目的 探讨多动宁胶囊联合托莫西汀治疗儿童注意力缺陷多动症的临床研究。方法 选取2019年4月—2021年4月在驻马店市中心医院妇女儿童医院诊治的134例注意力缺陷多动症患儿，根据随机数字表法分为对照组和治疗组，每组各67例。对照组患儿口服盐酸托莫西汀胶囊，0.5 mg/（kg·d），1次/d。治疗组患儿在对照组基础上口服多动宁胶囊，3粒/次，3次/d。两组患儿连续用药20 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状好转时间，血清皮质醇（COR）和促肾上腺皮质激素（ACTH）水平，Conner简明症状量表（ASQ）评分和斯若佩评估量表（SNAP-IV）评分及不良反应情况。结果 治疗后，治疗组总有效率明显高于对照组（P<0.05）。治疗后，治疗组患儿症状好转时间均早于对照组（P<0.05）。治疗后，两组患儿血清COR、ACTH水平明显升高（P<0.05），且治疗组患儿COR、ACTH水平明显高于对照组（P<0.05）。治疗后，两组患儿ASQ和SNAP-IV评分明显下降（P<0.05），且治疗组患儿ASQ和SNAP-IV评分明显低于对照组（P<0.05）。治疗期间，治疗组不良反应发生率明显低于对照组（P<0.05）。结论 多动宁胶囊与托莫西汀联合治疗儿童注意力缺陷多动症可有效改善临床症状，改善注意力和控制力，不良反应较小。

Objective To explore the clinical study of Duodongning Capsules combined with atomoxetine in treatment of children with attention deficit hyperactivity disorder. Methods Children (134 cases) with attention deficit hyperactivity disorder in Zhumadian Central Hospital from April 2019 to April 2021 were divided into control and treatment group according to random number table method, and each group had 67 cases. Children in the control group were po administered with Atomoxetine Hydrochloride Capsules, 0.5 mg/(kg·d), once daily. Children in the treatment group were po administered with Duodongning Capsules on the basis of the control group, 3 grains/time, three times daily. Children in two groups were treated for 20 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the levels of serum COR and ACTH, the scores of ASQ and SNAP-Ⅳ and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of serum COR and ACTH in two groups were significantly increased (P < 0.05), and which in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the scores of ASQ and SNAP-IV in two groups were significantly decreased (P < 0.05), and the scores of ASQ and SNAP-IV in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Duodongning Capsules combined with atomoxetine in treatment of children with attention deficit hyperactivity disorder can effectively improve clinical symptoms, ability of attention and control with less side effects.

R985

河南省医学科技攻关计划项目（201702312）