针刺疗法联合游戏干预治疗孤独症谱系障碍 儿童的临床效果

Efficacy of Acupuncture Therapy Combined with Game Intervention in the Treatment of Children with Autism Spectrum Disorder

摘要: 目的：探讨针刺疗法与游戏干预联合应用对孤独症谱系障碍(ASD)儿童临床症状的改善效果。方法：本研究为前瞻性随机对照试验，于2023年1月至2024年12月在中山大学孙逸仙纪念医院儿童医学中心神经专科开展，采用随机数字表法将符合《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准的60例ASD患儿分为治疗组和对照组，每组各30例。对照组接受游戏干预，治疗组在对照组基础上加用针刺疗法，疗程共12周。分别于治疗前、治疗6周及12周后，采用儿童孤独症评定量表(CARS)、孤独症治疗评估量表(ATEC)和孤独症行为量表(ABC)评估患儿症状改善情况，并比较两组疗效差异。结果：治疗6周和12周后，两组各量表评分均较治疗前显著降低；治疗组在治疗6周时ATEC、ABC、CARS量表总分已显著优于对照组，治疗12周时各量表评分改善幅度进一步扩大，且两组治疗12周时各量表评分均较治疗6周时持续降低。治疗12周后，治疗组总有效率显著高于对照组，两组疗效差异有统计学意义。两组均未出现严重不良反应。结论：针刺疗法联合游戏干预可显著改善ASD儿童的核心症状，尤其在社交沟通和行为方面优于单纯游戏干预，且安全性良好，可为ASD综合干预提供循证依据。

Abstract: Objective: To explore the effect of the combined application of acupuncture therapy and game intervention on the clinical symptoms of children with autism spectrum disorder (ASD). Methods: This study was a prospective randomized controlled trial conducted at the Neurology Department of the Children’s Medical Center of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2023 to December 2024. Using the random number table method, 60 children diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) (DSM-5) were divided into the treatment group and the control group, with 30 cases in each group. The control group received game intervention, while the treatment group received acupuncture therapy in addition to the control group. The treatment course lasted for 12 weeks. Before treatment, at 6 weeks, and at 12 weeks after treatment, the symptoms of the children were evaluated using the Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), and Autism Behavior Checklist (ABC), and the differences in efficacy between the two groups were compared. Results: After 6 weeks and 12 weeks of treatment, the scores of each scale in both groups were significantly lower than those before treatment. At 6 weeks of treatment, the total scores of ATEC, ABC, and CARS in the treatment group were significantly better than those in the control group. At 12 weeks of treatment, the improvement in the scores of each scale was further expanded, and the scores of each scale in the treatment group continued to decrease compared with those at 6 weeks of treatment. At 12 weeks of treatment, the total effective rate of the treatment group was significantly higher than that of the control group, and the difference in efficacy between the two groups was statistically significant. No serious adverse reactions occurred in both groups. Conclusion: Acupuncture therapy combined with game intervention can significantly improve the core symptoms of ASD children, especially in social communication and behavior, and is superior to simple game intervention. It has good safety and can provide evidence-based basis for comprehensive intervention for ASD.