沙盘游戏疗法联合哌甲酯治疗注意缺陷多动障碍效果及对心理状态、脑电θ/β比值的影响

摘要 目的：分析沙盘游戏疗法与哌甲酯联合治疗注意缺陷多动障碍（ADHD）的临床应用价值。方法：随机将2021年8月～2023年8月本院收治的70例ADHD患儿分为对照组与观察组，每组各35例，对照组给予哌甲酯治疗，观察组在对照组的基础上联合沙盘游戏疗法。观察两组的临床治疗效果；并在治疗前后采用中文版注意缺陷多动障碍SNAP-Ⅳ评定量表（SNAP-Ⅳ）评估两组临床症状，采用儿童抑郁障碍自评量表（DSRSC）、儿童焦虑性情绪障碍自评量表（SCARED）评估心理状态，采用脑电生物反馈治疗仪记录θ波和β波，并计算脑电θ/β比值。结果：治疗总有效率比较，观察组（97.14%）较高于对照组（82.86%）（P＜0.05）。注意力不集中、多动/冲动、对立违抗评分比较，治疗后观察组均比对照组低（P＜0.05）。DSRSC、SCARED评分比较，观察组治疗后明显低于对照组（P＜0.05）。治疗2、6、12周后观察组脑电θ/β比值均低于对照组（P＜0.05）。结论：哌甲酯联合沙盘游戏疗法治疗ADHD，可有效改善其临床症状和脑电波波形，同时还能缓解其心理状态，有利于进一步提升患儿的临床治疗效果。

The Effect of Sandplay Therapy Combined with Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder and Its Influence on Psychological State and EEG θ/β Ratio

ABSTRACT Objective: To analyze the clinical application value of sandplay therapy combined with methylphenidate in the treatment of attention deficit hyperactivity disorder (ADHD). Methods: A total of 70 children with ADHD admitted to our hospital from August 2021 to August 2023 were randomly divided into control group and observation group, with 35 cases in each group. The control group was treated with methylphenidate, and the observation group was combined with sandplay therapy on the basis of the control group. The clinical therapeutic effects of the two groups were observed. Before and after treatment, the Chinese version of the attention deficit hyperactivity disorder SNAP-IV rating scale (SNAP-IV) was used to evaluate the clinical symptoms of the two groups. The children ''s depression self-rating scale (DSRSC) and the children ''s anxiety emotional disorder self-rating scale (SCARED) were used to evaluate the psychological state. The EEG biofeedback therapy instrument was used to record the θ wave and β wave, and the θ/ β ratio of EEG was calculated. Results: The total effective rate of the observation group (97.14 %) was higher than that of the control group (82.86 %)(P<0.05). The scores of inattention, hyperactivity / impulsivity and oppositional defiance in the observation group were lower than those in the control group after treatment(P<0.05). The scores of DSRSC and SCARED in the observation group were significantly lower than those in the control group after treatment(P<0.05). After 2, 6 and 12 weeks of treatment, the θ/β ratio of EEG in the observation group was lower than that in the control group(P<0.05). Conclusion: Methylphenidate combined with sandplay therapy in the treatment of ADHD can effectively improve its clinical symptoms and brain wave waveform, and can also alleviate its psychological state, which is conducive to further improving the clinical treatment effect of children.