目的 探讨地牡宁神口服液联合托莫西汀治疗儿童注意力缺陷多动障碍的临床疗效。方法 回顾性分析2018年2月—2020年11月在南阳市中心医院进行治疗的94例注意力缺陷多动障碍患儿的临床资料，根据用药差别分为对照组和治疗组，每组各47例。对照组口服盐酸托莫西汀胶囊，体质量在70 kg下的患儿每日初始剂量为0.5 mg/kg，3 d后增加至1.2 mg/kg，单次服药，每日总剂量不可超过1.4 mg/kg；体质量大于70 kg的患儿每日初始总剂量为40 mg，3 d后可增加至目标剂量80 mg/d，单次服药，每日总剂量不可超过100 mg。治疗组在对照组基础上口服地牡宁神口服液，3～5岁5 mL/次，6～14岁10 mL/次，15岁以上15 mL/次，3次/d。两组均经12周治疗。观察两组的临床疗效，比较两组中医症候改善时间和相关评分。结果 治疗后，治疗组的总有效率是97.87%，显著高于对照组的82.98%（P<0.05）。经治疗，治疗组在多动不宁、注意力不集中、少眠多梦、手足心热、盗汗改善时间上均显著短于对照组（P<0.05）。经治疗，两组SNAP-Ⅳ评分、多动指数、CGI评分均较治疗前显著降低，但划消测验显著升高（P<0.05）；治疗后，治疗组相关量表积分改善优于对照组（P<0.05）。结论 地牡宁神口服液联合盐酸托莫西汀胶囊治疗儿童注意力缺陷多动障碍可有效改善患儿相关症候，有利于改善患儿冲动、多动的行为症状和认知能力，有着良好的临床应用价值。

Objective To investigate the effect of Dimu Ningshen Oral Liquid combined with tomoxetine in treatment of attention deficit hyperactivity disorder in children. Methods A retrospective analysis was performed on the clinical data of 94 children with ADHD treated in Nanyang Central Hospital from February 2018 to November 2020, and they were divided into control group and treatment group according to medication difference, with 47 cases in each group. Patients in the control group were po administered with Atomoxetine Hydrochloride Capsules, for children with body weight of 70 kg, the initial daily dosage was 0.5 mg/kg and increased to 1.2 mg/kg after 3 d. The total daily dosage should not exceed 1.4 mg/kg for a single dosage. For children with body weight greater than 70 kg, the initial daily total dosage was 40 mg/d, which could be increased to the target dosage of 80 mg/d after 3 d. The total daily dosage should not exceed 100 mg for a single dosage. Patients in the treatment group were po administered with Dimu Ningshen Oral Liquid on the basis of the control group, 3 — 5 years old, 5 mL/time, 6 — 14 years old, 10 mL/time, 15 mL/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time and correlation score of TCM symptoms were compared between the two groups. Results After treatment, the total effective rate of treatment group was 97.87%, significantly higher than that of control group 82.98% (P<0.05). After treatment, the treatment group was significantly shorter than the control group in the improvement time of Chinese medicine symptoms such as hyperrestlessness, inattention, less sleep and more dreams, hand, foot and heart heat, night sweat (P<0.05). After treatment, SNAP-Ⅳ score, hyperactivity index, and CGI score in two groups were significantly decreased compared with before treatment, but exclusion test was significantly increased (P<0.05). After treatment, the improvement of relevant scale score in the treatment group was better than that in the control group (P<0.05). Conclusion Dimu Ningshen Oral Liquid combined with Atomoxetine Hydrochloride Capsules in the treatment of attention deficit hyperactivity disorder in children can effectively improve the related symptoms of children, and is beneficial to improve the behavioral symptoms and cognitive ability of impulsive, hyperactive children, which has a good clinical application value.

R971

河南省医学科技攻关计划（LHGJ20200667）