中西医结合治疗特发性矮小症近期疗效分析

Analysis of short-term curative effect of 35 cases of idiopathic short stature treat with the combination of Chinese and Western medicine

目的观察中西医结合治疗儿童特发性矮小症的近期疗效。方法将80例特发性矮小症患儿随机分为治疗组35例和对照组45例,对照组给予重组人生长激素(rh GH)治疗,治疗组在rh GH治疗基础上,根据患儿体质类型给予相应的中药免煎颗粒口服。观察2组治疗后的身高、体质量变化,并测定患儿的胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、空腹血糖、肝肾功能和甲状腺功能,同时观察2组在治疗过程中的疾病发生情况和不良反应。结果治疗后,同组患儿0~3月、3~6月生长速度(GV)均较治疗前显著增高,差异均有统计学意义(P<0.05),且治疗组的生长速度变化(△GV)高于对照组,差异有统计学意义(P<0.05);2组治疗前后骨龄(BA)、△BA比较,差异均无统计学意义(P>0.05);治疗后,治疗组体质量标准差变化(△体质量SDS)、身高标准差变化(△Ht SDS)和血清IGF-1变化(△IGF-1)显著高于对照组,2组比较差异均有统计学意义(P<0.05);治疗组血清IGFBP-3变化(△IGFBP-3)与对照组比较,差异无统计学意义(P>0.05);治疗期间,治疗组呼吸系统和消化系统疾病发病率低于对照组,差异有统计学意义(P<0.05);2组在治疗过程中均未发现任何不良反应。结论中西医结合治疗特发性矮小症的近期疗效较单纯rh GH好,能加快特发性矮小患儿的生长速度。

Objective To observe the short-term curative effect of the combination of Chinese and Western medicine in treating of idiopathic short stature. Methods 80 cases of children with idiopathic short stature were di- vided randomly into two groups. The control group was given recombinant human growth hormone, while the therapy group, according to different children＇ s constitutions, was given oral decoction and granules of Chinese herbs based on the treatment of control group. After treatment, the changes of height and weight of two groups were observed, the IGF-1, IGFBP-3, FBG, hepatorenal and thyroid functions were tested. Meanwhile, during treatment, patients＇ disea- ses occurrence and untoward effect of two groups were observed. Results After treatment, patients＇ GV from 0 to 3 months,3 to 6 months increased obviously with significant differences （P〈0.05） , and it increased more quickly in therapy group than control group, differences were significant （ P〈0.05 ）. There were no significant differences in BA and ABA of two groups before and after treatment （P〉0.05）. The changes of SDS, AHtSDS and AIGF-1 were higher than these in control group with different significance. There were no significant differences in change of IGFBP-3 of two groups （P〉0.05）. During treatment, the morbidity rates of respiratory and digestive systems in therapy group were lower than these in control group with significant differences （P〈0.05）. There was no untoward effect in patients of two groups. Conclusion The combination of Chinese and Western medicine, thanks to accelerate growth of children with idiopathic short stature, has a better short-term effect than recombinant human growth hormone.