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        west china medical publishers
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        find Keyword "哌甲酯" 4 results
        • 癲癇患兒注意缺陷多動障礙篩查、診斷和管理的系統評價:國際抗癲癇聯盟兒科委員會共病工作組共識

          注意缺陷多動障礙(Attention-deficit/hyperactivity disorder,ADHD)是癲癇患兒一種常見且富有挑戰的共患病。國際抗癲癇聯盟(ILAE)兒科委員會共病工作組發現,關鍵問題在于識別和管理癲癇患兒中的 ADHD。對支持這些問題的方法的證據進行了系統評價,并根據美國神經病學學會實踐參數的標準進行了整理和分級。遵循系統評價和 Meta 分析優先報告的條目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)要求,使用 PROSPERO 注冊 (CRD42018094617)。與女性癲癇患兒相比,男性患兒無更高的共患 ADHD 風險(Level A)。孕期使用丙戊酸鈉與子代注意力不集中和多動相關(1 項 I 級研究),且有智力和發育障礙的患兒合并 ADHD 的風險更高(A 級)。起病年齡對是否合并 ADHD 的影響尚不明確(U 級),但是發作控制欠佳的患兒合并 ADHD 的風險更高(B 級)。ADHD 的篩查應該從 6 歲或者明確診斷時開始,并且每年篩查一次(U 級),在抗癲癇藥物調整后也應該重新評估(U 級)。ADHD 的診斷應該由受過 ADHD 專業培訓的醫務工作者參與(U 級)。支持使用優勢和困難問卷篩查工具(B 級)。強烈建議有學習障礙的癲癇患兒進行正式的認知測試(U 級)。多藥治療的患兒出現行為問題的比例較單藥治療者更高(C 級)。丙戊酸鈉可以加劇失神發作患兒的注意力集中障礙(A 級)。哌甲酯在癲癇患兒中耐受性及療效均良好(B 級)。支持阿托莫西汀耐受性好的證據尚有限(C 級)。多學科參與過渡期和成人 ADHD 的診治至關重要(U 級)。總之,雖然可以對一些研究問題提出建議,但這項系統評價強調了開展更全面、更有針對性的大樣本前瞻性研究的必要性。

          Release date:2019-11-14 10:46 Export PDF Favorites Scan
        • A Meta-analyses Comparing Atomoxetine with Methylphenidate for Treatement of Children with Attention- Deficit/ Hyperactivity Disorder

          Objective To assess atomoxetine and methylphenidate therapy for attention- deficit/ hyperactivity disorder (ADHD) .Methods We electronically searched the Cochrane Library (Issue 2, 2008), PubMed (1970 to 2008), MEDLINE (1971 to 2008), EMbase (1971 to 2008), Medscape (1990 to 2008), CBM (1978 to 2008), and NRR (1950 to 2008). We also hand-searched some published and unpublished references. Two independent reviewers extracted data. Quality was assessed by the Cochrane Reviewer’s Handbook 4.0. Meta-analysis was conducted by The Cochrane Collaboration’s RevMan 4.2.8 software. Results We finally identified 3 randomized controlled trials that were relevant to the study. Treatment response (reducing ADHD-RS Inattention subscale score) was significantly greater for patients in the methylphenidate group than in the atomoxetine group with WMD= – 1.79 and 95%CI – 2.22 to 1.35 (Plt;0.000 01). There was no statistical difference in other outcome measures between two groups (Pgt;0.05). Conclusions The effectiveness and tolerance of methylphenidate and atomoxetine are similar in treatment of ADHD. Further large randomized, double blind, placebocontrolled trials with end-point outcome measures in long-term safety and efficacy are needed.

          Release date:2016-09-07 02:09 Export PDF Favorites Scan
        • Preparation and in vitro Release Behavior of Methylphenidate Hydrochlori Desustained-release Capsules

          目的 制備一種鹽酸哌甲酯(MPH)緩釋微丸膠囊劑,并與進口控釋片專注達?體外釋放情況進行比較研究。 方法 利用流化床包衣技術制備一種含有3種不同釋藥速率微丸的MPH緩釋微丸膠囊劑:將部分載藥微丸包保護層后制成速釋微丸;以乙基纖維素(Surelease?)為緩釋材料制備單層緩釋微丸;通過內包溶脹層(歐巴代-7006,主成分為低黏度羥丙基甲基纖維素(HPMC),外加控釋層制備具有時滯的雙層擇時緩釋微丸。在模擬胃腸道pH值介質中比較自制膠囊劑與控釋片的體外釋藥情況。 結果 載藥微丸實際載藥量6.85%。單層緩釋微丸包衣增重14%;雙層擇時緩釋微丸溶脹層包衣增重16%,控釋層包衣增重22%,時滯約3.5 h。3種微丸按以下比例混合后裝膠囊:速釋微丸含MPH 22%,單層緩釋微丸含MPH 39%,雙層擇時緩釋微丸含MPH 39%。該膠囊劑1 h釋放可達25%,4 h釋放約50%,12 h釋放>95%。兩制劑在模擬胃腸道介質中的釋放曲線相似。 結論 制備出一種由3種微丸組成的,能連續12 h釋藥的MPH緩釋微丸膠囊劑,其工藝簡單,與進口控釋片專注達?有相同的體外釋放效果。

          Release date:2016-09-07 02:33 Export PDF Favorites Scan
        • Clinical Efficacy of Sensory Integration Training Combined with Methylphenidate Hydrochloride on Attention Deficit Hyperactivity Disorder in Children

          ObjectiveTo observe the effect of sensory integration training combined with methylphenidate hydrochloride on attention deficit hyperactivity disorder (ADHD). MethodsThe clinical data of 96 patients with ADHD diagnosed between January 2009 and March 2013 were retrospectively analyzed. The patients were divided into two groups by the table of random number. The trail group (n=48) received the combination therapy of sensory integration training combined with methylphenidate hydrochloride; while the control group (n=48) only received the medication of methylphenidate hydrochloride. The scores of sensory integration ability rating scale, integrated visual and auditory continuous performance test (IVA-CPT), Conner's behavior rating scale, Chinese Wechsler Intelligence Scale for Children (C-WISC) and adverse reactions were observed and compared between the two groups. ResultsThe scores of the sensory integration ability rating scale, FRCQ, FAQ (IVA-CPT), PIQ, VIQ, FIQ, C factor (C-WISC) in both of the two groups were significantly higher after the therapy; while the scores of the study, behavior, somatopsychic disturbance, impulsion, hyperactivity index and anxiety factor significantly decreased after the treatment (P<0.05). Compared with the control group, the trial group's scores of sensory integration ability rating scale, IVA-CPT, Conner's behavior rating scale, C-WISC were improved obviously, and the adverse reactions were significantly less (P<0.05). ConclusionThe sensory integration training combined with methylphenidate hydrochloride is sage and effective on children with attention deficit hyperactivity disorder.

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