CAJ | 학술논문

对国内过去12年间的62项注意缺陷／多动障碍干预研究结果进行了元分析，结果显示：（1）国内现有的ADHD干预措施取得了显著的干预效果；（2）在不同干预措施中，药物治疗与行为疗法或认知行为疗法相结合具有最佳疗效，单独的药物治疗次之，单独的行为疗法或认知行为疗法效果较低；（3）在各种效果指标中，学业指标上的效果量是最大的，这一结果与国外已有的元分析研究发现不一致；（4）在各种效果信息来源中，来自客观观察的效果量最高，来自父母评价的效果量次之，来自教师评定的效果量最差。（5）各种干预措施在不同效果指标上有不同的表现。药物治疗对于学业和行为指标的效果最强烈，而认知行为疗法和脑电反馈疗法对认知指标的效果最明显。最后，结合干预措施的选择、效果指标的采用以及研究质量问题进行了讨论。
대국내과거12년간적62항주의결함／다동장애간예연구결과진행료원분석，결과현시：（1）국내현유적ADHD간예조시취득료현저적간예효과；（2）재불동간예조시중，약물치료여행위요법혹인지행위요법상결합구유최가료효，단독적약물치료차지，단독적행위요법혹인지행위요법효과교저；（3）재각충효과지표중，학업지표상적효과량시최대적，저일결과여국외이유적원분석연구발현불일치；（4）재각충효과신식래원중，래자객관관찰적효과량최고，래자부모평개적효과량차지，래자교사평정적효과량최차。（5）각충간예조시재불동효과지표상유불동적표현。약물치료대우학업화행위지표적효과최강렬，이인지행위요법화뇌전반궤요법대인지지표적효과최명현。최후，결합간예조시적선택、효과지표적채용이급연구질량문제진행료토론。
Attention-deficit/hyperactivity disorder （ADHD） is the most common neurobehavioral disorder for children. They are at high risk relative to the normal population with respect to scholastic and social failure in school settings. Practice calls for effective interventions to decrease the developmental risk of ADHD. So a comprehensive evaluation on all the existing interventions is needed. There have been many descriptive and meta-analytic reviews on this topic in the West. However, the results from western reviews cannot be applied to China directly. First, the diagnostic criteria are different between the West and China; second, Traditional Chinese Medicine is an important intervention that is not used in the West; third, parents in China have more apprehensions on drug treatment and attach more importance on academic performance. So a meta-analytic approach was used to examine the effects of treatment with Attention deficit/ hyperactivity disorder children in China. A search was made of the CNKI （National Knowledge Infrastructure） databases. In order to decrease the heterogeneity among different treatment outcomes, we limited the search to articles published from 1994 to 2005 （the year in which the meta-analysis was commenced）. Criteria for including studies in the sample were that the type of intervention and outcome measures be sufficiently well described to enable classification and that it be possible to calculate an effect size. Additional criteria for selection of studies were that if children have more than one disorder, ADHD should be primary. Besides, the study should employ pretest-posttest design or control group design. We were able to locate 62 unique studies that met these criteria. Studies that met inclusion criteria were systematically coded based on specific features of the article. Coded variables included： number of participants, sex of participants, age range of participants, treatment time, type of intervention, and outcome relating to the type of treatment. The effect size is the difference between the mean of outcome measures at the end of the program and the mean prior to commencing the intervention （post-pre means） or the mean of the outcome measures administered in a treatment group compared to the mean of the outcome measures administered to a control group. In all cases, this difference between the mean is divided by the appropriate pooled group standard deviation. The results showed that：（1） The interventions aimed to improve the behavioral, academic, cognitive and/or social functioning of children with attention deficit/hyperactivity disorder have obvious effects. （2） Overall, the combined interventions have the largest effects, then larger for medical interventions and smaller for behavioral or cognitive- behavioral interventions. （3） Overall, there were larger effects of the various interventions on academic than on other outcomes, which is not consistent with foreign meta-analysis results. （4） Among indicators from different resources, the objective observations have the largest effects, then the parental rating, and then the teacher＇s rating. （5） Various interventions have different effects on different effect indices. The quality of intervention approaches, effect indexes and study quality were discussed according to the results described above.