Efficacy Of Different Methods In The Treatment Of Children With ADHD

This study systematically analyzed the intervention effects of commonly used psychotherapy in children with attention deficit hyperactivity disorder(ADHD)and the improvement of the core symptoms of ADHD in children.Search CBM,CNKI,Weipu database,Wanfang database,Chaoxing database,using search terms as attention deficit hyperactivity disorder,ADHD,ADHD,treatment,intervention.The search time limit is from the establishment of the database to December 2020,the language of the literature is limited to Chinese,and a total of 12946 articles are included.The literature inclusion criteria are randomized controlled trials(RCT)or self-controlled before and after trials.After the duplicate documents were eliminated by Note Express software,two researchers performed manual document screening,data extraction and bias evaluation.The bias evaluation was conducted in accordance with the "Cochrane Intervention System Evaluation Manual"(5th edition).In the end,there are 319 documents that meet the requirements.After extracting the data,use Review Manager 5.3 for Meta-analysis.A total of 319 studies were included in this study,of Which 272 were RCTs and the remaining 47 were self-control studies.A total of 26640 subjects,including 13598 in the experimental group and 13042 in the control group,aged 4-12 years.Among the included literatures,42 adopted western medicine intervention,62 adopted traditional Chinese medicine intervention,23 adopted combination of Chinese and Western medicine intervention,20 adopted sensory integration training intervention,9 adopted nursing intervention,39 adopted biofeedback intervention,18 adopted family training intervention,15 adopted cognitive behavior therapy intervention,15 adopted sand table game intervention,5 adopted group counseling intervention,and 26 adopted psychological intervention Six Were intervened by acupoint massage,4 by art,17 by acupuncture,4 by attention training,and 20 by comprehensive treatment.The duration of intervention ranged from 0.5 months to more than 6 months.A total of 319 clinical symptoms were analyzed:SMD=-0.97,95%CI:-1.1~0.84,P<0.00001.Then,the intervention methods were used as subgroup variables,and the non drug treatment Was used for subgroup analysis.Then,the outcome indexes were used as subgroup variables,and the subgroup analysis was carried out to compare the efficacy differences of common intervention methods on different outcome indexes.Then the intervention time was used as a subgroup variable for subgroup analysis to compare the efficacy of different intervention time.The results of subgroup analysis Were as follows:the effectiveness of sensory integration for ADHD:SMD=-1.18,95%CI:-1.61~-0.76,P<0.00001;the effectiveness of cognitive behavior therapy for ADHD:SMD=-1.23,95%CI:-1.78~-0.68,P<0.00001;The effectiveness of family training on ADHD:SMID=-1,95%CI:-1.73~-0.27,P<0.00001;the effectiveness of Sandplay Therapy on ADHD:SMD=-1.13,95%CI:-1.95~-0.31,P<0.00001;the effectiveness of psychological nursing intervention on ADHD:SMD=-1.12,95%CI:-1.27~-0.96,P<0.00001;the effectiveness of group counseling on ADHD:SMD=-1.16,95%CI:-2.05~-0.27,P<0.00001;the effectiveness of psychological nursing intervention on ADHD:SMD=-1.12,95%CI:-1.27~-0.96,P<0.00001;the effectiveness of group counseling on ADHD:SMD=-1.16,95%CI:-2.05 The effectiveness of substance feedback on ADHD:SMD=-0.2,95%CI:-0.63~-0.22,P<0.00001;the effectiveness of psychotherapy on ADHD:SMD=-1,95%CI:-1.45~-0.55,P<0.00001;the effectiveness of art therapy on ADHD:SMD=-1.55,95%CI:-2.91~-0.19,P<0.00001;the effectiveness of attention training on ADHD:SMD=-0.45,95%CI:-0.69~-0.2,P=0.0004.After Meta-analysis,the preliminary conclusions are as follows:(1)generally speaking,the commonly used intervention methods in recent 20 years can effectively improve the clinical symptoms of ADHD patients;(2)in all the Meta-analysis articles,the sample size is large.The distribution of all scatter points in funnel plot of publication bias is approximately symmetrical,indicating that there is no publication bias;(3)in this study,the overall P<0.001,I 2=96%,so it can be judged that the heterogeneity of the articles included in the study is high;(4)subgroup analysis of the effect of non drug treatment shows that:the effect of sandplay therapy,psychological nursing intervention,cognitive behavior therapy,family training and EGG biofeedback therapy The effect is better;(6)among the various evaluation indexes,Conners children’s behavior questionnaire parent version(PSQ),audio-visual whole continuous test(IVA-CPT),SNAP-Ⅳ and hyperactivity index scale(CIH)Were used more.The indicators with better effect were:PSQ total score of hyperactivity index,PSQ total score of impulsive hyperactivity,SNAP-Ⅳ average score of hyperactivity index,total score of Conners simple scale,BIS,DSM-Ⅳ.(7)The intervention effect of different intervention time is different.