虚拟现实认知训练辅助治疗儿童注意缺陷多动障碍疗效观察

蔡子耀; 陈春棉; 栾泓霖; 陈浩然; 叶鑫武; 马晓韵; 安雪微

doi:10.16766/j.cnki.issn.1674-4152.004088

虚拟现实认知训练辅助治疗儿童注意缺陷多动障碍疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.004088

温州市第七人民医院科教科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2023ZF164

温州市基础性科研项目 Y20220240

详细信息

通讯作者:
陈春棉，E-mail: chunmianchenwzmh@163.com

中图分类号: R729 R229
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- 文章访问数: 7
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-23
- 网络出版日期: 2025-10-25

The application value of VRCTS based on the theory of TCM sentiment in the treatment of children with ADHD

Department of Science and Education, the Seventh People ' s Hospital of Wenzhou, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的观察基于中医情志理论的虚拟现实认知训练(VRCTS)辅助治疗注意缺陷多动障碍(ADHD)的疗效，为改善ADHD患儿的治疗效果提供帮助。方法选取2021年1月—2023年2月就诊于温州市第七人民医院的98例ADHD患儿，采用信封法分为常规组、研究组各49例，2组均采用常规治疗，常规组开展认知行为疗法(CBT)，研究组在常规组基础上采用基于中医情志理论的VRCTS辅助疗法，比较2组患儿CONNERS评定量表(教师版)、Achenbach儿童行为量表(CBCL)家长版及临床疗效差异。结果 2组治疗后CONNERS评定量表、CBCL量表的各维度评分均较治疗前降低，且研究组CONNERS评定量表各维度评分、CBCL量表各维度(除躯体主诉评分)评分均低于常规组，差异均有统计学意义(P＜0.05)。研究组CONNERS减分率[(64.73±8.99)% vs.(53.13±8.93)%]及CBCL评定减分率[(46.03±6.69)% vs.(29.35±8.78)%]均高于常规组，差异有统计学意义(χ²=6.404、10.578，均P＜0.001)。结论对ADHD患儿采用基于中医情志理论的VRCTS辅助认知行为疗法，可有效改善患儿的在校期间品行问题、多动、注意缺陷等核心症状，减轻患儿居家期间情绪行为问题。
- 注意缺陷多动障碍 /
- 虚拟现实认知训练 /
- 中医情志理论 /
- 疗效 /
- 儿童
Abstract: Objective To observe the efficacy of virtual reality cognition training system (VRCTS) based on emotion theory of traditional Chinese medicine (TCM) in assisting the diagnosis and treatment of children with attention deficit hyperactivity disorder (ADHD), and to provide help to improve the treatment effect of children with ADHD. Methods A total of 98 children with ADHD admitted to Wenzhou Seventh People ' s Hospital from January 2021 to February 2023 were selected and divided into the routine group and the research group with 49 cases each by envelope method, and both groups were treated with conventional therapy, with the conventional group carrying out cognitive-behavioral therapy (CBT), On the basis of the conventional group, the research group adopted VRCTS adjuvant therapy based on the emotional theory of traditional Chinese medicine, to compare the differences in the CONNERS rating scale (teacher version), Achenbach child behavior scale (CBCL) parent version, and clinical efficacy between the two groups. VRCTS adjuvant therapy was used in the conventional group, and the CONNERS scale (teacher version), Achenbach ' s child behaviour scale (parent version), and clinical efficacy were compared between the two groups. Results After treatment, the scores of CONNERS rating scale and CBCL scale in both groups were lower than before treatment, and the scores of CONNERS rating scale and CBCL scale in the study group were lower than those in the conventional group, with statistical significance (P < 0.05). The reduction rate of CONNERS [(64.73±8.99)% vs. (53.13±8.93)%] and the reduction rate of CBCL [(46.03±6.69)% vs. (29.35±8.78)%] in the study group were higher than those in the conventional group, and the difference was statistically significant (χ²=6.404, 10.578, all P < 0.001). Conclusion VRCTS-assisted cognitive-behavioural therapy based on Chinese medicine ' s emotion theory for children with ADHD can effectively improve core symptoms such as conduct problems, hyperactivity, and attention deficits during the school day, and reduce emotional-behavioural problems during the home day.
- Attention deficit hyperactivity disorder /
- VR cognitive training /
- Emotion theory of traditional Chinese medicine /
- Efficacy /
- Children

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表 1 基于情志的VRCTS干预的个体化方案

Table 1. Individualized VRCTS intervention plan based on emotion

七情五志	临床表现	VRCTS任务场景
悲可以制怒	易怒和冲动	日落半月岛
喜可以治悲	情绪低落或悲伤	欢乐射击场
恐可以治喜	过度兴奋或注意力不集中	模拟逃生场景
怒可以制思	过度思考或担忧	乒乓球模拟器
思可以治恐	恐惧或担忧	超市购物、转盘迷宫

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表 2 2组ADHD患儿一般资料比较

Table 2. Comparison of general data between two groups of children with ADHD

组别	例数	性别(男/女，例)	年龄(x±s，岁)	病程(x±s，月)	药物治疗[例(%)]
常规组	49	26/23	8.63±1.44	7.16±2.36	26(53.06)
研究组	49	28/21	8.59±1.35	7.45±2.49	25(51.02)
统计量		0.165^a	0.145^b	0.583^b	0.041^a
P值		0.685	0.885	0.561	0.840
注：^a为χ²值，^b为t值。

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表 3 2组ADHD患儿CONNERS评定量表(教师版)评分比较(x±s, 分)

Table 3. Comparison of CONNERS teacher rating scale scores between two groups of children with ADHD (x±s, points)

组别	例数	品行问题		多动		注意力不集中		多动指数
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
常规组	49	9.35±4.26	4.65±1.03^b	10.53±4.12	4.27±0.53^b	12.02±4.12	7.86±1.29^b	16.43±4.97	5.27±1.27^b
研究组	49	9.39±4.37	3.12±0.95^b	10.55±4.27	3.63±0.49^b	12.43±4.53	6.82±0.86^b	16.49±5.23	3.00±1.51^b
统计量		0.047^a	58.479^c	0.024^a	38.000^c	0.466^a	4.700^c	0.059^a	8.065^c
P值		0.963	＜0.001	0.981	＜0.001	0.642	＜0.001	0.953	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组ADHD患儿CBCL量表(家长版)评分比较(x±s，分)

Table 4. Comparison of Achenbach CBCL parent version scores between two groups of children with ADHD (x ±s, points)

组别	例数	情感反应		焦虑抑郁		躯体主诉		退缩			攻击问题
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后		治疗前	治疗后
常规组	49	2.51±0.51	2.06±0.88^b	3.67±1.34	2.33±0.47^b	2.04±0.45	1.14±0.84	2.18±0.39	2.04±0.79^b		10.33±0.47	6.86±1.49^b
研究组	49	2.53±0.50	1.73±0.45^b	3.69±1.23	2.02±0.32^b	1.98±0.88	1.02±0.25	2.06±0.32	1.63±0.49^b		10.31±0.47	4.49±0.82^b
统计量		0.200^a	5.310^c	0.078^a	3.740^c	0.434^a	0.968^c	1.703^a	8.400^c		0.215^a	94.270^c
P值		0.842	0.023	0.938	＜0.001	0.666	0.328	0.092	0.005		0.830	＜0.001

组别	例数	注意问题		睡眠问题		内向性问题		外向性问题
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前		治疗后
常规组	49	2.63±0.49	1.84±0.75^b	2.82±0.81	2.10±0.47^b	10.41±2.34	7.57±1.74^b	>13.16±3.18		>8.96±1.72^b
研究组	49	2.69±0.47	1.10±0.82^b	2.84±0.75	1.63±0.49^b	10.31±2.28	6.41±1.24^b	>13.14±3.15		>6.51±1.37^b
统计量		0.636^a	21.080^c	0.130^a	23.578^c	0.219^a	3.805^c	>0.032^a		>60.382^c
P值		0.526	＜0.001	0.897	＜0.001	0.827	＜0.001	>0.975		>＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 2组ADHD患儿临床疗效比较(x±s，%)

Table 5. Comparison of clinical efficacy between two groups of children with ADHD (x ±s, %)

组别	例数	CONNERS减分率	CBCL评定减分率
常规组	49	53.13±8.93	29.35±8.78
研究组	49	64.73±8.99	46.03±6.69
t值		6.404	10.578
P值		＜0.001	＜0.001

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