Efficacy of cognitive behavioral training combined with methylphenidate hydrochloride sustained-release tablets on children with attention-deficit hyperactivity disorder
10.3760/cma.j.cn101721-20241101-00349
- VernacularTitle:认知行为训练联合MPH缓释片对ADHD患儿的疗效
- Author:
Hui LI
1
;
Linjuan LI
;
Xueting GAO
;
Minna LIU
Author Information
1. 西北妇女儿童医院儿童保健科，西安 710061
- Publication Type:Journal Article
- Keywords:
Attention-deficit hyperactivity disorder;
Cognitive behavioral training;
Methylphenidate hydrochloride sustained-release tablets;
Cognitive function
- From:
Clinical Medicine of China
2025;41(3):200-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficiency of cognitive behavioral training combined with methylphenidate hydrochloride sustained-release tablets on children with attention-deficit hyperactivity disorder (ADHD).Methods:118 children with ADHD in Northwest Women' s and Children' s Hospital were selected from June 2022 to July 2023. Based on the principle of baseline feature matching between groups, they were randomly divided into MPH group and combined group by coin tossing method, with 59 cases in each group. Children in the MPH group were treated with MPH sustained-release tablets orally (The initial dose was 18mg each time, whole tablet was swallowed in the morning, dose adjustment was increased by 18 mg each time, once a week, and maximum dose was not more than 54 mg), while the children in the combined group were combined with cognitive behavior training on the basis of the treatment in the MPH group. Children in both groups were continuously treated for 3 months. The clinical efficacy, scores of dimensions of Swanson Nolan and Pelham, rating scale-version IV (SNAP-IV) parent edition, scores of Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), scores of Wisconsin Card Sorting Test (WCST) and serological indicators [dopamine, 25 (OH)D 3, cortisol, brain-derived neurotrophic factor (BDNF)] before and after treatment and incidence of adverse reactions were compared between groups. Results:After 3 months of treatment, the combined group [93.2%(55/59)] had higher total effective rate than the MPH group [79.7% (47/59)] ( χ2=4.63, P=0.031). The scores of three dimensions, including attention deficit, hyperactivity-impulsion and oppositional defiance in both groups were lower than those before treatment, and the scores in combined group were lower than those in MPH group, the differences were statistically significant [(1.27±0.19) points vs (1.65±0.23) points, (1.35±0.25) points vs (1.78±0.27) points, (1.55±0.13) points vs (1.86±0.22) points, t=9.78, 8.98, 9.32,respectively, all P<0.001]. The control quotient score and attention quotient score were higher than those before treatment, and the scores in combined group were higher than those in MPH group, the differences were statistically significant [(99±6) points vs (91±3) points, (98±5) points vs. (92±3) points, t=8.47, 7.46,respectively, all P<0.001]. The total response count, completed categories count and correct response count were all higher than those before treatment, and the scores were higher in combination group than those in MPH group, the differences were statistically significant [(116±16) points vs(105±14) points, (4.57±0.35) points vs (4.15±0.25) points, (83±12) points vs (72±10) points, t=4.07, 7.50, 5.48, respectively, all P<0.001). Perspective response count was lower than that before treatment, and the score in combined group was lower than that in MPH group, the difference was statistically significant [(15.6±1.8) points vs (18.2±2.0) points, t=7.35, P<0.001]. Serum levels of dopamine, 25(OH)D 3 and BDNF were higher than those before treatment, and the levels in combined group were all higher than those in MPH group, the differences were statistically significant [(16.2±2.8) pmol/L vs (13.8±2.4) pmol/L, (78±10) nmol/L vs. (70±9) nmol/L, (1 060±135) pmol/L vs (986±126) pmol/L, t=5.00, 4.59, 3.08, respectively, all P<0.05]. Serum cortisol level was lower than that before treatment, and the level in combined group was lower than that in MPH group, the difference was statistically significant [(255±27) nmol/L vs (271±28) nmol/L, t=3.16, P=0.002]. There was no statistical significance difference in the incidence rate of adverse reactions between combined group and MPH group during treatment [6.8% (4/59) vs 5.1% (3/59)] ( χ2=0.00, P=1.000). Conclusion:Cognitive behavioral training combined with MPH sustained-release tablets in the treatment of children with ADHD can significantly enhance the efficacy, improve the ADHD symptoms and cognitive function, and increase the levels of serum dopamine and 25 (OH)D 3, and have good safety.
