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目的探讨盐酸托莫西汀治疗共患抽动障碍的注意缺陷多动障碍(ADHD)的临床疗效。方法对符合美国《精神障碍诊断与统计手册》中ADHD和抽动障碍诊断标准的儿童予系统的盐酸托莫西汀治疗,逐渐滴定至最适剂量。盐酸托莫西汀胶囊每日晨单次服用。以家长填写的ADHD评定量表为主要疗效评价指标评定注意缺陷多动症状;以耶鲁综合抽动严重程度量表评定抽动症状。结果本研究完成系统盐酸托莫西汀滴定的ADHD患儿20例,注意缺陷型10例,混合型9例,多动冲动型1例。男17例,女3例;年龄(7.58～17.0)(10.55±2.58)岁。完成剂量滴定患儿的最后剂量为(1.19±0.21)mg/(kg.d)。ADHD总分治疗前为(31.10±8.52)分,治疗后为(12.65±9.08)分;注意缺陷评分治疗前为(17.60±3.09)分,治疗后为(7.45±4.75)分;多动冲动评分:治疗前为13.0分,治疗后为3.0分。治疗后家长ADHD症状评定量表总分及分量表分较治疗前均显著下降(P<0.001)。治疗后抽动总分9.0分,运动抽动分(8.15±5.29)分,发声抽动分0分;治疗前抽动总分32.5分,运动抽动分(30.0±16.93)分,发声抽动分7.0分。治疗后运动抽动及发声抽动的数量、频度、强度和复杂性均较治疗前显著减少(Pa<0.05)。结论盐酸托莫西汀治疗共患抽动障碍的ADHD患儿的多动冲动、注意力缺陷、运动抽动、发声抽动均有明显疗效。
Objective To investigate the clinical efficacy of atomoxetine hydrochloride in the treatment of attention deficit hyperactivity disorder (ADHD) with comorbid tic disorder. Methods Children in the diagnostic criteria for ADHD and tic disorder in the Handbook of Mental Disorders Diagnostic and Statistical Manuals were given a systematic instillation of atomoxetine and gradually titrated to the optimal dose. Inomix hydrochloride daily single-use capsules. Assessment of symptoms of attention-deficit hyperactivity disorder (ADHD) was performed using the ADHD rating scale completed by parents as the primary outcome measure. Symptoms of tics were assessed using the Yale Comprehensive Tic Severity Scale. Results In the present study, 20 children with ADHD titrated with tomoxetine hydrochloride were enrolled in this study. Ten cases were deficient in ADHD, nine were mixed and one was hyperactivity. There were 17 males and 3 females with a mean age of (7.58 ~ 17.0) (10.55 ± 2.58) years. The final dose of completed dose titration children (1.19 ± 0.21) mg / (kg.d). The total score of ADHD was (31.10 ± 8.52) minutes before treatment and (12.65 ± 9.08) minutes after treatment. The attention deficit score was (17.60 ± 3.09) before treatment and (7.45 ± 4.75) minutes after treatment. The scores of hyperactivity impulsive : 13.0 before treatment, 3.0 after treatment. After treatment, the scores of ADHD Symptoms Rating Scale and subscale of parents decreased significantly (P <0.001). After treatment, the total score of twitch 9.0 points, twitch points (8.15 ± 5.29) points, vocal twitch points 0 points; twitch total score before treatment 32.5 points, sports twitch points (30.0 ± 16.93) points, vocal twitch points 7.0 points. After treatment, the number, frequency, intensity and complexity of twitching and vocal twitching were significantly decreased compared with before treatment (Pa <0.05). Conclusion: Assessment of multiple motility impotence, attention deficit, motor twitching and vocal tumefaction in patients with comorbid tic disorder caused by atomoxetine hydrochloride.