健脾益肾汤辅助治疗身材偏矮脾肾气虚证37例临床观察

Clinical observation on 37 cases of children of relatively short stature with qi deficiency of both spleen and kidney syndrome adjuvantly treated by Jianpi Yishen Tang(健脾益肾汤)

目的 观察健脾益肾汤辅助治疗身材偏矮脾肾气虚证的临床疗效。方法 选取2019年10月至2020年10月在南京中医药大学常熟附属医院儿科门诊就诊的80例身材偏矮脾肾气虚证患儿,采用随机数字表法分为对照组和治疗组,各40例,其中对照组脱落2例,治疗组脱落3例,最终完成75例临床观察。对照组38例口服赖氨肌醇B_(12)口服液,治疗组37例在对照组治疗方法的基础上给予健脾益肾汤加减,2组均连续治疗3个月为1个疗程,2个疗程后统计临床疗效。结果 治疗组总有效率为94.59%(35/37),高于对照组的57.89%(22/38),2组比较,差异有统计学意义(P<0.01)。治疗前,2组中医主症、次症积分比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组上述积分与同组治疗前比较均降低(P<0.05),且治疗组降低更显著,差异有统计学意义(P<0.05)。治疗前,2组身高、体质量比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组身高、体质量均较同组治疗前增加(P<0.05),且治疗组增加更显著,差异有统计学意义(P<0.05)。治疗前,2组血清类胰岛素生长因子(IGF-1)水平、骨龄比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,2组IGF-1水平较同组治疗前均增加(P<0.05),且治疗组增加更显著,差异有统计学意义(P<0.05);2组骨龄与同组治疗前比较,差异均无统计学意义(P>0.05)。结论 健脾益肾汤辅助治疗身材偏矮脾肾气虚证患儿疗效满意,可显著降低中医证候积分,提高血清IGF-1水平,值得临床推广应用。

Objective To observe the clinical efficacy of Jianpi Yishen Tang(健脾益肾汤)in adjuvant treatment of children of relatively short stature with qi deficiency of both spleen and kidney syndrome.Methods From October 2019 to October 2020,80 cases of children of relatively short stature with qi deficiency of both spleen and kidney syndrome consulted in the outpatient service of pediatrics department of Changshu Affiliated Hospital of Nanjing University of Chinese Medicine were divided into control group and treatment group according to the random number table method,with 40 cases in each group.Among them,2 cases dropped out in the control group and 3 cases dropped out in the treatment group.Finally,75 cases of clinical observation were completed,The control group with 38 cases was given oral administration of lysine,inositol and vitamin B_(12) oral solution,on this basis,the treatment group with 37 cases was given modified Jianpi Yishen Tang(健脾益肾汤).The 2 groups were treated continuously for 3 months as 1 course of treatment.After 2 courses of treatment,we kept statistics about the clinical efficacy.Results The total effective rate of the treatment group was 94.59%(35/37),which was significantly higher than 57.89%(22/38)of the control group,and the difference was statistically significant between the 2 groups(P<0.01).Before treatment,the difference was not statistically significant in TCM cardinal symptom score and assident score between the 2 groups(P>0.05),indicating comparability.After treatment,the above-mentioned scores in the 2 groups significantly decreased than those in the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in height and body mass between the 2 groups(P>0.05),indicating comparability.After treatment,the height and body mass of the 2 groups increased than those of the same group before treatment(P<0.05),and the increase in the treatment group was more significant,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in serum insulin-like growth factor-1(IGF-1)level and bone age between the 2 groups(P>0.05),indicating comparability.After treatment,IGF-1 level of the 2 groups increased than that in the same group before treatment(P<0.05),moreover,the increase in the treatment group was more significant,and the difference was statistically significant(P<0.05).There was no statistically significant difference in bone age between the 2 groups and the same group before treatment(P>0.05).Conclusion It has satisfactory efficacy,can markedly decrease TCM syndrome score and increase the level of serum IGF-1 to use Jianpi Yishen Tang in adjuvant treatment of children of relatively short stature with qi deficiency of both spleen and kidney syndrome,which deserves clinical promotion and application.