执行功能训练对ADHD儿童抑制控制功能的干预效果研究

Effects of Executive Function Training on Inhibitory Control in Children with ADHD

摘要: 目的：探讨在药物治疗基础上附加执行功能训练对注意缺陷多动障碍(ADHD)儿童抑制控制功能及临床症状的改善效果。方法：将63例符合入组标准的ADHD患儿随机分为训练组(n = 33)与对照组(n = 30)。两组患儿均维持药物治疗，训练组在此基础上接受为期8周的执行功能训练。干预前后采用注意缺陷多动障碍评定量表(SNAP-IV)和执行功能行为评定量表(BRIEF)进行评估，通过两因素重复测量方差分析检验交互效应并比较临床有效率。结果：干预后，训练组在SNAP-IV的注意缺陷(F = 12.44, p = 0.001)、对立违抗(F = 16.83, p < 0.001)与BRIEF的抑制(F = 16.96, p < 0.001)、一般执行总分(F = 18.76, p < 0.001)维度的时间 × 组别交互作用均显著，简单效应分析表明，干预后训练组在上述四项指标的得分均显著低于对照组(p < 0.01)。训练组在上述指标的临床有效率均显著高于对照组(p < 0.05)。结论：执行功能训练不仅能改善ADHD儿童的抑制控制能力，还能有效缓解注意缺陷与对立违抗症状，为ADHD儿童的临床干预提供了有效依据。

Abstract: Objective: To explore the effects of executive function training adjunct to pharmacological treatment on improving inhibitory control and clinical symptoms in children with attention deficit hyperactivity disorder (ADHD). Methods: Sixty-three children with ADHD who met the inclusion criteria were randomly assigned to a training group (n = 33) and a control group (n = 30). Both groups maintained their standard pharmacological treatment, while the training group additionally received an 8-week executive function training program. The Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV) and the Behavior Rating Inventory of Executive Function (BRIEF) were used for assessment before and after the intervention. A two-way repeated measures analysis of variance (ANOVA) was conducted to test the interaction effects, and clinical efficacy rates were compared. Results: After the intervention, significant time × group interaction effects were observed in the training group for the domains of inattention (F = 12.44, p = 0.001) and oppositional defiance (F = 16.83, p < 0.001) on the SNAP-IV, as well as inhibition (F = 16.96, p < 0.001) and the Global Executive Composite (GEC) (F = 18.76, p < 0.001) on the BRIEF. Simple effect analysis indicated that the post-intervention scores of the training group across these four indicators were significantly lower than those of the control group (p < 0.01). Furthermore, the clinical efficacy rates of the training group for the aforementioned indicators were significantly higher than those of the control group (p < 0.05). Conclusion: Executive function training can effectively improve inhibitory control and alleviate symptoms of inattention and oppositional defiance in children with ADHD, providing a valid basis for clinical interventions.