| This text studied the literature of modern medicine and Chinese medicine on attention deficit hyperactivity disorder,and carried on a research about acupuncture from clinical observation and experiment.ObjectiveTo observe the clinical curative effect of acupuncture for treating attention deficit hyperactivity disorder,and mechanism from the experimental point of view of its preliminary study carried out for attention deficit hyperactivity disorder to provide new ideas for treatment.MethodsAt clinical observations,to the preparation of the American Psychiatric Institute of the mental disorders,"Diagnostic and Statistical Manual" (Diagnostic and Statistical Manual of Mental disorders,DSM) fourth and revised edition(DSM-Ⅳ-R) on attention deficit hyperactivity disorder diagnosis for the diagnosis standards,would be consistent with the diagnosis and the standard of 33 6-12 year-old ADHD children into the group acupuncture (Jin three-needle).Prescription:sishenzhen,dingshenzhen,shouzhizhen; modification:deficiency Qi of heart and spleen,sanyinjiao,zusanli;phlegm and fire confusing the heart,shaofu,fenglong;deficiency of kidney and flaring-up of liver-yang,taixi,xingjian.1 hour each time,take acupuncture every day during the winter and summer vacations,six times a week;take acupuncture every two days during going to school,three times a week;45 times as a period of treatment.The outcome measures are Childhood attention deficit hyperactivity disorder rating scale;Conners Parents questionnaire(PSQ) scale.Evaluate was carried on before and after treatment, statistical analysis the values with software of spss 15.0.In experimental studies,spontaneously hypertensive rats(SHR) model was selected,having multi-level simulation of the clinical features of ADHD,and being internationally recognized and referencing the animal model.18 male SHR rats were randomly separated into group acupuncture,group Ritalin,model control group,and six in each group.And another 6 normal rats were set up as blank control group.Treatment:group acupuncture took baihui,yintang, selecting 30th 0.5-inch needles,inserted into the acupoints of head,one time each day,3-5 seconds each time,continued 20 days.Group Ritalin gavaged with Ritalin aqueous solution 4 mg·kg-1·d-1 each morning,model control group fed with the same amount of normal saline each morning,one time each day, continued 20d.To observe the changes of the SHR rats' weight,after the end of the experiment,the content of noradrenaline(NE),dopamine(DA),and 5-hydroxytryptamine(5-HT) in serum and brain tissue of SHR rats was detected by the therapy of high performance liquid and compared with the blank control group.ResultsClinical observation indicated that a comparison of before and after treatment,the hyperactivity index scores in the treatment of the first course of treatment,the second course of treatment compared with before treatment were significantly different(P＜0.05),clued on acupuncture for treatment of Attention Deficit Hyperactivity Disorder to be effective,total effective rate was 84.85%.Compared with pre-treatment,it was significantly different (P＜0.05) about the 5 factors of morality,learning,psychosomatic disorder, impulse-hyperactivity and anxiety in Conners Parent Questionnaire of the first and the second treatment,showed that acupuncture for Attention Deficit Hyperactivity Disorder was the overall and comprehensive improvement of symptoms.It was significantly different(x~2=9.0659,P＜0.05) between the group of 6～8-year-old and the group of 8~+～12-year-old,and the former was more effective than the latter,showed that the curative effect of the younger was better.Duration≥4 years was poor effective,and the difference was significant(P＜0.05),showed that the children of Attention Deficit Hyperactivity Disorder should be treated with acupuncture as early as possible, so as not to miss the best time of treatment.The second course of treatment was more efficient than the first course of treatment,the difference was significant(P＜0.05),suggesting that the curative effect of acupuncture for ADHD increased with extended treatment.ADHD mixed type was the most, accounting for 63.64 percent,followed by attention deficit-based,accounting for 30.3%,hyperactivity disorder-type was the least,accounting for 6.06%; the curative effect of acupuncture for the different types of ADHD were significantly different(P＜0.05),hyperactivity disorder-type and mixed type showed a better effect.In the TCM Syndrome Types of ADHD,the type of deficiency qi of heart and spleen was the most,accounting for 51.52%,followed by the type of phlegm and fire confusing the heart,36.36%,the type of deficiency of kidney and flaring-up of liver-yang was the least,accounting for 12.12%.The curative effect of acupuncture for the different TCM Syndrome Types of ADHD were significantly different(P＜0.05),the type of deficiency qi of heart and spleen showed a better effect.In experimental research,the measured body weight of rats in the group acupuncture and group Ritalin compared with the model control group in all time points,were no significant difference(P＞0.05),comparing with group acupuncture and group Ritalin,there was also no significant difference (P＞0.05).The body weight of SHR rats was not affected by the treatments of acupuncture and Ritalin.The serum levels of NE,DA,5-HT in Model rats were higher than the concentration of the blank control group,that were significantly different(P＜0.05),and the content of NE and DA in brain tissue of model group,was lower than the concentration of the blank control group, that was significantly different(P＜0.05).The serum levels of NE,5-HT in the group acupuncture and group Ritalin,was little higher,and the serum levels of DA was lower compared with the model group,which were no significant difference(P＞0.05).The serum levels of NE,5-HT of group acupuncture were lower than the concentration of group Ritalin,which was no significant difference(P＞0.05);the serum levels of DA of group acupuncture was lower than the concentration of group Ritalin,which was significant difference (P＜0.05).The levels of NE,DA in brain tissue of the group acupuncture and Ritalin,was little higher compared with the model group,which were no significant difference(P＞0.05).The levels of NE,DA in brain tissue of group acupuncture was higher than the concentration of group Ritalin,which was no significant difference(P＞0.05).These results suggestd that the content of monoamine neurotransmitter was not significantly influenced by the group acupuncture and group Ritalin,but the group acupuncture and group Ritalin were significantly different in reducing the content of DA in serum. ConclusionAcupuncture can improve ADHD in morality,psychosomatic disorder,and anxiety problems,reduce impulse-hyperactivity symptoms,and improve the learning ability,it is effective in treating ADHD by acupuncture.There is better curative effect in smaller age and shorter duration,suggesting the children of Attention Deficit Hyperactivity Disorder should be treated with acupuncture as early as possible,so as not to miss the best time of treatment. Slowly effecting,the curative effect of acupuncture for ADHD increased with extended treatment.There is better curative effect on the type of hyperactivity disorder and Deficiency Qi of heart and spleen by acupuncture. The serum levels of NE,DA,5-HT in SHR rats were significantly higher than the concentration of the normal control group which was considered that the content of monoamine neurotransmitters in blood reflects the sympathetic excitability.It seems likely that the action resulted in the activities of ADHD children;and the content of NE and DA in brain tissue of SHR rats was significantly lower than the normal control group,that was confirmed the hypothesis of deficient function in catecholamine system.CA was insufficiency resulting in the lack of inhibition in brain function,which is likely to be one of the reasons for inattention,hyperactivity impulse of ADHD.The content of monoamine neurotransmitter was not significantly influenced by acupuncture, but group acupuncture was better than group Ritalin in reducing the content of DA in serum.Its treatment mechanism may not relevant with influencing the monoamine neurotransmitter.
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