Pharmacotherapy:现有干预措施对自闭症谱系障碍儿童的睡眠问题是否有效?

2017-06-29 门鹏 环球医学资讯

自闭症谱系障碍(ASD)是一种发育性障碍,其特征包括异常的语言能力、异常的交往能力、狭窄的兴趣以及固执的行为模式。2017年5月,发表在《Pharmacotherapy》的一项由澳大利亚科学家进行的系统评价,考察了闭症谱系障碍儿童基于睡眠的干预措施的有效性。

自闭症谱系障碍(ASD)是一种发育性障碍,其特征包括异常的语言能力、异常的交往能力、狭窄的兴趣以及固执的行为模式。2017年5月,发表在《Pharmacotherapy》的一项由澳大利亚科学家进行的系统评价,考察了闭症谱系障碍儿童基于睡眠的干预措施的有效性。

自闭症谱系障碍(ASD)儿童常见睡眠问题。本研究整合了8项已发表的检测睡眠干预在ASD儿童中有效性的系统评价,试图呈现试验干预的明确分析。整合的评价纳入了治疗ASD儿童的5个主要睡眠干预措施:褪黑素治疗、除褪黑素之外的药物治疗、行为干预、家长教育/教育项目、替代治疗(按摩治疗、芳香疗法、复合维生素和铁补充剂)。这8项评价基于38项原始研究,考察了干预措施对17项睡眠问题的有效性。结果表明,没有单一措施对ASD儿童所有睡眠问题是有效的。然而,与其他干预措施相比,褪黑素、行为干预和家长教育/教育项目等干预措施在改善多个睡眠问题上是最有效的。由于致病因素和睡眠紊乱的表现的异质性,睡眠干预措施有效性的进一步研究要针对具体的表型亚组,而非对普通ASD人群进行广泛分析。相似的,为了提供证据来指导医生最佳实践,将来的研究需要考虑不同多种治疗手段的有效性。同时,本评价支持医生对ASD人群中鉴别出来的多数睡眠问题所制定的决策。

原始出处:
Belinda M. Cuomo,et al.Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder: A Meta-Synthesis.Pharmacotherapy.17 May 2017
DOI: 10.1002/phar.1920

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  5. 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  6. 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time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216757, encodeId=2064216e57e1, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 29 17:58:11 CST 2017, time=2017-06-29, status=1, ipAttribution=)]
    2017-09-02 jj000001
  7. 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time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216757, encodeId=2064216e57e1, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 29 17:58:11 CST 2017, time=2017-06-29, status=1, ipAttribution=)]
    2017-07-03 changjiu

    学习了,谢谢

    0

  8. 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  9. 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time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216757, encodeId=2064216e57e1, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 29 17:58:11 CST 2017, time=2017-06-29, status=1, ipAttribution=)]
    2017-07-01 xiongke014
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time=2017-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216757, encodeId=2064216e57e1, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 29 17:58:11 CST 2017, time=2017-06-29, status=1, ipAttribution=)]
    2017-06-29 131****1460

    学习了受益匪浅。

    0

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目前,缺乏全面评估中ICU中改善团队沟通、吸引患者和护理伙伴参与的干预措施的相关研究。近期,一项发表在杂志Crit Care Med上的研究探讨了在医疗ICU中,以病人为中心的护理和参与计划的有效性。此项研究为前瞻性干预研究。在大型三级保健中心的医疗ICU中进行。受试对象为自2013年7月至2014年5月和2014年7月至2015年5月期间,两千一百五十名入院患者(干预前为1,030人,干预期间为

Lancet Neurol:药物或生活方式干预真的能影响具有记忆障碍老人的认知功能吗?

尚无大型临床试验证实,特定药物+数种生活方式改善的这一强大干预措施,与安慰剂相比,对老年人预防认知能力下降方面的效果如何。2017年5月,发表在《Lancet Neurol》的一项随机安慰剂对照试验调查了长期ω-3多不饱和脂肪酸补充联合或不联合多因素干预对具有记忆障碍的老人认知功能的影响。

评价干预措施效果指标解释:RR,ARR,RRR,NNT

假设某研究拟探讨A药对于室性心律失常的治疗效果,试验结果为服用A药的患者10%死亡,对照组20%死亡。那么RR(Relative Risk, 相对危险度)是?很简单:RR=10%/20%=0.5。不了解RR是什么? 一、RR能说明什么? 假设另一项拟探讨B药对于急性心肌梗死的治疗效果,试验结果为服用B药的患者40%死亡,对照组80%死亡。RR=40%/80%=0.5。(表1) 表1. 两种药

Plos one:早期干预能改善产妇的健康吗?

近期,一项发表在plos one杂志上的研究使用随机对照试验设计,评估了有针对性的早期儿童干预计划对全球和经验的孕产妇健康测量的影响。此项试验干预的主要目的是通过直接与父母一起改善他们的儿童发展和育儿行为的知识,提高儿童学校的准备技能。该计划的一个外在因素是父母的幸福感,因为他们直接关注改善父母的应对,自我效能和解决问题的能力,以及通过针对儿童发育问题产生对父母福利的间接影响。此项研究的参与者来自