【作者】 赵志强；

【导师】 郑毅；

【作者基本信息】 首都医科大学 ， 精神病与精神卫生， 2007， 硕士

【摘要】 目的探讨注意缺陷多动障碍(Attention Deficit Hyperactivity Disorder,ADHD)治疗模式的现状及影响治疗模式选择的相关因素,指导ADHD治疗模式的正确选择。对象与方法来源于2006年1月19日至2006年6月1日北京安定医院儿科门诊ADHD患者。符合DSM-IV诊断标准,男性33例,女性17例,年龄6～18岁,自由选取治疗模式。(1)依据治疗模式进行分组:分为西药治疗组和其它组,分别为26例和24例。(2)依据是否已治疗过分组:分为首次治疗组和已治疗组,分别为33例和17例。(3)依据ADHD分型分组:分为混合型组和注意缺陷为主型组,分别为42例和8例。采用自然观察法,多因素调查与相关分析和综合评估治疗模式选择的影响因素。结果(1)目前治疗现状:发现问题时患儿年龄平均为4.5岁,最初诊治时年龄为8.55±3.14岁,本次就诊时患儿年龄为10.20±3.33岁,第一次选择西药治疗的年龄为10.46±3.15岁,第一次选择中药治疗的年龄为8.33±2.73岁,最初治疗与发现问题时间间隔3.34±3.25年;西药治疗52%,中药治疗40%,无治疗8%。(2)影响就诊时治疗模式选择的因素是患儿年龄和有无信息来源,P值分别为0.004和0.020,OR值分别为1.382和0.156。(3)影响首次治疗患儿的治疗模式选择的因素是患儿年龄和有无信息来源,P值分别0.038和0.034,OR值分别为1.322和0.131。(4)影响ADHD混合型患儿治疗模式选择的因素是有无信息来源和发现问题人,P值分别为0.009和0.013,OR值分别为0.081和0.116。结论(1)目前ADHD治疗模式的选择不科学。(2)影响ADHD治疗模式选择的因素:患儿年龄和有无信息来源。(3)综合医院没有介绍治疗模式的相关知识,或者讲解不清,导致首次治疗与已治疗过的在治疗模式的选择上没有区别。(4)父母对ADHD亚型的忽视,导致不同亚型间在治疗模式的选择上没有区别。加强科学的宣传,正确地指导ADHD治疗模式的选择,是ADHD预后的关键因素,对家庭和社会有显著的影响。更多还原

【Abstract】 ObjectiveTo approach Status of ADHD treatment mode and multiple factor analysis of impacting the choice of treatment mode, to guild correct choice of treatment mode in patients with ADHD.Object and MethodsObject: 50 patients with ADHD were selected and met diagnostic criteria of DSM-IV, which were from outpatient pediatic clinic in Beijing anding hospital,from 19 Jan in 2006 to 1 Jun in 2006. There were 33 males and 17 females, aged from 6 to18 years old. All the patients choosed treatment mode freedomly. (1) Patients were assigned to western medicine therapy group which had 26 patients and other therapy group which had 24 patients according to treatment mode. (2) Patients were assigned to first time therapy group which had 33 patients and finished therapy group which had 17 patients according to if patients had been treated. (3) Patients were assigned to ADHD-C group which had 42 patients and ADHD-I group which had 8 patients according to ADHD subtypes.Methods:(1) By applying naturalistic observation methord, status of ADHD treatment mode was evaluated.(2) By applying naturalistic observation methord, impacting factor about choice of ADHD treatment mode was attained based on multiple factor investigation、multiple factor correlation analysis and synthesis evaluation. Results(1) Status of ADHD treatment mode:Patients’average age was 4.5 year old when symptoms were discovered. Patients’age was 8.55±3.14 year old when they were treated first time. Patients’age was 10.46±3.15 year old when they were treated by western medicine first time. Patients’age was 8.33±2.73 year old when they were treated by the traditional Chinese medicine first time. Time cell was 3.34±3.25 years between age when they were treated first time and age when they were discovered symptom. Patients that selected western medicine were 52 percent of all patients. Patients that selected the traditional Chinese medicine were 40 percent of all patients. Patients that did not select treatment mode were 8 percent of all patients.(2) Factors of impacting the choice of treatment mode were patient’s age and if information source, P=0.004 and P=0.020, OR=1.382 and 0.156.(3) Factors of impacting the choice of treatment mode were patient’s age and if information source, P=0.038 and P=0.034, OR=1.322 and 0.131, when patient was treated first time.(4) Factors of impacting the choice of treatment mode were if information source and person who discovered child’s symptoms, P=0.009 and P=0.013, OR=0.081 and 0.116.Conclusions(1) At present choice of treatment mode lacked norm.(2) Age of patients and if information source were factors that influenced choice of ADHD treatment mode.(3) Doctors in general hospital didn’t introduce correlation knowledge about treatment mode, or explain distinctly, so as to have no difference in choice of treatment mode between first time therapy and finished therapy. (4)Parents ignored ADHD subtypes so as to have no difference in choice of treatment mode among different subtypes.(5) It is critical factor of ADHD rehabilitation that strengthens reasonable propaganda and guide choice of ADHD treatment exactly.更多还原