口服布美他尼聯(lián)合康復(fù)訓(xùn)練治療兒童孤獨癥的初步研究
發(fā)布時間：2019-03-06 16:19
【摘要】：目的：觀察康復(fù)訓(xùn)練聯(lián)合布美他尼治療對新診斷的孤獨癥患兒社會交往、言語及非言語交流、興趣行為的影響，為兒童孤獨癥的治療尋求新的治療方法。 方法：收集吉林大學(xué)白求恩第一醫(yī)院小兒神經(jīng)康復(fù)科自2010年10月至2011年12月收治的96例新診斷的孤獨癥患兒的病例資料。根據(jù)患兒家長的意愿分為三組:布美他尼治療組26例，康復(fù)訓(xùn)練治療組32例，康復(fù)訓(xùn)練聯(lián)合布美他尼治療組38例�？祻�(fù)訓(xùn)練項目主要有人際關(guān)系發(fā)展干預(yù)、圖片交換交流系統(tǒng)、作業(yè)治療、言語治療、孤獨癥以及相關(guān)障礙兒童治療教育課程、應(yīng)用行為分析療法、丹佛模式，患兒每天接受3-4種訓(xùn)練項目，1次30-45分鐘；布美他尼：3歲以內(nèi)患兒0.3mg/次，日2次口服，3歲以上患兒0.5mg/次，日2次口服，，最高不超過2mg/天。三組于治療前及治療后1個月、2個月、3個月、6個月分別行ABC、CARS、CGI評估；對BUM組及RT+BUM組分別于開始治療前及服用布美他尼后1個月、2個月、3個月、6個月復(fù)診進(jìn)行血常規(guī)、尿常規(guī)、肝功、心肌酶、腎功、血離子、血糖及心電圖評估。 結(jié)果： （1）三組一般特征資料比較：三組年齡、起病年齡、病程、居住地、撫養(yǎng)人、母孕年齡、父育年齡、陽性家族史、胎次、分娩類型、出生體重、出生窒息史、爬行史、語言發(fā)育史組間比較差異均無統(tǒng)計學(xué)意義。 （2）治療前后ABC評分比較：治療后三組ABC總分及單項分與治療前比較均有降低。治療后6個月ABC總分與治療前比較，三組治療前后差異均有統(tǒng)計學(xué)意義，其中，RT+BUM組ABC總分及單項分降低最明顯，其次為RT組，最后為BUM組，三組ABC總分組間差異兩兩比較均有統(tǒng)計學(xué)意義。 （3）治療前后CARS評分比較：治療后三組CARS總分及單項分與治療前比較均有降低。治療后6個月CARS總分與治療前比較，三組治療前后差異均有統(tǒng)計學(xué)意義，其中，RT+BUM組CARS總分及單項分降低最明顯，其次為RT組，最后為BUM組，BUM與RT+BUM組總分差異有統(tǒng)計學(xué)意義。 （4）治療前后CGI評分比較：與治療前比較，治療后三組SI均有降低。治療后6個月SI與治療前比較，三組治療前后差異均有統(tǒng)計學(xué)意義，其中，RT+BUM組SI、GI降低、EI提高最明顯，其次為RT組，最后為BUM組，BUM組與RT+BUM組SI、GI、EI評分差異均有統(tǒng)計學(xué)意義。 （5）治療后保留率比較：治療后6個月BUM組的保留率為84.6%（22/26例）；RT組的保留率為87.5%(28/32例)；RT+BUM組的保留率為86.8%（33/38例）。三組治療后6個月保留率比較無統(tǒng)計學(xué)意義。 （6）副作用觀察：三組6個月治療隨訪過程中，BUM組及RT+BUM組血常規(guī)、尿常規(guī)、肝功、心肌酶、腎功、血離子、血糖、心電圖均未發(fā)現(xiàn)異常。 結(jié)論： （1）布美他尼可減少孤獨癥兒童孤獨癥樣行為，而且沒有明顯的副作用。 （2）康復(fù)訓(xùn)練聯(lián)合布美他尼治療兒童孤獨癥效果優(yōu)于單純康復(fù)訓(xùn)練治療。
[Abstract]:Aim: to observe the effects of rehabilitation training combined with bumetanil on social communication, verbal and nonverbal communication, and behavior of interest in newly diagnosed autistic children, so as to find a new treatment for children with autism. Methods: the data of 96 newly diagnosed autistic children in the Department of Pediatric Neurorehabilitation, Bethune first Hospital, Jilin University from October 2010 to December 2011 were collected. According to the parents' wishes, they were divided into three groups: bumetanil treatment group (26 cases), rehabilitation training group (32 cases) and rehabilitation training combined with bumetanil treatment group (38 cases). Rehabilitation training programs include interpersonal relationship development interventions, picture exchange communication systems, job therapy, speech therapy, autism and related disorder treatment education courses for children, applied behavioral analysis therapy, Denver model, The children received 4 kinds of training items every day for 30 minutes and 45 minutes at a time. Bumetanil: 0.3mg/ twice a day in children under 3 years old, 0.5mg/ twice a day in children over 3 years old, and no more than 2 times a day in children over 3 years old. The highest dose was no more than 2mg/ days. Three groups were evaluated by ABC,CARS,CGI before treatment and 1 month, 2 months, 3 months and 6 months after treatment. Blood routine, urine routine, liver function, myocardial enzyme, renal function, blood ion, blood glucose and electrocardiogram were evaluated before and 1 month, 2 months, 3 months and 6 months after the treatment of bumetanil in BUM group and RT BUM group, respectively. The blood routine, urine routine, liver function, myocardial enzyme, renal function, blood ion, blood sugar and ECG were evaluated. Results: (1) the data of three groups were compared: age, onset age, course of disease, place of residence, caregiver, pregnant age, paternity age, positive family history, number of births, birth type, birth weight, birth asphyxia history. There was no significant difference in reptile history and language development history between groups. (2) comparison of ABC scores before and after treatment: after treatment, the total score and single score of ABC in the three groups were lower than those before treatment. Six months after treatment, the total scores of ABC in the three groups were significantly lower than those before and after treatment. The total score and single score of ABC in the, RT BUM group decreased most significantly, followed by the RT group, and the last group was the BUM group. The difference among the three groups of ABC was statistically significant. (3) comparison of CARS scores before and after treatment: after treatment, the total score and single score of CARS in the three groups were lower than those before treatment. Six months after treatment, the total scores of CARS in the three groups were significantly lower than those before and after treatment. The total score and single score of CARS in the, RT BUM group decreased most significantly, followed by the RT group, and the last group was the BUM group. There was a significant difference in the total score between BUM and RT BUM group. (4) comparison of CGI scores before and after treatment: compared with pre-treatment, the SI of three groups decreased after treatment. 6 months after treatment, there were significant differences in SI between the three groups before and after treatment. SI,GI in, RT BUM group was decreased and EI was increased most obviously, followed by RT group, BUM group and RT BUM group SI,GI,. The difference of EI score was statistically significant. (5) comparison of retention rate after treatment: the retention rate in BUM group was 84.6% at 6 months after treatment (87.5% in 22 cases of); RT group and 86.8% in 32 cases of); RT BUM group in 28 cases). There was no significant difference in retention rate at 6 months after treatment among the three groups. (6) side effects observation: during the 6-month follow-up of three groups, no abnormality was found in blood routine, urine routine, liver function, myocardial enzyme, kidney function, blood ion, blood sugar and ECG in BUM group and RT BUM group. Conclusion: (1) bumetanil can reduce autism-like behavior in autistic children without obvious side effects. (2) the effect of rehabilitation training combined with bumetanil in the treatment of childhood autism was better than that of rehabilitation training alone.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.94
[Abstract]:Aim: to observe the effects of rehabilitation training combined with bumetanil on social communication, verbal and nonverbal communication, and behavior of interest in newly diagnosed autistic children, so as to find a new treatment for children with autism. Methods: the data of 96 newly diagnosed autistic children in the Department of Pediatric Neurorehabilitation, Bethune first Hospital, Jilin University from October 2010 to December 2011 were collected. According to the parents' wishes, they were divided into three groups: bumetanil treatment group (26 cases), rehabilitation training group (32 cases) and rehabilitation training combined with bumetanil treatment group (38 cases). Rehabilitation training programs include interpersonal relationship development interventions, picture exchange communication systems, job therapy, speech therapy, autism and related disorder treatment education courses for children, applied behavioral analysis therapy, Denver model, The children received 4 kinds of training items every day for 30 minutes and 45 minutes at a time. Bumetanil: 0.3mg/ twice a day in children under 3 years old, 0.5mg/ twice a day in children over 3 years old, and no more than 2 times a day in children over 3 years old. The highest dose was no more than 2mg/ days. Three groups were evaluated by ABC,CARS,CGI before treatment and 1 month, 2 months, 3 months and 6 months after treatment. Blood routine, urine routine, liver function, myocardial enzyme, renal function, blood ion, blood glucose and electrocardiogram were evaluated before and 1 month, 2 months, 3 months and 6 months after the treatment of bumetanil in BUM group and RT BUM group, respectively. The blood routine, urine routine, liver function, myocardial enzyme, renal function, blood ion, blood sugar and ECG were evaluated. Results: (1) the data of three groups were compared: age, onset age, course of disease, place of residence, caregiver, pregnant age, paternity age, positive family history, number of births, birth type, birth weight, birth asphyxia history. There was no significant difference in reptile history and language development history between groups. (2) comparison of ABC scores before and after treatment: after treatment, the total score and single score of ABC in the three groups were lower than those before treatment. Six months after treatment, the total scores of ABC in the three groups were significantly lower than those before and after treatment. The total score and single score of ABC in the, RT BUM group decreased most significantly, followed by the RT group, and the last group was the BUM group. The difference among the three groups of ABC was statistically significant. (3) comparison of CARS scores before and after treatment: after treatment, the total score and single score of CARS in the three groups were lower than those before treatment. Six months after treatment, the total scores of CARS in the three groups were significantly lower than those before and after treatment. The total score and single score of CARS in the, RT BUM group decreased most significantly, followed by the RT group, and the last group was the BUM group. There was a significant difference in the total score between BUM and RT BUM group. (4) comparison of CGI scores before and after treatment: compared with pre-treatment, the SI of three groups decreased after treatment. 6 months after treatment, there were significant differences in SI between the three groups before and after treatment. SI,GI in, RT BUM group was decreased and EI was increased most obviously, followed by RT group, BUM group and RT BUM group SI,GI,. The difference of EI score was statistically significant. (5) comparison of retention rate after treatment: the retention rate in BUM group was 84.6% at 6 months after treatment (87.5% in 22 cases of); RT group and 86.8% in 32 cases of); RT BUM group in 28 cases). There was no significant difference in retention rate at 6 months after treatment among the three groups. (6) side effects observation: during the 6-month follow-up of three groups, no abnormality was found in blood routine, urine routine, liver function, myocardial enzyme, kidney function, blood ion, blood sugar and ECG in BUM group and RT BUM group. Conclusion: (1) bumetanil can reduce autism-like behavior in autistic children without obvious side effects. (2) the effect of rehabilitation training combined with bumetanil in the treatment of childhood autism was better than that of rehabilitation training alone.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.94
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