Objective To assess atomoxetine and methylphenidate therapy for attention- deficit/ hyperactivity disorder (ADHD) .Methods We electronically searched the Cochrane Library (Issue 2, 2008), PubMed (1970 to 2008), MEDLINE (1971 to 2008), EMbase (1971 to 2008), Medscape (1990 to 2008), CBM (1978 to 2008), and NRR (1950 to 2008). We also hand-searched some published and unpublished references. Two independent reviewers extracted data. Quality was assessed by the Cochrane Reviewer’s Handbook 4.0. Meta-analysis was conducted by The Cochrane Collaboration’s RevMan 4.2.8 software. Results We finally identified 3 randomized controlled trials that were relevant to the study. Treatment response (reducing ADHD-RS Inattention subscale score) was significantly greater for patients in the methylphenidate group than in the atomoxetine group with WMD= – 1.79 and 95%CI – 2.22 to 1.35 (Plt;0.000 01). There was no statistical difference in other outcome measures between two groups (Pgt;0.05). Conclusions The effectiveness and tolerance of methylphenidate and atomoxetine are similar in treatment of ADHD. Further large randomized, double blind, placebocontrolled trials with end-point outcome measures in long-term safety and efficacy are needed.
ObjectiveTo observe the effect of sensory integration training combined with methylphenidate hydrochloride on attention deficit hyperactivity disorder (ADHD). MethodsThe clinical data of 96 patients with ADHD diagnosed between January 2009 and March 2013 were retrospectively analyzed. The patients were divided into two groups by the table of random number. The trail group (n=48) received the combination therapy of sensory integration training combined with methylphenidate hydrochloride; while the control group (n=48) only received the medication of methylphenidate hydrochloride. The scores of sensory integration ability rating scale, integrated visual and auditory continuous performance test (IVA-CPT), Conner's behavior rating scale, Chinese Wechsler Intelligence Scale for Children (C-WISC) and adverse reactions were observed and compared between the two groups. ResultsThe scores of the sensory integration ability rating scale, FRCQ, FAQ (IVA-CPT), PIQ, VIQ, FIQ, C factor (C-WISC) in both of the two groups were significantly higher after the therapy; while the scores of the study, behavior, somatopsychic disturbance, impulsion, hyperactivity index and anxiety factor significantly decreased after the treatment (P<0.05). Compared with the control group, the trial group's scores of sensory integration ability rating scale, IVA-CPT, Conner's behavior rating scale, C-WISC were improved obviously, and the adverse reactions were significantly less (P<0.05). ConclusionThe sensory integration training combined with methylphenidate hydrochloride is sage and effective on children with attention deficit hyperactivity disorder.
目的 制備一種鹽酸哌甲酯（MPH）緩釋微丸膠囊劑，并與進口控釋片專注達?體外釋放情況進行比較研究。 方法 利用流化床包衣技術制備一種含有3種不同釋藥速率微丸的MPH緩釋微丸膠囊劑：將部分載藥微丸包保護層后制成速釋微丸；以乙基纖維素（Surelease?）為緩釋材料制備單層緩釋微丸；通過內包溶脹層（歐巴代-7006，主成分為低黏度羥丙基甲基纖維素（HPMC），外加控釋層制備具有時滯的雙層擇時緩釋微丸。在模擬胃腸道pH值介質中比較自制膠囊劑與控釋片的體外釋藥情況。 結果 載藥微丸實際載藥量6.85%。單層緩釋微丸包衣增重14%；雙層擇時緩釋微丸溶脹層包衣增重16%，控釋層包衣增重22%，時滯約3.5 h。3種微丸按以下比例混合后裝膠囊：速釋微丸含MPH 22%，單層緩釋微丸含MPH 39%，雙層擇時緩釋微丸含MPH 39%。該膠囊劑1 h釋放可達25%，4 h釋放約50%，12 h釋放＞95%。兩制劑在模擬胃腸道介質中的釋放曲線相似。 結論 制備出一種由3種微丸組成的，能連續12 h釋藥的MPH緩釋微丸膠囊劑，其工藝簡單，與進口控釋片專注達?有相同的體外釋放效果。