(1) Neuroblocker/antipsychotic: Its main pharmacological function is to block the neurotransmitter dopamine released by the conduction nerve endings between nerve spaces, so that it is not accepted by the receptors of sensory nerve endings, thus reducing and regulating excessive nerve conduction. Therefore, it is also called dopamine receptor antagonist (Zeng Wenxing, Min 83). Drugs such as haloperidol are effective in treating excitement, hyperactivity, aggression, rigid behavior and emotional instability. The most common side effect is excessive sedation. Other side effects include acute myotonia (muscle contraction, grimacing, torticollis, difficulty in speaking and swallowing), pseudoparkinsonism and akathisia. The long-term side effects include weight gain, withdrawal dyskinesia and tardive dyskinesia. The main symptoms are randomness and irregularity in the muscles of the head, limbs and trunk. The repetitive movements of dancing. Pimozide, another drug, can effectively reduce the movement and convulsion of Tourette's syndrome, and its side effects include sedation and pseudoparkinsonism (Tsai, 1992).
(2) Stimulants: Stimulants include dextroamphetamine and methylphenidate. Magnesium pimoline (Cylert), etc. These drugs can enhance the release of caticholamine and caudate nucleus from sympathetic nerve endings. Doping may be more effective for high-functioning autism without spasms and neurological disorders, but it has problems such as short attention duration, distraction, impulsiveness and excitement (Tsai, 1992). Its side effects include anorexia and vomiting.
Sedatives: Sedatives such as diazepam (diazepam) and diphenhydramine (diphenhydramine) can stimulate GABA (aminobutyric acid) system, which is usually used to relieve anxiety and treat children's sleep disorders, with side effects such as drowsiness and dizziness.
(d) Beta blockers: They can reduce blood pressure, heart rate and myocardial contractility, and their effects on serious aggressive behavior and self-injury behavior need further study.
(5) Antidepressants: There are two main types, monoamine oxidation inhibitors (Maois) and tricyclic antidepressants. Monoamine oxidation inhibitors mainly inhibit the destruction and storage of nerve media recovered from nerve endings. There is no empirical evidence about the effect of increasing the total amount of conducting nerve media and the safety of children's use (Tsai, 1992). Tricyclic antidepressants, especially imipramine, have been proved to be effective in enuresis, attention deficit hyperactivity disorder, learning fear, etc., and also effective in some autistic patients' melancholy behavior, or severe hyperactivity and impulsiveness, and their side effects include dry mouth, constipation, fatigue and tremor.
(6) Selective serotonin recovery inhibitor (SSRI): Because the concentration of serotonin in the blood of 35%-40% autistic patients is higher than that of the general population, three commonly used serotonin recovery inhibitors, namely, Anafranil, Prozac and fluvoxamine, can effectively reduce the frequency of repetitive and ritual behaviors of autistic patients. Other influences include visual contact, positive social interaction and improvement of reaction behavior. The most common side effects of these drugs are hyperactivity, impulsiveness and sleep disorders. Other side effects include dry mouth, constipation, heart rate changes and decreased spasm threshold.
(7) Opioid antagonists: The β -endorphin of some autistic patients is higher than that of the general population. Low dose naltrexone can be used to block the endorphin, which can improve self-injury behavior and social communication behavior.
Other drugs, such as lithium salt, are used to treat bipolar disorder and antispasmodic drugs
Two. Diet/vitamin intervention
Dietary restriction (dietary restriction)
Some research results show that allergic reactions to certain foods may be the cause of some autistic patients' problem behaviors. The researchers put forward a hypothesis that some people with autism cannot completely catabolize gluten (protein produced by gluten, wheat and other grains) and casein (protein produced by human beings and milk). Gluten and casein will produce activities similar to opioid endorphins, and these amino acids will enter the blood vessels from the intestine and eventually cross the blood-brain barrier, which will have a negative impact on nerve transmission. Lowdon, 199 1, quoted from gemmell &; Chambliss, 1997). Recently, Owens (1998) put forward the hypothesis of the relationship among digestive system, immune system and nervous system, which also mentioned the possible correlation of incretin. In view of this possible metabolic abnormality, some researchers suggest avoiding gluten-free and casein-free diet in daily life, but there are only limited experimental studies at present, although some results show that strange behaviors, fears, physical contact resistance and other behaviors of autistic patients have decreased after food restriction. However, the use of language for communication has increased. However, due to the limited related research, flawed research methods and inconsistent research results, it is still impossible to draw a conclusion on the efficacy of dietary restriction on autism, and more research is needed to explore it (Gemmell &: Chambliss,1997; Hao Lin, 1998).
(2). Vitamin therapy (vitamin therapy)
Some researchers believe that autism has genetic or metabolic abnormalities, so they need to add some specific nutrients. Vitamin therapy for autism is mainly a mixture of vitamin B6 (whose main function is to help digestion) and magnesium. Because a large amount of vitamin B6 may cause malnutrition symptoms, magnesium needs to be supplemented. Although there are more than a dozen research results by Rimland and other researchers, after taking a huge amount of vitamin B6, autistic people show more visual contact, less self-stimulation behavior and more interest in the environment. However, due to some research methods, the efficacy of vitamins needs more research and discussion, and attention should be paid to whether huge food intake may lead to health problems (Pfeiffer, Norton, Nelson, & Shott,1995; Smith,1996; Hao Lin, 1998).
3. Dietary intake of dimethyl glycyl acid (DMG)
DMG is classified as food, and there is a small amount of DMG in some foods, such as brown rice and liver. Although many parents of autistic patients report that their language and social communication behavior have improved after taking DMG, there has been a lack of relevant experimental research. Domestic research by Dr. Zheng (unpublished) shows that it has effects on anxiety, depression, repetitive movements, hyperactivity and distraction, and language performance of autistic patients, but the foreign research result is Richmond, 1999).
Four. Intestinal secretin
1998, ABC TV1October 6, NBC TV1October 7 news line and many other newspapers and media reported the story of Parker Baker and incretin, an autistic child, which attracted the attention of many autistic families in the United States and paid great attention to the curative effect of incretin on autistic patients.
Intestinal glucagon is a conductive substance and a hormone responsible for digestion. Its main function is to stimulate the pancreas to secrete digestive juice containing bicarbonate. Stimulate the stomach to make stomach protein; Stimulate the liver to produce bile. The human body itself has this main hormone, but the incretin used in medical treatment is mainly extracted from the duodenum of pigs, which is used to diagnose gastrointestinal problems, such as pancreatic function or stomach problems. At present, incretin has no known therapeutic effect on gastrointestinal diseases, and in addition, there are no known diseases caused by incretin deficiency. Human incretin is also synthesized and manufactured. Its structure is different from that of pigs, and there are two amino acids in 27 kinds of amino acids. At present, the US Food and Drug Administration (FDA) has not been officially approved by the FDA except for the above diagnostic purposes, and all other uses are labels. In addition, the effect of incretin on autistic children (function level, whether there is long-term diarrhea, male or female) is uncertain, and there are no research data for reference whether there are side effects or health concerns after long-term use. For the above reasons, the National Institutes of Health has no formal position on the therapeutic use of incretin in autism (NICHD, 1998).
So far, there is only one research document about the therapeutic effect of incretin on autism. That is to say, horvath et al. published an article in the Journal of the Association of Academic Minority Physicians at 1998, "Social and language skills were affected after the confidentiality of medication was given to patients". Treatment of patients with autism spectrum disorders. " It is pointed out in the article that after five weeks of using incretin, the gastrointestinal problems and behaviors of three autistic children have improved obviously, such as the increase of visual contact, alertness and expressive language (quoted from NIH News Alert, 1998), and studies by horvath, PapaDimitriou, Labouze Ting, Delongberg & ampTidon (1999) and others also believe that. In addition to horvath's research, other researches on the therapeutic effect of incretin on autism, such as Owley, Steele, Corsello, Risi, McKaig, Lord, Leventhal, & Cook (1999, in India) and Sandler, Sutton, Dewey and Girardi, have adopted random sampling, double-blind, placebo-controlled studies. Bodfish (1999) and others' research results on the use of synthetic human incretin show that it has no obvious effect on autistic patients. However, according to the International Review of Autism Research published by the Institute of Autism, according to the estimates published in February 1999 and112, thousands of autistic children have received oxytocin. According to parents' reaction, it is estimated that it has certain effect on about 70% autistic patients, and the possible negative effects mainly include hyperactivity and aggression. So far, the effect of oxytocin has improved.
Verb (abbreviation of verb) auditory integration training
Comprehensive listening training was developed by Guy Berard, a French otolaryngologist, in 199 1 year, and was not introduced to the United States until 1 year, mainly because Annabel Stehli published The Sound of Miracle. Therefore, it has aroused the interest of many parents with autism. Although most experts believe that the physiological mechanism of auditory integration training is not clear, Dr Berard believes that the annoying behavior of autistic patients is mainly caused by auditory hypersensitivity, and these auditory distortions can be found in audiograms. Listening integration training mainly uses filters to eliminate these over-sensitive peaks. The process and key points of listening integration training are as follows (Society of Hearing Intervention Technology, 1993):
1. Before hearing integration training, health-related professionals should check the ears of the treated person to ensure that there is no excessive earwax and ear fluid, because too much earwax and ear fluid may reduce the input of hearing integration training.
2. The early Guy Berard thought that the age of listening integration training should be at least four years old, but recently it was revised to at least three years old.
3. Patients generally receive 18-20 times of auditory energy therapy, 30 minutes twice a day, ten times in a row, with an interval of at least three hours each time, or rest for one or two days after five times.
4. Find out the peak of the patient's auditory allergy from the audiogram.
5. In the 30-minute listening training course, the patient listens to the processed music through headphones, and the sound filter will randomly adjust the volume of the frequency. The volume is usually below 85 decibels.
6. The audiogram should be tested before the comprehensive listening training, during the half course of treatment and after the course of treatment.
At present, only a few research reports show that listening integration training can improve the behavior and language ability of some autistic children (Rimland &; Edelson,1995; Edelson, Arlene, Bowman, Lucas, Rudy, Shoral, and. Rimland, 1999), but the research results are inconsistent (Howlin, 1998). In addition, the research results can not confirm the problem of improving the hearing sensitivity of autistic children claimed by auditory integration training (Rimland & Edelson, 1995). Therefore, the effect of integrated listening training in the treatment of autistic children still lacks research support, and many experts still doubt its effect (Heflin &: Simpson,1999; Haolin,1998; Smith, 1996). The American Academy of Pediatrics also issued a formal statement (American Academy of Pediatrics, 1998), saying that the current research results can not support the effect of integrated listening training. The US Federal Drug and Food Administration has not received any report that the hearing integration training equipment can treat any medical condition or disease, and no organization has applied for medical use. Therefore, the Federal Drug and Food Administration believes that listening integration training can only be used as an educational aid for educational purposes, and cannot be used for medical purposes claiming to treat autism, attention deficit hyperactivity disorder or other physical or mental conditions. .......