维生素D辅助哌甲酯治疗伴中央颞区棘波良性癫痫患儿共病注意缺陷多动障碍的临床效果
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安徽省安庆市2023年度医疗卫生类自筹经费科技计划项目(2023Z1019);


Clinical effect of vitamin D assisted with methylphenidate in the treatment of comorbid attention deficit hyperactivity disorder in children with benign epilepsy with centrotemporal spikes
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    目的:探讨维生素D辅助哌甲酯治疗伴中央颞区棘波良性癫痫(BECTS)患儿共病注意缺陷多动障碍(ADHD)的临床效果。方法:选取60例BECTS共病ADHD患儿为研究对象,按治疗方式不同分为对照组和联合组,每组各30例。对照组患儿予以哌甲酯治疗;观察组患儿予以维生素D联合哌甲酯治疗,疗程均为3个月。比较两组患儿临床疗效、临床核心症状[Conners儿童行为父母问卷(PSQ)评分]、认知功能[韦氏儿童智力量表第四版(WISC-Ⅳ)及简易精神状态检测量表(MMSE)评分]、血清炎症因子[白细胞介素6(IL-6)、IL-1β、肿瘤坏死因子α(TNF-α)]水平、脑电θ/β比值及不良反应发生情况。结果:联合组患儿临床总有效率高于对照组(93.33%vs. 73.33%,P<0.05)。治疗3个月后,两组患儿PSQ评分均降低(P<0.05),且联合组低于对照组(P<0.05);WISC-Ⅳ及MMSE评分均提高(P<0.05),且联合组高于对照组(P<0.05);血清炎症因子TNF-α、IL-1β、IL-6水平和脑电θ/β比值降低(P<0.05),且联合组低于对照组(P<0.05)。两组患儿不良反应总发生率比较,差异无统计学意义(6.67%vs. 13.33%,P>0.05)。结论:在哌甲酯治疗BECTS共ADHD患儿的基础上加用维生素D可提高临床疗效,缓解临床核心症状,改善患儿认知功能,降低炎症水平及脑电θ/β比值,且安全性良好。

    Abstract:

    Objective:To explore the clinical efficacy of vitamin D-assisted methylphenidate in the treatment of children with be-nign epilepsy with centrotemporal spikes(BECTS)complicated with attention deficit hyperactivity disorder(ADHD).Methods:60 children with BECTS and ADHD were selected as the research subjects.According to the different treatment methods,they were divided into control group and combined group,30 cases in each group.The control group was treated with methylphenidate,and the observation group was treated with vitamin D combined with methylphenida,continuous treatment for 3 months.The clinical efficacy,clinical core symptoms[Conners Children's Behavioral Parent Questionnaire(PSQ)],cognitive function[Wechsler Intelligence Scale for Children-Ⅳ(WISC-Ⅳ),Mini-Mental State Examination(MMSE)],serum inflammatory factors[interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)],EEG θ/β ratio and incidence of adverse reactions were compared between the two groups.Results:The total effec-tive rate of combined group was higher than that of the control group(93.33%vs.73.33%,P<0.05).After 3 months of treatment,the PSQ scores of the two groups were decreased(P<0.05),and the combined group was lower than the control group(P<0.05).The scores of WISC-Ⅳ and MMSE of children in the two groups were increased(P<0.05),and those in the combined group were higher than the control group(P<0.05).The levels of serum inflammatory factors TNF-α,IL-1 β,IL-6 and EEG θ/β ratio of children in the two groups were decreased(P<0.05),and those in the combined group were lower than those in the control group(P<0.05).The total incidence of adverse reactions between the two groups had no significant difference(6.67%vs.13.33%,P>0.05).Conclu-sion:Vitamin D supplementation on the basis of methylphenidate in the treatment of BECTS children with ADHD can improve the clini-cal efficacy,relieve the clinical core symptoms,improve the cognitive function,reduce the level of inflammation and EEG θ/β ratio,and has good safety.

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路琰;刘芳;苏琼;.维生素D辅助哌甲酯治疗伴中央颞区棘波良性癫痫患儿共病注意缺陷多动障碍的临床效果[J].川北医学院学报,2025,40(1):89-93.

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  • 在线发布日期: 2025-07-24
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