维生素D联合盐酸托莫西汀对ADHD患儿的效果及对其行为功能障碍和神经功能损伤的影响

doi:10.20223/j.cnki.1000-8535.2025.09.017

摘要/Abstract

摘要： 目的探讨对注意缺陷多动障碍（ADHD）患儿联合应用维生素D与盐酸托莫西汀的效果及对其行为功能障碍和神经功能损伤的影响。方法选择于我院接受治疗的105例ADHD患儿,纳入时间为2023年7月—2024年3月,按照计算机分组法分为对照组52例给予盐酸托莫西汀治疗,观察组53例给予维生素D联合盐酸托莫西汀治疗,比较两组临床疗效、神经与行为功能、不良反应。结果观察组总有效率（96.23%）高于对照组（78.85%）（P<0.05）。治疗后,与对照组比较,观察组神经元特异性烯醇化酶水平与行为、学习、躯体、冲动多动、焦虑及多动指数评分更低（P<0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论对于ADHD患儿,使用维生素D联合盐酸托莫西汀显示出更为显著的疗效,能有效缓解行为功能障碍,减少神经功能损伤,且具有良好的安全性。

关键词: 注意力缺陷多动障碍, 神经功能, 盐酸托莫西汀, 维生素D

Abstract: Objective To explore the effect of combined use of vitamin D and atomoxetine hydrochloride on children with attention deficit hyperactivity disorder（ADHD）and its impact on their behavioral dysfunction and neurological damage. Methods A total of 105 children with ADHD treated in the hospital were included from July 2023 to March 2024. They were divided into control group with 52 cases treated with atomoxetine hydrochloride,and observation group with 53 cases treated with vitamin D combined with atomoxetine hydrochloride using a computerized grouping method. The clinical efficacy,neurological function,behavioral function,and adverse reactions were observed in both groups. Results The total effective rate of the observation group（96. 23%）was higher than that of the control group（78. 85%）（P<0. 05）. After treatment,compared with the control group,the levels of neuron-specific enolase in the observation group were significantly lower in terms of behavior,learning,physical fitness,impulsivity hyperactivity,anxiety and hyperactivity index scores（P<0. 05）. The comparison of the incidence of adverse effects between the two groups was not significant（P>0. 05）. Conclusions The combined use of vitamin D and atomoxetine hydrochloride has a more significant therapeutic effect on children with ADHD,which can effectively alleviate behavioral dysfunction,reduce neurological damage,and has good safety.

Key words: attention deficit hyperactivity disorder, neurological function, atomoxetine hydrochloride, vitamin D

谢积强, 高兴珺, 李睿. 维生素D联合盐酸托莫西汀对ADHD患儿的效果及对其行为功能障碍和神经功能损伤的影响[J]. 广州医药, 2025, 56(9): 1277-1282.

XIE Jiqiang, GAO Xingjun, LI Rui. The effect of vitamin D combined with atomoxetine hydrochloride on ADHD children and its impact on their behavioral dysfunction and neurological damage[J]. Guangzhou Medical Journal, 2025, 56(9): 1277-1282.

参考文献

[1] 钦云峰,凌寅杰,郎妍.维生素D联合盐酸托莫西汀治疗儿童注意力缺陷多动障碍的临床疗效和安全性评价[J].中国药师,2024,27(2):287-294.
[2] 于晓雯. 盐酸托莫西汀胶囊对小儿多动症的治疗疗效及对血清25-羟维生素D3水平的影响[J].中国处方药,2022,20(5):102-104.
[3] 梁淑晶. 盐酸托莫西汀(ATX)与盐酸哌甲酯(MPH)治疗儿童注意缺陷多动障碍(ADHD)的临床疗效及安全性比较[J].中国医药指南,2020,18(7):82-83.
[4] 陈瑞琴,陶容,姬翠影,等.盐酸托莫西汀在儿童ADHD合并短暂性抽动障碍中的疗效观察[J].中国妇幼健康研究,2021,32(12):1797-1801.
[5] 符迪,郭宏丽,胡雅慧.托莫西汀在注意力缺陷多动障碍患儿中的精准药学研究:CYP2D6基因检测和治疗药物监测[J].中国当代儿科杂志,2023,25(1):98-103.
[6] 钟贞,邹力,史晓宁.盐酸托莫西汀联合耳部铜砭刮痧及压豆法治疗注意缺陷多动症患儿的疗效观察[J].世界中西医结合杂志,2023,18(1):179-182,208.
[7] 毛萌.儿童注意力缺陷多动障碍的临床诊断与治疗[J].中国儿童保健杂志,2008,16(2):125,128.
[8] 贾芝妮,汪金梅,欧阳萍.盐酸托莫西汀治疗注意缺陷多动障碍患儿的体重降低情况及危险因素和对策分析[J].中国当代医药,2023,30(25):117-120.
[9] 谢凤,刘晓峰,林泓,等.注意缺陷/多动障碍儿童服用盐酸托莫西汀治疗的疗效与安全性观察[J].中南药学,2020,18(11):1920-1927.
[10] ROY N M,AL-HARTHI L,SAMPAT N,et al.Impact of vitamin D on neurocognitive function in dementia,depression,schizophrenia and ADHD[J].Front Biosci(Landmark Ed),2021,26(3):566-611.
[11] SHAW P,SUDRE G.Adolescent attention-deficit/hyperactivity disorder:Understanding teenage symptom trajectories[J].Biol Psychiatry.2021,89(2):152-161.
[12] 张延赤,张晓敏,王艳波,等.发育性语言障碍共病注意缺陷多动障碍患儿血清维生素D水平检测及其意义[J].吉林大学学报(医学版),2023,49(2):492-500.
[13] 杨桃妮,王嫚,贾永苗,等.维生素D辅助治疗对癫痫共患注意力缺陷多动障碍患儿认知功能与血清炎性因子水平的影响[J].延安大学学报(医学科学版),2023,21(1):55-58.
[14] 王慧婷,刘子奇,杨健.维生素D在注意缺陷多动障碍发病机制中的研究进展[J].中国医药,2023,18(11):1733-1737.
[15] 沈玲,蔡世忠,季忆婷,等.注意缺陷多动障碍儿童血清维生素D水平分析[J].右江民族医学院学报,2021,43(3):373-375.
[16] 崔盈,仇午娴,徐华,等.维生素D联合盐酸哌甲酯治疗在合并维生素D缺乏的注意缺陷多动障碍患儿中的应用效果[J].广西医学,2023,45(17):2057-2062.
[17] 陈先睿,黄建琪,陈玲,等.不同维生素D水平与注意缺陷多动障碍关系的Meta分析[J].中国全科医学,2020,23(35):4490-4497.
[18] 杜林军,马敬斌,张晓兰,等.注意缺陷多动障碍患儿血清NSE,S100β水平与社会功能的关系研究[J].四川医学,2024,45(5):502-506.
[19] 房海波,王荣,褚琳娜,等.血清维生素D水平与伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿认知功能的相关性分析[J].中国儿童保健杂志,2022,30(7):775-778.
[20] 牟春燕,韩波.盐酸托莫西汀联合听觉统合训练治疗儿童注意缺陷多动障碍的效果[J].医学临床研究,2023,40(11):1645-1648.
[21] 蔡婧晔,邹秋艳,孙丽娜,等.盐酸托莫西汀联合心理-行为疗法在儿童多动症的应用效果[J].中国当代医药,2023,30(12):86-89.
[22] 沈辉. 静灵口服液联合盐酸托莫西汀口服溶液治疗儿童注意缺陷多动障碍效果的探讨[J].现代医学与健康研究电子杂志,2024,8(9):99-101.
[23] 夏莹莹,吕莹波,吕兰秋.儿童注意缺陷多动障碍的研究进展[J].现代实用医学,2023,35(2):270-272.
[24] 李赛,樊秋月,刘旭华,等.儿童注意缺陷多动障碍相关危险因素的研究进展[J].中国中西医结合儿科学,2023,15(5):410-415.
[25] SEYEDI M,GHOLAMI F,SAMADI M,et al.The effect of vitamin D3 supplementation on serum BDNF,dopamine,and serotonin in children with attention-deficit/hyperactivity disorder[J].CNS Neurol Disord Drug Targets,2019,18(6):496-501.