养心抗闭汤联合干预训练治疗心脾两虚型儿童自闭症的临床观察
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摘要
目的:观察养心抗闭汤联合干预训练治疗心脾两虚型儿童自闭症的临床疗效。方法:将96例心脾两虚型儿童自闭症患儿分为对照组和观察组各48例。对照组采用干预训练,包括行为治疗和结构化教育,由儿童康复科专业人员进行,每天1次,27 d为1个疗程,休息1周后行下1个疗程。观察组在干预训练的同时使用养心抗闭汤治疗,每3 d 1剂,9剂为1个疗程,休息1周后行下1个疗程。两组均进行4个疗程。观察两组患儿治疗前后儿童自闭症评估量表(CARS)评分、临床疗效等。结果:治疗4个疗程后,对照组有效率为62. 5%,观察组有效率为87. 5%,两组有效率比较差异有统计学意义(P <0. 05);两组治疗后CARS得分均有所下降(P <0. 05),且观察组低于对照组(P <0. 05)。结论:养心抗闭汤和干预训练均为治疗儿童自闭症的有效方法,养心抗闭汤联合干预训练治疗儿童自闭症具有积极的协同作用和较好的临床疗效。
Objective: To observe the clinical curative effect of Yangxin Kangbi Decoction(YXKBD) Combined with Intervention Training in the Treatment of Autism in Children with Deficiency of Heart and Spleen. Methods: A total of 96 children with autism of deficiency of both heart and spleen were divided into the control group and the observation group,with 48 cases in each group.The control group received intervention training,including behavioral therapy and structured education by professionals in pediatric rehabilitation department,once a day. The observation group was treated with YXKBD every 3 days,9 doses as a course of treatment,27 days as a course of treatment. Another course of treatment began after a week of rest. The two groups were treated with four courses of treatment. The children's autism assessment scale(CARS) score. Results: After four courses of treatment,the effective rate of the control group was 62. 5%,and that of the observation group was 87. 5%. There was significant difference in the effective rate between the two groups(P < 0. 05). After the treatment,the CARS score of the two groups decreased(P <0. 05),and that of the observation group was lower than that of the control group(P < 0. 05). Conclusion: Both YXKBD and intervention training are effective clinical methods for treating children' s autism. The combination of them has positive synergistic effect and good clinical efficacy in treating children'4 s autism.
Objective: To observe the clinical curative effect of Yangxin Kangbi Decoction(YXKBD) Combined with Intervention Training in the Treatment of Autism in Children with Deficiency of Heart and Spleen. Methods: A total of 96 children with autism of deficiency of both heart and spleen were divided into the control group and the observation group,with 48 cases in each group.The control group received intervention training,including behavioral therapy and structured education by professionals in pediatric rehabilitation department,once a day. The observation group was treated with YXKBD every 3 days,9 doses as a course of treatment,27 days as a course of treatment. Another course of treatment began after a week of rest. The two groups were treated with four courses of treatment. The children's autism assessment scale(CARS) score. Results: After four courses of treatment,the effective rate of the control group was 62. 5%,and that of the observation group was 87. 5%. There was significant difference in the effective rate between the two groups(P < 0. 05). After the treatment,the CARS score of the two groups decreased(P <0. 05),and that of the observation group was lower than that of the control group(P < 0. 05). Conclusion: Both YXKBD and intervention training are effective clinical methods for treating children' s autism. The combination of them has positive synergistic effect and good clinical efficacy in treating children'4 s autism.
引文
[1]LAVELLE T A,WEINSTEIN M C,NEWHOUSE J P,et al.Economic burden of childhood autism spectrum disorders[J].Pediatrics,2014,133(3):520-529.
[2]韩笑,林成仁,任钧国,等.中医对孤独症儿童三大核心障碍的认识[J].中国中医基础医学杂志,2016,22(3):431-433.
[3]段云峰,吴晓丽,金峰.自闭症的病因和治疗方法研究进展[J].中国科学:生命科学,2015,45(9):820-844.
[4]殷敏,袁茵.美国最新自闭症谱系障碍诊断标准解析[J].中小学心理健康教育,2014,14(9):16-18.
[5]丁一芸,卫利,王素梅.自闭症中西医研究进展及中医研究思路浅析[J].世界中医药,2014,9(6):820-822.
[6]曲丽芳.论儿童自闭症与《黄帝内经》“使道不通”“心主任物”之关系[J].中华中医药杂志,2012,27(10):2727-2729.
[7]王惠,冯治平,唐文富.“心与小肠相表里”理论治疗小肠梗阻合并精神症状1例及其文献回顾[J].河北中医,2013,35(5):698-699.
[8]FURNESS J B.The Enterric Nervous System.Frontmatter,in The Enteric Nervous System[J].Malden:Blackwell Publishing,2007,52(7):514-522.
[9]张思超.脑肠相通病机研究[D].济南:山东中医药大学,2002.
[10]FORSYTHE P,SUDO N,DINAN T,et al.Mood and gut feelings[J].Brain Behav Immun,2010,24(3):9-16.
[11]MCELHANON B O,MCCRACKEN C,KARPEN S,et al.Gastrointestinal symptoms in autism spectrum disorders:A meta-analysis[J].Pediatri cs,2014,133(5):872-883.
[12]HSIAO E Y.Gastrointestinal issues in autism spectrum disorder[J].Harv Rev Psychiatry,2014,22(1):104-111.
[13]ELAINE Y,HSIAO,SARA W,et al.Microbiota Modulate Behavioral and Physiological Abnormalities Associated with Neurodevelopmental Disorders[J].Cell,2013,155(14):1451-1463.
[14]MAZEFSKY C A,SCHREIBER D R,OLINO T M,et al.The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism[J].Autism,2014,18(5):493-501.
[15]DINAN T G,STILLING R M,STANTON C,et al.Collective unconscious:how gut microbes shape human behavior[J].J Psychiatr Res,2015,63(1):1-9.
[16]MAYER E A,PADUA D,TILLISCH K.Altered brain-gut axis in autism:comorbidity or causative mechanisms[J].BioEssays,2014,36(9):933-939.
[17]江晓宇,蔡在欣,李爱武,等.基于厥阴论治的自闭症刻板动作病机分析[J].时珍国医国药,2015,26(12):2971-2972.
[18]中华医学会儿科学分会发育行为学组,中国医师协会儿科分会儿童保健专业委员会,儿童孤独症诊断与防治技术和标准研究项目专家组.孤独症谱系障碍儿童早期识别筛查和早期干预专家共识[J].中华儿科杂志,2017,55(12):890-896.
[19]SCHREIBMAN L,DAWSON G,STAHMER AC,et al.Naturalistic Developmental Behavioral Interventions:Empirically Validated Treatments for Autism Spectrum Disorder[J].Autis Dev Disord,2015,45(8):2411-2428.
[2]韩笑,林成仁,任钧国,等.中医对孤独症儿童三大核心障碍的认识[J].中国中医基础医学杂志,2016,22(3):431-433.
[3]段云峰,吴晓丽,金峰.自闭症的病因和治疗方法研究进展[J].中国科学:生命科学,2015,45(9):820-844.
[4]殷敏,袁茵.美国最新自闭症谱系障碍诊断标准解析[J].中小学心理健康教育,2014,14(9):16-18.
[5]丁一芸,卫利,王素梅.自闭症中西医研究进展及中医研究思路浅析[J].世界中医药,2014,9(6):820-822.
[6]曲丽芳.论儿童自闭症与《黄帝内经》“使道不通”“心主任物”之关系[J].中华中医药杂志,2012,27(10):2727-2729.
[7]王惠,冯治平,唐文富.“心与小肠相表里”理论治疗小肠梗阻合并精神症状1例及其文献回顾[J].河北中医,2013,35(5):698-699.
[8]FURNESS J B.The Enterric Nervous System.Frontmatter,in The Enteric Nervous System[J].Malden:Blackwell Publishing,2007,52(7):514-522.
[9]张思超.脑肠相通病机研究[D].济南:山东中医药大学,2002.
[10]FORSYTHE P,SUDO N,DINAN T,et al.Mood and gut feelings[J].Brain Behav Immun,2010,24(3):9-16.
[11]MCELHANON B O,MCCRACKEN C,KARPEN S,et al.Gastrointestinal symptoms in autism spectrum disorders:A meta-analysis[J].Pediatri cs,2014,133(5):872-883.
[12]HSIAO E Y.Gastrointestinal issues in autism spectrum disorder[J].Harv Rev Psychiatry,2014,22(1):104-111.
[13]ELAINE Y,HSIAO,SARA W,et al.Microbiota Modulate Behavioral and Physiological Abnormalities Associated with Neurodevelopmental Disorders[J].Cell,2013,155(14):1451-1463.
[14]MAZEFSKY C A,SCHREIBER D R,OLINO T M,et al.The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism[J].Autism,2014,18(5):493-501.
[15]DINAN T G,STILLING R M,STANTON C,et al.Collective unconscious:how gut microbes shape human behavior[J].J Psychiatr Res,2015,63(1):1-9.
[16]MAYER E A,PADUA D,TILLISCH K.Altered brain-gut axis in autism:comorbidity or causative mechanisms[J].BioEssays,2014,36(9):933-939.
[17]江晓宇,蔡在欣,李爱武,等.基于厥阴论治的自闭症刻板动作病机分析[J].时珍国医国药,2015,26(12):2971-2972.
[18]中华医学会儿科学分会发育行为学组,中国医师协会儿科分会儿童保健专业委员会,儿童孤独症诊断与防治技术和标准研究项目专家组.孤独症谱系障碍儿童早期识别筛查和早期干预专家共识[J].中华儿科杂志,2017,55(12):890-896.
[19]SCHREIBMAN L,DAWSON G,STAHMER AC,et al.Naturalistic Developmental Behavioral Interventions:Empirically Validated Treatments for Autism Spectrum Disorder[J].Autis Dev Disord,2015,45(8):2411-2428.