标题：托莫西汀治疗注意力缺陷多动障碍患儿疗效观察

      作者：贾永飞，贾永苗，杨桃妮    宝鸡高新医院儿科，陕西 宝鸡 721000

      卷次： 2021年32卷20期

      【摘要】 目的 探究注意力缺陷/多动障碍(ADHD)患儿接受托莫西汀治疗的临床效果。方法 选取宝鸡高新医院2019年1月至2021年1月收治的70例ADHD患儿，按随机数表法分为哌甲酯组与托莫西汀组各35例，哌甲酯组患儿予以哌甲酯治疗，托莫西汀组患儿予以托莫西汀治疗，比较两组患儿治疗前、治疗后1周、4周、8周的血清白介素-6 (IL-6)水平，利用ADHD父母评定量表及韦氏儿童智力量表(C-WISC)评估治疗前后患儿注意力缺陷/多动障碍情况、认知功能，统计给药期间两组患儿的毒副反应发生情况。结果 治疗前两组患儿的血清 IL-6水平比较差异无统计学意义(P>0.05)，治疗后1周、4周、8周时，两组患儿的血清 IL-6水平较治疗前显著下降，差异均有统计学意义(P<0.05)，但托莫西汀组治疗后各时间点的血清 IL-6水平与哌甲酯组比较差异均无统计学意义(P>0.05)；治疗前两组患儿的ADHDRS-Ⅳ总分及两个分量表评分(注意力缺陷评分、多动/冲动评分)比较差异均无统计学意义(P>0.05)，治疗后两组患儿的ADHDRS-Ⅳ总分及两个分量表评分明显下降，差异均有统计学意义(P<0.05)，但组间比较差异均无统计学意义(P>0.05)；治疗前两组患儿的认知功能各项评分比较差异均无统计学意义(P>0.05)，治疗后两组患儿的认知功能各项评分明显上升，与治疗前比较差异均有统计学意义(P<0.05)，但两组间比较差异均无统计学意义(P>0.05)；托莫西汀毒组患儿和副反应发生率为5.71%，明显低于哌甲酯组的22.86%，差异有统计学意义(P<0.05)。结论 托莫西汀治疗ADHD可降低患儿的血清 IL-6水平，改善患儿的注意力缺陷/多动障碍症状，提高其认知能力，治疗效果与哌甲酯相似，但其药物毒副作用小，安全性高。
      【关键词】 注意力缺陷；多动障碍；托莫西汀；哌甲酯；白介素-6
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2021）20—2659—04

Clinical efficacy of atomoxetine in the treatment of children with attention deficit/hyperactivity disorder.
JIAYong-fei, JIA Yong-miao, YANG Tao-ni. Department of Pediatrics, Baoji High-tech Hospital, Baoji 721000, Shaanxi,CHINA
【Abstract】 Objective To explore the clinical effects of atomoxetine treatment in children with attention deficit/hyperactivity disorder (ADHD). Methods A total of 70 children with ADHD admitted to Baoji High-tech Hospitalfrom January 2019 to January 2021 were selected and divided into methylphenidate group and atomoxetine group accord-ing to the random number table, with 35 children in each group. The children in methylphenidate group were treatedwith methylphenidate, and those in the atomoxetine group were treated with atomoxetine. The serum IL-6 levels of thetwo groups before treatment, 1 week, 4 weeks, and 8 weeks after treatment were compared using ADHD. The parentalrating scale and the C-WISC for Children's Intelligence Scale (C-WISC) were used to evaluate the attention deficit/hy-peractivity disorder and cognitive function of the children before and after treatment, and the incidence of toxic and sideeffects in the two groups during the administration period was counted. Results There was no significant difference inserum IL-6 levels between the two groups before treatment (P>0.05). At 1 week, 4 weeks, and 8 weeks after treatment,the serum IL-6 levels of the two groups were significantly decreased compared with those before treatment (P<0.05),but there was no significant difference in serum IL-6 levels between the atomoxetine group and the methylphenidategroup at each time point after treatment (P>0.05). Before treatment, there was no significant difference in the ADHDRS-Ⅳ total score and the two subscale scores (attention deficit score, hyperactivity/impulsivity score) between the twogroups before treatment (P>0.05); after treatment, the ADHDRS-Ⅳ total score and the scores of the two subscales de-creased significantly (P<0.05), but the differences between the groups were not statistically significant (P>0.05). In thecomparison of cognitive function scores, there was no statistically significant difference in the scores (C factor, arithme-tic, mathematical breadth, coding) between the groups before treatment (P>0.05); the scores increased after treatment,which was statistically different from those before treatment (P<0.05); but the difference between the methylphenidategroup and the atomoxetine group was not statistically significant (P>0.05). The incidence of toxicity and side effects ofatomoxetine was significantly lower than that of the methylphenidate group, and the difference was statistically signifi-