六味地黄丸加减联合耳穴压豆治疗肝肾阴虚证注意缺陷多动障碍儿童的临床疗效

Clinical efficacy of modified Liuwei Dihuang pill combined with auricular point pressing in the treatment of pediatric ADHD of liver-kidney Yin deficiency syndrome

摘要

目的 观察六味地黄丸加减联合耳穴压豆法治疗肝肾阴虚证注意缺陷多动障碍（ADHD）儿童的临床疗效。方法 选取2025年1月至2026年3月湖州市南浔区中医院收治的肝肾阴虚证ADHD患儿52例为研究对象, 随机分为观察组和对照组各26例。对照组予心理行为干预, 观察组在此基础上加用六味地黄丸加减联合耳穴压豆, 连续治疗3个月。对比治疗前后两组患儿斯诺佩评估量表（SNAP-Ⅳ）评分、中医证候积分、Conners多动指数积分及治疗总有效率。结果 对照组脱落1例, 观察组脱落1例, 最终完成全程观察者共50例（对照组25例, 观察组25例）。治疗后观察组患儿注意力不集中、多动冲动、对立违抗症状改善均显著优于治疗前, 且观察组改善均显著优于对照组, 差异有统计学意义（P<0.05）。治疗后观察组主症积分、次症积分、总积分均显著低于治疗前, 且观察组主症积分、次症积分、总积分显著低于对照组, 差异有统计学意义（P<0.05）。治疗后观察组Conners多动指数积分显著低于治疗前, 且观察组Conners多动指数积分显著低于对照组, 差异有统计学意义（P<0.05）。治疗后观察组总有效率为96.0%（24/25）, 高于对照组68.0%（17/25）, 差异有统计学意义（P<0.05）。结论 六味地黄丸加减联合耳穴压豆可显著改善肝肾阴虚证ADHD儿童的行为表现, 且可有效提高患儿的临床疗效。

Abstract

Objective To observe the clinical efficacy of modified Liuwei Dihuang pill combined with auricular point pressing in the treatment of pediatric attention deficit hyperactivity disorder (ADHD) of the liver-kidney Yin deficiency syndrome. Methods Fifty-two children with ADHD of the liver-kidney Yin deficiency syndrome admitted to Huzhou Nanxun District Traditional Chinese Medicine Hospital from January 2025 to March 2026 were included as research subjects, and they were randomly divided into two groups, with 26 cases in each group. The control group received psychological and behavioral intervention, while the observation group additionally received modified Liuwei Dihuang pill combined with auricular point pressing. Both groups were treated continuously for three months. The Swanson, Nolan and Pelham rating scale-Ⅳ (SNAP-Ⅳ) scores, traditional Chinese medicine (TCM) syndrome scores, Conners Hyperactivity Index scores, and total effective rate were compared between the two groups before and after treatment. Results One patient dropped out from the control group and one from the observation group. Ultimately, a total of 50 patients completed the entire observation course, including 25 patients in the control group and 25 in the observation group. After treatment, the observation group showed significant improvement in inattention, hyperactivity-impulsivity, and oppositional defiant symptoms compared with before treatment (P<0.05). The observation group also demonstrated significantly greater improvement in these symptoms compared with the control group (P<0.05). After treatment, the primary symptom scores, secondary symptom scores, and total scores in the observation group were significantly lower than those before treatment (P<0.05). The observation group also had significantly lower primary symptom scores, secondary symptom scores, and total scores compared with the control group (P<0.05). After treatment, the Conners Hyperactivity Index score in the observation group was significantly lower than that before treatment (P<0.05). The observation group also had a significantly lower Conners Hyperactivity Index score compared to the control group (P<0.05). After treatment, the total effective rate of the observation group was 96.0% (24/25), which was higher than that of the control group (68.0%, 17/25) (P<0.05). Conclusion Modified Liuwei Dihuang pill combined with auricular point pressing can significantly improve the behavioral manifestations of pediatric ADHD of the liver-kidney Yin deficiency syndrome and effectively increase the clinical effect on ADHD children.

关键词

注意缺陷多动障碍 / 肝肾阴虚 / 六味地黄丸 / 耳穴压豆 / 儿童

Key words

ADHD / Liver-kidney Yin deficiency / Liuwei Dihuang pill / Auricular point pressing / Child

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基金资助

浙江省中医药科技计划项目(2023ZL683)