摘要
目的:评估改良阿特金斯饮食(MAD)治疗全面性发育迟缓(GDD)的疗效和安全性。方法:前瞻性多中心临床对照研究。选择2017年7月至10月就诊于河南省八家医院儿童康复科的GDD患儿,将154例符合纳入标准的GDD患儿按简单随机化法分为常规治疗组(66例)和MAD治疗组(88例)。MAD治疗组62例和常规治疗组59例患儿完成了15个月的研究。常规治疗组予以综合康复训练,MAD治疗组在康复训练的基础上给予MAD治疗,采用两因素重复测量方差分析比较不同时间点数据的差异。结果:3个月后,2组在中国幼儿情绪及社会性发展量表(CITSEA)/Achenbach患儿行为量表(CBCL)问题和能力领域的得分比较,差异均有统计学意义(均 P<0.05),MAD治疗组有明显改善。6个月后,MAD治疗组在Gesell发育量表的语言和社交行为较常规治疗组得分均有显著提高(均 P<0.05)。9个月后,MAD治疗组患儿在Gesell发育量表适应能区和婴儿-初中学生社会生活能力量表(S-M量表)的得分优于常规治疗组,差异均有统计学意义(均 P<0.05)。15个月后,MAD治疗组患儿精细运动优于常规治疗组( P<0.05)。治疗早期,MAD治疗组28例患儿有轻微不良反应,经对症治疗后好转,无其他严重不良反应。 结论:MAD治疗可以改善GDD患儿神经发育、情绪和社会适应性行为,无严重不良反应。
Objective To evaluate the efficacy and safety of modified Atkins diet(MAD)in treating global growth retardation(GDD).Methods A prospective multicenter clinical controlled study was conducted.The children were included from 8 departments of children′s rehabilitation in Henan Province from July 2017 to October 2017.A total of 154 children who met the inclusion criteria were randomly assigned into the routine treatment group(88 cases)and MAD therapy group(66 cases).A total of 62 children in MAD therapy group and 59 children in routine treatment group completed the study for 15 months.The routine treatment group was provided comprehensive rehabilitation training,and the MAD therapy group was given MAD treatment on the basis of rehabilitation training.Two-way repeated-measures ANOVA was used to compare the differences among datas at different time points.Results After 3 months,there were significant differences in the scores of the Chinese Version of Urban Infant-Toddler Social and Emotional Assessment(CITSEA)/Achenbach Children′s Behavior Scale(CBCL)between the 2 groups(all P<0.05).Significant improvement was seen in the MAD group.After 6 months,the MAD therapy group had significantly higher scores on the Gesell Developmental Scale for language and social behavior than the routine treatment group(all P<0.05).After 9 months,the scores of the children in the MAD therapy group were better than those in the routine treatment group in the Gesell Developmental Scale adaptive energy area and the infant-junior high school student social life scale(S-M scale),and the differences were statistically significant(all P<0.05).After 15 months,the fine motor in the MAD therapy group was better than that in the routine treatment group(P<0.05).At the early stage of MAD therapy,28 patients showed mild adverse reactions that were reversed after symptomatic treatment.No severe adverse reactions were observed.Conclusions MAD therapy can improve the neuro-development,emotional and social behaviors,and adaptive behaviors with no severe adverse effects.
作者
王以文
朱登纳
马娜
苏振军
杨淑明
宋舜意
付京梅
王海涛
刘娟
张涛
Wang Yiwen;Zhu Dengna;Ma Na;Su Zhenjun;Yang Shuming;Song Shunyi;Fu Jingmei;Wang Haitao;Liu Juan;Zhang Tao(Department of Child Rehabilitation,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Child Rehabilitation,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Child Rehabilitation,Puyang Maternal and Child Health Hospital,Puyang 457000,China;Department of Child Rehabilitation,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Child Rehabilitation,Hebi Maternal and Child Health Hospital,Hebi 458000,China;Department of Child Rehabilitation,Luohe Central Hospital,Luohe 462000,China;Department of Children′s Rehabilitation,Puyang Oilfield General Hospital,Puyang 457000,China;Department of Children′s Rehabilitation,Nanyang Traditional Chinese Medicine Hospital,Nanyang 473000,China)
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2022年第12期929-933,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省医学科技攻关计划项目 (SBGJ2018047)。
