脑电生物反馈联合盐酸哌甲酯、DHA治疗注意缺陷多动障碍儿童的疗效分析

Combined therapeutic effects of EEG biofeedback, methylphenidate hydrochloride, and DHA on pediatric attention-deficit/hyperactivity disorder

摘要:

目的 评估脑电生物反馈联合盐酸哌甲酯及二十二碳六烯酸（DHA）对注意缺陷多动障碍（ADHD）儿童核心症状、执行功能及神经递质水平等的改善效果，探索更优的综合干预方案。方法 选取2023年1月—2025年12月山西省儿童医院收治的88例ADHD儿童，根据随机数字表法分为对照组（接受盐酸哌甲酯联合DHA口服治疗）和观察组（在对照组基础上加用脑电生物反馈治疗），各44例。比较两组患儿的核心症状［斯诺佩评估量表第4版父母版（SNAP-Ⅳ）、Conners症状问卷父母版（PSQ）］、临床疗效、执行功能［执行功能行为评定量表（BRIEF）］、认知功能［韦氏儿童智力量表第4版（WISC-Ⅳ）］、血清神经递质指标［多巴胺（DA）、去甲肾上腺素（NE）、5-羟色胺（5-HT）］及不良反应。结果 观察组治疗后SNAP-Ⅳ及PSQ各维度评分均低于对照组（P <0.05）；同一组内，治疗后SNAP-Ⅳ及PSQ各维度评分均低于治疗前（P <0.05）。观察组总有效率高于对照组（P <0.05）。观察组治疗后BRIEF各维度评分均低于对照组，WISC-Ⅳ各维度评分、DA、NE、5-HT水平均高于对照组（P <0.05）；同一组内，治疗后BRIEF各维度评分均低于治疗前，WISC-Ⅳ各维度评分、DA、NE、5-HT水平均高于治疗前（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 脑电生物反馈联合盐酸哌甲酯及DHA能显著改善ADHD儿童的核心症状、执行功能及认知功能，提高临床疗效，上调血清DA、NE、5-HT水平，且不增加不良反应发生率，值得临床推广。

Abstract:

Objective To evaluate the effects of electroencephalographic (EEG) biofeedback combined with methylphenidate hydrochloride and docosahexaenoic acid (DHA) on the core symptoms, executive function, and neurotransmitter levels of children with attention-deficit/hyperactivity disorder (ADHD) and to explore an improved comprehensive intervention strategy.Methods A total of 88 children with ADHD who were treated at Shanxi Children's Hospital from January 2023 to December 2025 were enrolled. Using a random number table, they were divided into a control group, which received oral methylphenidate hydrochloride combined with DHA, and an observation group, which additionally received EEG biofeedback, with 44 children in each group. The two groups were compared in terms of core symptoms [Swanson, Nolan and Pelham Rating Scale, Fourth Edition, Parent Form (SNAP-IV) and Conners Parent Symptom Questionnaire (PSQ) ], clinical efficacy, executive function [Behavior Rating Inventory of Executive Function (BRIEF) ], cognitive function [Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) ], serum neurotransmitters [dopamine (DA), norepinephrine (NE), and 5-hydroxytryptamine (5-HT) ], and adverse reactions.Results After treatment, all SNAP-IV and PSQ dimension scores were lower in the observation group than in the control group (P < 0.05), and all dimension scores were lower after treatment than before treatment within each group (P < 0.05). The total effective rate was higher in the observation group than in the control group (P < 0.05). After treatment, all BRIEF dimension scores were lower, whereas all WISC-IV dimension scores and DA, NE, and 5-HT levels were higher, in the observation group than in the control group (P < 0.05). Within each group, all BRIEF dimension scores were lower, whereas all WISC-IV dimension scores and DA, NE, and 5-HT levels were higher, after treatment than before treatment (P < 0.05). The total incidence of adverse reactions did not differ significantly between the two groups (P > 0.05).Conclusion EEG biofeedback combined with methylphenidate hydrochloride and DHA significantly improves the core symptoms, executive function, and cognitive function of children with ADHD, increases clinical efficacy and serum DA, NE, and 5-HT levels, and does not increase the incidence of adverse reactions.