目的 探讨地牡宁神口服液联合阿立哌唑片治疗儿童注意力缺陷多动障碍的临床疗效。方法 选取河南省儿童医院郑州儿童医院在2021年6月—2024年6月收治注意力缺陷多动障碍患儿共计80例。按照随机数字表法分为对照组和治疗组，每组各40例。对照组口服阿立哌唑片，1次/d，初始剂量每次2 mg,2 d后增至5 mg，持续2周后调整剂量，维持剂量2片/d，分2次服用。治疗组患儿在对照组的基础上口服地牡宁神口服液，3～5岁剂量5 mL/次，6～14岁，剂量10 mL/次，15岁以上剂量15 mL/次，3次/d。两组持续治疗8周。比较两组患儿的治疗效果、多动症状、注意力功能和血清指标。结果 治疗组患儿总有效率为92.50%，明显高于对照组的总有效率75.00%，组间差异显著（P<0.05）。治疗后，两组注意力缺陷评分、冲动–多动评分、对立违抗评分均降低（P<0.05），治疗组相较于对照组的注意缺陷多动障碍量表（SNAP-Ⅳ）各领域评分更低（P<0.05）。治疗后，两组的视听持续性操作测试系统（IVA-CPT）注意力商数、反应控制力商数、视觉商数均增加（P<0.05），治疗组的注意力商数、反应控制力商数、视觉商数均大于对照组（P<0.05）。治疗后，两组的血清脑源性神经营养因子（BDNF）、胶质细胞源性神经营养因子（GDNF）水平升高，血清神经元特异性烯醇化酶（NSE）水平降低（P<0.05）；治疗组的血清BDNF、GDNF水平高于对照组，血清NSE水平低于对照组（P<0.05）。结论 地牡宁神口服液联合阿立哌唑片可提高儿童注意力缺陷多动障碍的临床疗效，减轻患儿多动症状，改善注意力，促进神经修复。

Objective To explore the therapeutic effect of Dimu Ningshen Oral Liquid combined with Aripiprazole Tablets in treatment of attention deficit hyperactivity disorder in children. Methods 80 Children with attention deficit hyperactivity disorder admitted to Henan Children’s Hospital, Zhengzhou Children’s Hospital from June 2021 to June 2024, and were divided into control group and treatment group according to the random number table method, with 40 in each group. Children in the control group were po administered with Aripiprazole Tablets, once daily, the initial dose was 2 mg each time, and increased to 5 mg after 2 d. After 2 weeks,the dose was adjusted, and the maintenance dose was 2 tablets daily, which was taken twice. Children in the treatment group were po administered with Dimu Ningshen Oral Liquid on the basis of the control group, with a dose of 5 mL/time for ages 3 — 5, 10 mL/time for ages 6 — 14, and 15 mL/time for ages 15 and above, 3 times daily. Two groups received continuous treatment for 8 weeks. The treatment efficacy, hyperactivity symptoms, attention function, and serum indicators between two groups of children were compared.Results The total effective rate of the treatment group（92.50%） was significantly higher than 75.00% of the control group, with a significant difference between the groups（P＜0.05）. After treatment, the attention deficit score, impulse hyperactivity score, and oppositional defiant score in both groups were decreased（P＜0.05）, and the treatment group had lower Attention Deficit Hyperactivity Disorder Scale（SNAP-IV） scores in various fields（P＜0.05）. After treatment, the attention quotient, reaction control quotient, and visual quotient of the audio-visual continuous operation testing system（IVA-CPT） were increased in both groups（P＜0.05）, and the attention quotient, response control quotient, and visual quotient of the treatment group were all higher than those of the control group（P＜0.05）. After treatment, the levels of serum BDNF and GDNF were increased in both groups, but the levels of serum NSE were decreased（P＜0.05）. The serum levels of BDNF and GDNF in the treatment group were higher than those in the control group, but the serum levels of NSE were lower than those in the control group（P＜0.05）. Conclusion The combination of Dimu Ningshen Oral Liquid and Aripiprazole Tablets can improve the clinical efficacy of attention deficit hyperactivity disorder in children, alleviate hyperactivity symptoms, improve attention, and promote nerve repair.

R971

河南省医学科技攻关项目(LHGJ2020021837)