Clinical Study On Comprehensive Intervention Of Children With ADHD(Liver-kidney Yin Deficiency Syndrome) Internet Addiction Based On Network Time Management

Objective1.Literature research: Systematically evaluate the effectiveness and safety of treating attention deficit hyperactivity disorder(ADHD)with treatment from kidney in using traditional Chinese medicine recent 20 years.2.Case-control study: Based on logistic regression analysis,explore the relationship between Internet addiction related factors and ADHD.3.Clinical trial: To explore the Clinical observation on comprehensive intervention of children with ADHD(deficiency of liver and kidney yin)Internet Addiction based on network time management.Method1.To search data various databases by computer,the related domestic and foreign literatures about treating ADHD from kidney by traditional Chinese medicine in recent 20 years were collected,and which included the published articles with the content of clinical control study of treating ADHD from kidney by traditional Chinese medicine(taking western medicine as the control group),extracted and counted the data,analyzed the data,and conducted meta-analysis with Review Manager5.3 software.2.Using the design method of case-control study,at least 120 cases of ADHD and non-ADHD children aged 6-17 years with complete information collection were traced and included,which were required to meet the inclusion criteria.With ADHD children as the case group and non-ADHD children as the control group,logistic regression analysis was conducted on ADHD related factors to explore the relationship between Internet addiction related factors and children’s ADHD.3.Adopt a prospective,randomized controlled clinical research design method,and include at least 60 children with ADHD(liver-kidney yin deficiency syndrome)who are 6-17 years old,have complete clinical data,good treatment compliance and meet the inclusion criteria.They are randomly divided into experimental group and control group,with at least30 cases in each group.The experimental group adopts the traditional Chinese medicine compound Yizhi Ningshen Decoction combined with network time management,while the control group simply adopts traditional Chinese medicine Yizhi Ningshen Decoction.The period is 12 weeks.Observe the clinical efficacy of the two groups after treatment and the evaluation of various clinical indexes such as SNAP-Ⅳ scale score,TCM symptom integral scale score,CGAS,etc.Results1.Related results of meta-analysis of literature research:(1)A total of 51 articles were included in this part of the study,of which 51 studies reported the total effective rate(4775 children with ADHD in total)and 28 studies(2566children with ADHD in total)reported the incidence of adverse reactions.(2)Meta-analysis showed that the total effective rate of treating ADHD with Chinese herbs from kidney was higher than that of the control group with western medicine(OR = 0.09,95% CI: [0.07,0.11],Z=8.28,p<0.01),and the difference was statistically significant.The incidence of adverse reactions was lower than that of western medicine control group(OR = 0.11,95% CI: [0.08,0.14],Z=15.80,p < 0.01),and the difference was statistically significant(p<0.05).The results of meta-analysis suggest that there may be some publication bias in the research,and the sensitivity analysis shows that the results are stable and the research is highly reliable.2.Logistic regression analysis results of case-control study:(1)Logistic regression was used in this study,and the visiting time was traced from December 2021 to December 2019,looking back at the children in the pediatric ADHD clinic of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,the children who were diagnosed with ADHD and met the inclusion criteria were included in the observation group,and the healthy children who did not meet the diagnosis of ADHD were included in the control group.A total of 256 children were included,120 in the case group and 156 in the control group.In this study,the characteristics of ADHD-related factors between ADHD(case group n=120)and non-ADHD children(control group n=156)were reviewed by Logistic regression,and the influence of Internet addiction on ADHD was explored by logistic analysis.This paper analyzes the influence of eight factors on children’s ADHD,such as gender age internet morbid use,internet addiction,parents’ hyperactivity history,parents’ educational level,children’s picky eaters and partial eclipse,and parents’ long-term independent upbringing.The factors included in the study are all binary independent variables and among them,the age is divided into adolescence(the age ≥12 years old)and pre-adolescence(the age <12 years old),and there is no continuous independent variable.One observation included in the analysis in this study has a studentized residual of-2.579,which remains in the analysis.At last,the Logistic model was statistically significant(c2=88.198,p<0.05).(2)Among the eight ADHD-related factors included in the model,gender,age ≥12 years(adolescence),internet morbid use,parents’ educational level,and children’s picky eaters and partial eaters are statistically significant.Gender(OR=5.153,95% CI: [2.656-9.999],p<0.05),the risk of ADHD in men is 5.153 times that in women;age ≥12 years old(the adolescence)(OR=0.363,95% CI: [0.177-0.745],p<0.05),the risk of ADHD in people aged ≥12 years old(the adolescence)is 0.363 times that in people younger than 12 years old(before adolescence);ill-conditioned internet use(OR=5.239,95% CI: [2.016-13.61],p < 0.05),the risk of ADHD among users with ill-conditioned internet is 5.239 times that of users without ill-conditioned internet;parents’ educational level(OR=2.096,95% CI: [1.116-3.937],p< 0.05),the risk of ADHD in high school or below is 2.096 times higher than that in college or above.The situation of children’s picky eaters and partial eaters(OR=2.299,95% CI: [1.090-4.849],p<0.05),and the analysis of ADHD in children who are picky eaters and partial eaters is 2.299 times higher than that in children who are not picky eaters and partial eaters.3.Related results of randomized controlled clinical trials:This study included 60 children who met the inclusion criteria,and they were randomly divided into experimental group and control group.After a 12-week treatment cycle,5 of them fell off,and finally 55 children with ADHD were included in the statistics.Among them28 cases in the experimental group and 27 cases in the control group were finally included.Baseline comparison: The distribution or scores of gender,age,disease severity,reference indexes(IVA,IAT),primary and secondary curative effect indexes(SNAP-Ⅳrough score,TCM symptom score,CGAS)、IAD between the experimental group and the control group were compared by baseline,and statistics showed that all the baselines between the two groups were comparable(p>0.05).(1)Intra-group comparison: The baseline of the experimental group and the control group were compared with the main efficacy indexes and secondary efficacy indexes after 12 weeks of treatment in this group respectively(p<0.05),and the differences were statistically significant,so it was considered that both the experimental group and the control group were clinically effective.(2)Comparison between groups: compare the main efficacy indexes and secondary efficacy indexes between the experimental group and the control group after 12 weeks of treatment.ADHD main efficacy indexes:(1)disease efficacy: the total effective rate of disease efficacy between the experimental group and the control group(p<0.05),the difference is statistically significant,so it is considered that there is a difference between the two treatment methods in the experimental group and the control group.(2)TCM symptom curative effect:The total effective rate of TCM symptom curative effect between the experimental group and the control group(p>0.05),the difference is not statistically significant,and it cannot be considered that there is a difference in TCM symptom curative effect between the experimental group and the control group.ADHD secondary efficacy indexes:(1)SNAP-Ⅳscores: both the total SNAP-Ⅳscores(p<0.05)and the SNAP-Ⅳopposition scores(p<0.05)between the experimental group and the control group.Coarse score of attention deficit(p < 0.05)and the rough score of hyperactivity/impulsiveness(p<0.05)were statistically significant.It is considered that there are differences between the experimental group and the control group in the efficacy of improving oppositional defiance,attention deficit and hyperactivity/ impulsiveness symptoms.(2)TCM symptom score table: The scores of TCM symptoms between the experimental group and the control group in the 12 th week(p>0.05)are not statistically significant,so it cannot be considered that the experimental group and the control group are improving.(3)CGAS:After the treatment of CGAS between the experimental group and the control group(p>0.05),there is no significant difference in the scores,and it cannot be considered that there is a difference between the experimental group and the control group in improving children’s overall behavior.Compared with the curative effect of Internet addiction,the difference was statistically significant(p>0.05),and the IAD score of the experimental group was lower.Conclusion1.Meta-analysis conclusion of literature research:(1)The total effective rate of treating ADHD from kidney with traditional Chinese medicine is higher.Under the guidance of treating ADHD from kidney with traditional Chinese medicine,it is clinically effective and can be used as a reference for clinical diagnosis and treatment of ADHD.The scheme of treating ADHD from kidney with traditional Chinese medicine can be promoted as an option or combined with western medicine to enhance the curative effect.The incidence of adverse reactions of treating ADHD from kidney with traditional Chinese medicine is lower,and its safety is higher,which has certain clinical reference value and can provide a relatively safe medication plan for clinical treatment of ADHD.(2)At present,most of the existing researches on the treatment of ADHD with traditional Chinese medicine from kidney are not perfect in the design of blind method Metating and publication bias,few complete RCT studies,most of them are case-control studies,and the random design scheme is insufficient or not set randomly.Many limitations will affect the final meta-analysis results,which can make the evaluation results biased.More and higher-quality clinical studies are still needed to further support the conclusions.2.Logistic regression analysis conclusion of case-control study:(1)There are differences between ADHD and non-ADHD children in seven factors,such as gender,age≥12 years(adolescence),morbid use of Internet,tendency of Internet addiction(including no tendency of Internet addiction,tendency of Internet addiction and Internet addiction),history of parents’ hyperactivity,parents’ educational level(including junior college and above,senior high school and below),and children’s picky eaters and partial eclipse.(2)Gender,age,internet morbid use,parents’ education,children’s picky eaters and partial eclipse have influence on ADHD,among which male gender,internet morbid use,parents’ education level of high school or below,children’s picky eaters and partial eclipse are risk factors for ADHD;age≥12 years(adolescence)is the protective factor of ADHD.3.Conclusions of randomized controlled clinical trials:(1)Traditional Chinese medicine Yizhi Ningshen decoction combined with network time management and simple traditional Chinese medicine Yizhi Ningshen decoction are both clinically effective in the treatment of ADHD(liver and kidney yin deficiency syndrome)children with internet addiction and tendency to internet addiction,which can provide reference for clinical treatment.(2)Traditional Chinese medicine Yizhi Ningshen Decoction combined with network time management has advantages in improving oppositional defiance,attention deficit and hyperactivity/impulsivity symptoms.(3)Traditional Chinese medicine Yizhi Ningshen Decoction combined with network time management has advantages in treating the internet morbid use of ADHD children with liver and kidney yin deficiency syndrome.