健脾助长方加减治疗青春期特发性矮身材儿童的临床研究

Clinical Study on Idiopathic Short Stature in Adolescents Treated with Jianpi Zhuzhang Decoction(健脾助长方)Modified

目的:观察健脾助长方加减联合常规干预及rhGH治疗青春期特发性矮身材(ISS)儿童的疗效、安全性以及对生长发育调节因子胰岛素样生长因子(IGF-1)及胰岛素样生长因子结合蛋白-3(IGFBP-3)的影响。方法:选择13~15岁ISS儿童110例作为研究对象,采用随机数表法分为观察组55例和对照组55例,对照组患儿进行常规生活方式干预联合rhGH药物治疗,观察组患儿在对照组的基础上联合使用健脾助长方加减进行治疗,治疗12个月,比较治疗前后两组患儿身高标准差(Ht-SD)、生长速度(GV)、预测成年身高(PAHt),ELISA检测血清IGF-1、IGFBP-3水平,并观察治疗期间不良反应。结果:经过12个月治疗,观察组及对照组患儿Ht-SD、GV、PAHt、IGF-1、IGFBP-3水平均显著改善(P<0.05),且观察组改善效果显著于对照组,差异有统计学意义(P<0.05)。观察组及对照组均未出现严重不良反应。结论:健脾助长方加减联合常规生活方式干预及rhGH治疗可有效促进患儿生长发育,提高预测成年身高,且安全性好。

Objective:To observe the curative effect and safety of Jianpi Zhuzhang Decoction Modified in treatment of idiopathic short stature(ISS)in adolescents and its effects on IGF-1 and IGFBP-3 levels.Methods:110 Cases with ISS at 13~15 years old were selected and were divided into observation group(55 cases)and control group(55 cases),control group was treated with routine lifestyle intervention and rhGH,observation group was treated with Jianpi Zhuzhang Decoction Modified on the basis of control group,they were treated for 12 months.Compare the changes of Ht-SD,GV,PAHt before and after treatment,ELISA methid was applied to determine serum IGF-1 and IGFBP-3 levels;observed and recorded adverse reactions.Results:After treatment for 12 months,changes of Ht-SD,GV,PAHt and serum IGF-1 and IGFBP-3 levels in the two groups all were improved significantly,improvement effects in observation group were more significant than those in control group(P<0.05);there was no severe adverse reactions during treatment in the two group.Conclusion:Jianpi Zhuzhang Decoction Modified combined with routine lifestyle intervention and rhGH can effectively promote growth of ISS children,increase their PAHt and it is safe.