Rudimental Research Into Effects Of Combination Therapy Of Rehabilitation Training And Oral Bumetanide On Children With Autism

Objective: To observe the effects of rehabilitation training and oralbumetanide on the aspects of the social interaction, verbal and nonverbalcommunication, interests and behavior of newly diagnosed children withautism, and seek a new treatment for the therapy of the children with autism.Methods:96cases with newly diagnosed autism were gathered fromOctober of2010to December of2011in the department of pediatric neurologyand rehabilitation of the first hospital of Jilin University. According to thewillingness of the children's parents, the cases were divided into three groups:rehabilitation training group (32cases), bumetanide treatment group (26cases),rehabilitation training combined with bumetanide treatment group (38cases).Rehabilitation training items consisted of RDI, PECS, OT, ST, TEACCH, ABA,ESDM. The children received3-4training programs per day,30-40minutes perprogram; the bumetanide was orally administrated at the dose of0.3mg, twicea day to children who were younger than3years old and0.5mg, twice a day tothose who were older than3years old. The maximum dose was no more than2mg per day. The assessment of ABC, CARS and CGI was performed at thetime points before and at the end of1st,2nd,3rd,6th month after the initiationof treatment among the three groups, and laboratory tests such as blood routinetest, urine routine test, liver function test, renal function test, blood electrolytes,blood glucose and ECG were examined in the BUM group and RT+BUMgroup simultaneously.Results:(1) The general characteristics of three groups: There was no significant difference in the comparison of the age, age of onset, duration, place ofresidence, supporter, maternal age, paternal age, positive family history, parity,delivery type, birth weight, birth asphyxia, history of crawling, languagedevelopment among the three groups.(2) Comparison of ABC scores before and after the treatment: The totaland item scores of ABC were decreased in the three groups after the treatmentwhen compared with those scores in the groups prior to treatment respectively.After six months of the treatment, total scores of ABC of the three groups werestatistically significant when compared with those in the groups prior totreatment respectively. Of which the RT+BUM group had the lowest total anditem scores of ABC, followed by the RT group, the final group was BUMgroup, and differences of total scores of ABC among the three groups werestatistically significant.(3) Comparison of CARS scores before and after the treatment: The totaland item scores of CARS were decreased in the three groups after the treatmentwhen compared with those in the groups prior to treatment respectively. Aftersix months of the treatment, total scores of CARS of the three groups werestatistically significant when compared with those scores in the groups prior totreatment respectively. Of which the RT+BUM group had the lowest total anditem scores of CARS, followed by the RT group, the final group was BUMgroup, and the difference of the total score of CARS between BUM group andRT+BUM group was statistically significant.(4) Comparison of the Clinical Global Impression scores: Scores of SIwere decreased in the three groups after the treatment when compared withthose scores in the groups prior to treatment. After six months of the treatment,scores of SI of the three groups were decreased significant when compared withthose in the groups prior to treatment respectively. Of which the RT+BUMgroup had the lowest score of SI and GI, and the highest score of EI, followed by the RT group, the final group was BUM group, and the differences of scoresof SI, GI and EI between BUM group and RT+BUM group were statisticallysignificant.(5) Comparison of the retention rate after the treatment: After six monthsof the treatment, the retention rate of BUM group was84.6%(22/26cases), theRT group was87.5%(28/32cases), and the RT+BUM group was86.8%(33/38cases). There was no significant difference among the three groups in theretention rate.(6) The side effects:During the six months follow-up, abnormality was notfound in the laboratory data such as nothing abnormal was discovered aboutblood routine test, urine routine test, liver function test, renal function test,blood electrolytes, blood glucose and ECG of BUM group and RT+BUMgroup.Conclusion:(1) Bumetanide can decrease autistic behaviors without side effects.(2) The effect of rehabilitation training combined with bumetanidetherapy is better than simple rehabilitation training in the treatment of childrenwith autism.