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目的:本研究旨在比较盐酸哌甲酯控释剂单用与联合感觉统合训练对高功能孤独症谱系障碍(HFA)共病注意缺陷多动障碍(ADHD)儿童的疗效。方法:80例符合诊断标准的门诊患儿,以药物单用或联合感统训练治疗6个月,以视听整合持续操作测验(IVA-CPt)、ADHD评定量表(ADHD-RS-IV)、孤独症行为评定量表(ABC)评估核心症状。结果:1两组患者IVA-CPt项目分值均较治疗前提高(P<0.001),联合治疗组改善优于药物组(tFRCQ=-2.6874,P=0.0090;tFAQ=-2.6933,P=0.0089);2两组患者ADHD-RS-IV各分值均较治疗前降低(P<0.001),联合治疗组改善优于药物组(t注意缺陷=-2.3322,P=0.0254;t多动冲动=-2.0479,P=0.0479;t总分=-2.1817,P=0.0357);3药物组ABC交往分较治疗前改善(t=2.0413,P=0.0486);联合组ABC总分(t=2.1223,P=0.0408),感觉分(t=2.17213,P=0.0365),交往分(t=2.0576,P=0.0476),运动分(t=2.0986,P=0.0429)较治疗前改善。结论:药物联合感统训练对共病ADHD的HFA患儿核心症状疗效优于药物单用。
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Objective: To investigate the efficacy of medication combined with Sensory Integration Therapy(SIT) for children with comorbid High-Functioning Autism Spectrum Disorder(HFA) and Attention Deficit and Hyperactivity Disorder (ADHD). Methods: A total of 80 children with comorbid HFA and ADHD were chosen from the Child Psychiatry Outpatient of Hangzhou Seventh Hospital. The subjects entered randomly into 2 groups: the medication treatment group and the medication combined with SIT group. IVA-CPT, ADHD-RS-IV and ABC were used to assess behavioral characteristics of subjects before and 6 months after treatments respectively. Results: ①Compared with the medication treatment group, subjects in the combined therapy group got higher scores in IVA-CPT( t FRCQ =-2.6874, P =0.0090; t FAQ =-2.6933, P =0.0089) and lower scores in ADHD-RS-IV( t attentional deficit =-2.3322, P =0.0254； t impulsivity =-2.0479, P =0.0479； t total score =-2.1817, P = 0.0357)； ②For subjects in medical treatment group, only scores of communication in ABC reduced significantly( t =2.0413, P =0.0486); for subjects in combined treatments group, ABC total scores( t =2.1223, P =0.0408)，sensory scores( t =2.17213, P = 0.0365), communication scores( t =2.0576, P =0.0476) and physical active scores( t =2.0986, P =0.0429) reduced significantly. Conclusion: Medication combined with SIT may have better efficiency on the symptoms of ASD as well as ADHD in children with comorbid HFA and ADHD than solely medical therapy．
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