维生素D3联合早期介入丹佛模式治疗幼儿孤独症谱系障碍的疗效

Clinical effect of vitamin D3 combined with the Early Start Denver Model in the treatment of autism spectrum disorder in toddlers

摘要:

目的 探讨维生素D₃（VitD₃）联合早期介入丹佛模式（ESDM）对幼儿孤独症谱系障碍（ASD）的疗效。方法 选择102例1~3岁的ASD幼儿为研究对象。按家长意愿分为三组：常规康复组、ESDM组、ESDM+VitD₃组。各组幼儿治疗前及治疗3个月后进行ASD行为量表（ABC）、ASD评定量表（CARS）评估。结果 常规康复组治疗3个月后ABC总分、躯体运动能区、生活自理能区分数均降低（P < 0.05）。ESDM组治疗3个月后ABC总分、躯体运动能区、生活自理能区、交往能区、言语能区及CARS总分均降低（P < 0.05）。ESDM+VitD₃组治疗3个月后25（OH）D水平明显升高，ABC总分、生活自理能区、感觉能区、交往能区、言语能区及CARS总分均降低（P < 0.05）。ESDM组交往能区分数差显著高于常规康复组，ESDM+VitD₃组交往能区分数差高于其余两组（P < 0.05）。结论 ESDM治疗可有效改善ASD幼儿的临床症状，特别针对交往能区相比常规康复疗效显著；ESDM联合VitD₃治疗对ASD幼儿交往能力改善更优，其可能是目前改善ASD幼儿临床症状的最佳方案之一。

Abstract:

Objective To study the clinical effect of vitamin D₃ (VitD₃) combined with the Early Start Denver Model (ESDM) in the treatment of autism spectrum disorder (ASD) in toddlers. Methods A total of 102 toddlers with ASD, aged 1 to 3 years, were enrolled. According to the wishes of their parents, they were divided into conventional rehabilitation, ESDM and ESDM+VitD₃ groups. Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used evaluate behavior problems before treatment and after 3 months of treatment. Results The conventional rehabilitation group had significant reductions in the total score and the scores on somatic movement and self-care subscales of the ABC scale after 3 months of treatment (P < 0.05). After 3 months of treatment, the ESDM group had significant reductions in the total score and the scores on somatic movement, self-care, social interaction and language subscales of the ABC scale (P < 0.05), as well as a significant reduction in the total score of the CARS (P < 0.05). After 3 months of treatment, the ESDM+VitD₃ group had a significant increase in the level of 25(OH)D and significant reductions in the total score and the scores on self-care, sensation, social interaction and language subscales of the ABC scale (P < 0.05), as well as a significant reduction in the total score of the CARS (P < 0.05). The ESDM group had a significantly greater reduction in the score on social interaction subscale than the conventional rehabilitation group (P < 0.05). The ESDM+VitD₃ group had a significantly greater reduction in the score on social interaction subscale than the other two groups (P < 0.05). Conclusions ESDM can effectively improve the clinical symptoms of toddlers with ASD, with a significantly better clinical effect in improving social interaction and somatic movement than conventional rehabilitation. ESDM combined with VitD₃ has a significantly better clinical effect in improving social communication skills and may be one of the best strategies for improving the clinical symptoms of toddlers with ASD.