Study On The Effect Of Jingning Granules On Executive Function And Clinical Efficacy In Children With ADH

Objective:This clinical study is divided into two parts.The first part is to compare the difference of response inhibition function and serum BDNF level between ADHD children and normal children,and to explore the correlation between response inhibition function and ADHD symptoms,the correlation between serum BDNF level and ADHD core symptoms,and the correlation between serum BDNF and response inhibition function.The second part mainly re-evaluates the clinical efficacy and safety of Jingning Particles in the treatment of ADHD children with Qi and Yin deficiency syndrome.The effects of Jingning Particles on response inhibition function and serum BDNF in executive function of children with ADHD before and after treatment were evaluated.Methods:The first part of the study included 33 ADHD children who met the inclusion criteria and 12 children who underwent normal physical examination in our hospital from December 2021 to February 2023 in the pediatric outpatient department of Dongzhimen Hospital of Beijing University of Chinese Medicine.Collect their basic data including age,gender,and intelligence.Two groups of children were evaluated by SNAP-Ⅳ scale,Stroop test and serum BDNF level.The second part of the study included children who visited the pediatric outpatient department of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine and the pediatric outpatient department of Xiamen Hospital of Traditional Chinese Medicine of Beijing University of Traditional Chinese Medicine from December 2021 to February 2023.The legal guardians of the children signed the informed consent of the patients and agreed to participate in the study.A total of 26 children aged 6-14 years old who met the diagnostic criteria and TCM syndrome differentiation of qi and yin deficiency syndrome were included,including 24 children in Dongzhimen Hospital and 2 children in Xiamen Hospital of Traditional Chinese Medicine.The included ADHD children were given Jingning formula Particles orally for 8 weeks.The SNAP-Ⅳ scale and TCM syndrome score scale were filled out at 0 weeks,4 weeks and 8 weeks,respectively.The CONNERS behavior scale(parental version),Stroop test and serum BDNF level were filled out at 0 weeks and 8 weeks.Results:The results of the first part of the study are as follows:33 ADHD children were compared with 12 normal children.There was no significant difference in age,gender and intelligence level of the included children.The correct number of ADHD children in the Stroop test was lower than that of normal children,and the difference was statistically significant.The consistent reaction time,the contradictory reaction time and the meaning interference time of the word color were significantly longer than those of the normal children,and the difference was statistically significant.The word color irrelevant reaction time was longer than that of normal children,and the difference was statistically significant.There was no significant difference in the reaction time between the word meaning irrelevant and the sound meaning related and the normal children.The analysis results of the correlation between the results of Stroop and the core symptoms of ADHD are as follows:the time of character-color contradiction is moderately correlated with the total score of SNAP-Ⅳ;the time of semantic interference was moderately correlated with the total score of SNAP-Ⅳ.The correct number is weakly correlated with the attention deficit subscale;the reaction time of color contradiction was weakly correlated with the attention deficit subscale.The word meaning interference time is weakly correlated with the attention deficit subscale;the word meaning irrelevant reaction time was moderately correlated with the oppositional defiant subscale,and the remaining scores were not correlated with the items.Due to poor compliance of children and parents and refusal to take serum samples,13 children with ADHD and 10 normal children were included for comparison and correlation analysis.There was no significant difference in age and sex between the two groups.The serum BDNF level of ADHD children was significantly lower than that of normal children,and the difference was statistically significant.There was a moderate correlation between the serum BDNF level and the hyperactivity impulse subscale,and there was no correlation between the remaining item scale scores and the serum BDNF level.In ADHD children,there was a moderate correlation between the reaction time of word meaning consistency and serum BDNF level.There was a strong correlation between reaction time and serum BDNF level,and the other Stroop items were related to normal children and ADHD children.Conclusion:The conclusions of the first part of the study are as follows:1.In comparison with normal children,there are differences in the response inhibition function and serum BDNF levels in the executive function of ADHD children.The impairment of response inhibition function in ADHD children may be one of the reasons for the obvious attention deficit symptoms in the core symptoms.The serum BDNF of ADHD children in this study may affect the hyperactive impulse symptoms of the three core symptoms of ADHD.4.In this study,there was no significant correlation between the key items of response inhibition function of ADHD children and serum BDNF levels.The second part of the research conclusions are as follows:1.Jingning formula Particless can significantly improve the core symptoms of ADHD children with deficiency of both qi and yin,which is reflected in the significant improvement of SNAP-Ⅳ scale,CONNERS behavior scale(parental version)and TCM syndrome score scale.2.After 8 weeks of treatment with Jingning Particles,ADHD children improved in the Stroop test in the time of consistent character color,the time of unrelated character color and the time of contradictory character color,suggesting that Jingning Particles may improve the executive function of ADHD children and reduce the impact of core symptoms;after 8 weeks of treatment,the serum BDNF level of ADHD children was also effectively improved,suggesting that Jingning Particles may play a role by regulating serum BDNF.