厌食症患儿外周血食欲调节因子水平变化与小儿厌食颗粒干预的影响

Change of peripheral blood appetite regulation factor of anorexia children and infect of child anorexia granule

探讨小儿厌食颗粒对厌食症患儿血清促人生长激素腺释放肽（ghrelin）与瘦素（leptin）水平的变化及临床疗效。选择81例1~6岁厌食症患儿随机分为观察组42例和对照组39例。对照组给予多潘立酮混悬液0.3 mg·kg-1·d-1,每日3次饭前30 min口服。观察组给予小儿厌食颗粒1~3岁1包,每日2次口服;4~6岁1包,每日3次口服,4周为1个疗程。观察各组治疗前后血清ghrelin,leptin的变化及临床疗效。并与30名正常健康儿童作比较。研究表明治疗前2组ghrelin均低于健康组（P〈0.01）,leptin水平均高于健康组（P〈0.01）。治疗后2组ghrelin水平均升高,leptin水平均降低,但观察组ghrelin和leptin水平与对照组比较（P〈0.01）差异有显著性。提示厌食症患儿ghrelin与leptin水平存在负相关。2组临床总有效率分别是95.23%,74.35%,差异有显著性（P〈0.01）。2组治疗后随访6个月时,观察组较治疗前体重明显增加（P〈0.01）。结果提示小儿厌食颗粒能促进ghrelin的分泌,抑制leptin产生,有效改善患儿的食欲状况,其对血浆ghrelin,leptin水平的影响可能是获得临床疗效的内在机制之一。

Study the infect of child anorexia granule on serum ghrelin and leptin of anorexia children and its clinical efficacy. Selected 81 cases of anorexia children aged 1-6 years old into treatment group（42 cases） and control group（39 cases） ,in addition, 30 case healthy children as healthy control group. The control group children were treated with domperidone suspension 0. 3 mg~ kg- ~ ~ d-~, rid, orally 30 minutes before meals. Treatment group were treated with child anorexia granule, 1-3 years 1 package,bid; 4-6 years 1 package, tid ; po, 4 weeks as a course of treatment. Study the change of serum ghrelin and leptin before and after therapy. The study demonstrates that before treatment, the serum ghrelin level of disease group was lower than healthy group（P 〈 0. 01 ）, and the serum leptin level was higher than healthy group（ P 〈0.01 ）. After treatment, the serum ghrelin level both increase, and the serum leptin decline. And the change of treatment group was significantly different with control group （P 〈0.01 ）. And the chnical effective rate are 95.23% and 74. 35% （P 〈 0. 01 ）. After 6 months of follow-up visit, the children weight significantly increase in treatment group （P 〈 0. 01 ）. Results indicate that child anorexia granule can facilitate secretion of ghrelin, and inhibit secretion of leptin, so as to work up an appetite. And the molecular mechanism is its infect on serum ghrelin, leptin.