目的 探討精苓合劑聯(lián)合哌甲酯治療兒童注意缺陷多動(dòng)障礙的臨床療效。方法 選取2020年1月—2022年12月蘇州市立醫(yī)院北區(qū)門(mén)診診治的88例注意缺陷多動(dòng)障礙患兒，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各44例。對(duì)照組口服鹽酸哌甲酯緩釋片，初始劑量18 mg/次，療效欠佳者增加劑量18 mg至每日劑量36 mg，1次/d，溫開(kāi)水整片送服。治療組在對(duì)照組治療基礎(chǔ)上口服精苓合劑，6歲＜患兒≤9歲，6～9 mL/次；9歲＜患兒≤12歲，10 mL/次；均為2次/d。兩組療程均為12周。觀察兩組的臨床療效，比較兩組核心癥狀好轉(zhuǎn)時(shí)間及治療前后Swanson, Nolan and Pelham父母評(píng)定量表（SNAP）-Ⅳ、Conners父母癥狀問(wèn)卷（PSQ）、兒童困難問(wèn)卷（QCD）、Weiss功能缺陷量表（父母版）（WFIRS-P）、長(zhǎng)處和困難問(wèn)卷（SDQ）、Achenbach兒童行為量表（CBCL）評(píng)分。結(jié)果 治療后，治療組總有效率是95.45%，較對(duì)照組的81.82%顯著提高（P＜0.05）。治療后，治療組多動(dòng)、注意缺陷、沖動(dòng)的好轉(zhuǎn)時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組注意缺陷評(píng)分、多動(dòng)-沖動(dòng)評(píng)分、對(duì)立違抗評(píng)分和總分均較治療前顯著降低（P＜0.05）；且治療后，治療組SNAP-Ⅳ各評(píng)分顯著低于對(duì)照組（P＜0.05）。治療后，兩組PSQ、WFIRS-P、SDQ、CBCL評(píng)分均顯著降低，而QCD評(píng)分則顯著增加（P＜0.05）；治療后，治療組PSQ、WFIRS-P、SDQ、CBCL、QCD評(píng)分改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 精苓合劑聯(lián)合哌甲酯治療兒童注意缺陷多動(dòng)障礙總體療效確切，能有效加快患兒核心癥狀好轉(zhuǎn)，減輕功能損害及情緒和行為問(wèn)題，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Jingling Mixture combined with methylphenidate in treatment of attention deficit hyperactivity disorder in children. Methods A total of 88 children with attention deficit hyperactivity disorder diagnosed and treated in North District of Suzhou Municipal Hospital from January 2020 to December 2022 were selected, and all patients were divided into control group and treatment group according to random number table method, with 44 cases in each group. Children in the control group were po administered with Methylphenidate Hydrochloride Prolonged-Release Tablets, and the initial dosage was 18 mg/time, and if the efficacy was not good, the dosage was increased by 18 mg to 36 mg daily, once daily, and the whole tablet was taken with warm water. Patients in the treatment group were po administered with Jingling Mixture on the basis of the control group, 6 years old < children ≤ 9 years old, 6 - 9 mL/time; 9 years old < children ≤ 12 years old, 10 mL/time, twice daily. The treatment course of both groups was 12 weeks. The efficacy of two groups was observed. The improvement time of core symptoms was compared between two groups. And Swanson before and after treatment, Nolan and Pelham Parent Rating Scale (SNAP)-Ⅳ, Conners Parent Symptom Questionnaire (PSQ), Child Difficulty Questionnaire (QCD), Weiss Functional Impairment Scale (Parent version) (WFIRS-P), Strengths and Difficulties Questionnaire (SDQ), Achenbach Child Behavior Scale (CBCL) scores before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 95.45%, which was significantly higher than that of control group (81.82%) (P < 0.05). After treatment, the improvement time of hyperactivity, attention deficit and impulsivity in the treatment group was significantly shorter than that in control group (P < 0.05). After treatment, attention deficit score, hyperactivity-impulse score, oppositional defiant score and total score were significantly decreased in both groups compared with before treatment (P < 0.05). After treatment, SNAP-Ⅳ scores in treatment group were significantly lower than those in control group (P < 0.05). After treatment, PSQ, WFIRS-P, SDQ and CBCL scores were significantly decreased, but QCD scores were significantly increased in both groups (P < 0.05). After treatment, the scores of PSQ, WFIRS-P, SDQ, CBCL and QCD in treatment group were better than those in control group (P< 0.05). Conclusion Jingling Mixture combined with methylphenidate has accurate overall effect in treatment of attention deficit hyperactivity disorder in children, and can effectively accelerate the improvement of core symptoms, reduce functional impairment, emotional and behavioral problems, which is worthy of clinical application.

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