Department of Clinical Psychology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine;Department of Traditional Chinese Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine;Department of Pediatrics, Shanghai Traditional Chinese Medicine Hospital;Department of Traditional Chinese Medicine, Children’s Hospital of Fudan University;Department of Children’s Psychology, Children’s Hospital of Fudan University;Department of Child Health Care, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine;Hospital of Integrated Traditional Chinese and Western Medicine in Baoshan District;

【通讯作者】 薛征;吴敏;

【机构】 上海交通大学医学院附属新华医院临床心理科上海交通大学医学院附属新华医院中医科上海市中医医院儿科复旦大学附属儿科医院中医科复旦大学附属儿科医院儿童心理科上海交通大学医学院附属儿童医院儿保科上海市宝山区中西医结合医院

【摘要】 儿童注意缺陷多动障碍(attention deficit and hyperactivity disorder, ADHD)往往伴随情绪问题或情绪障碍,这增加了诊疗的复杂性。西医(即现代医学)依据《精神障碍诊断与统计手册(第5版)》(DSM-5)或《国际疾病分类(第11版)》(ICD-11)的标准,对ADHD及其伴随的情绪问题(如焦虑、抑郁)进行诊断,并采用心理治疗或药物治疗;中医(即中国传统医学)则根据辨证分型(如心肝火旺证、痰火内扰证等),运用中药(如丹栀逍遥散、黄连温胆汤)及外治法(针灸、推拿)开展治疗。该文基于中西医协同理念,提出了ADHD伴情绪问题的诊治方案。该方案强调多学科评估,动态调整治疗方案,结合患儿年龄、病情及家庭需求,实现个体化干预。同时,方案涵盖轻度至重度情绪问题的分级治疗策略,并注重疗效评价、安全性监测及家庭社会支持,以此提升ADHD的整体疗效,改善患儿的生活质量。

【Abstract】 Attention deficit and hyperactivity disorder(ADHD) in children is frequently comorbid with various emotional problems or disorders, increasing the complexity of diagnosis and treatment. In Western medicine(modern medicine), diagnoses of ADHD and its comorbid emotional problems(e.g., anxiety, depression) were based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition(DSM-5) or the International Classification of Diseases, 11th edition(ICD-11), employing psychological or pharmacological interventions. Traditional Chinese medicine(TCM) adopts a syndrome differentiation approach(e.g., hyperactivity of heart-liver fire, internal disturbance of phlegm-fire) and utilizes herbal formulations(such as Danzhi Xiaoyao Powder or Huanglian Wendan Decoction) alongside external therapies(e.g. acupuncture,moxibustion, and massage). This article proposes an integrated diagnosis and treatment plan using both Chinese and Western medicine for ADHD with emotional problems. The plan emphasizes multidisciplinary assessment, adaptive treatment planning,and personalized interventions tailored to each child’s age, condition, and family demands. It implements a tiered approach to emotional problems, ranging from mild to severe, while prioritizing treatment efficacy assessment, safety monitoring, and familysocial support, ultimately aiming to optimize ADHD management and enhance patients’ quality of life.

【基金】 上海市卫生健康委员会上海市中医药管理局综合医院中西医协同引导项目(ZXXT-202209)
  • 【文献出处】 教育生物学杂志 ,Journal of Bio-education , 编辑部邮箱 ,2025年04期
  • 【分类号】R749.94
  • 【下载频次】108
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