肝脾补益法联合rhGH治疗ISS骨骼增长量的长期随访研究

Long term follow-up study on skeleton increment of Ganpi Buyi method combined with rhGH in treating ISS

目的观察比较肝脾补益法联合重组人生长激素(rhGH)治疗特发性矮小症(ISS)的效果及骨骼增长量的长期随访结果。方法选取64例ISS患儿为研究对象,按照年龄分层后随机数字法分为观察组和对照组各32例。对照组给予rhGH皮下注射治疗,观察组在rhGH治疗基础上联合应用肝脾补益法中药内服治疗,两组患儿均治疗和随访12个月,观察两组患儿治疗前后骨骼增长量相应指标情况。结果两组患儿治疗前身高、身高增长速度(GV)、预测成年身高(PAH)、身高标准差积分(HtSDS)、维生素D、骨钙素、胰岛素样生长因子-1(IGF-1)等指标比较,差异均无统计学意义(P>0.05)。与治疗前比较,治疗12个月后,两组患儿上述各指标均明显提高(P<0.05),且观察组患儿在身高GV、PAH、HtSDS、维生素D、骨钙素、IGF-1指标方面均优于对照组[(12.13±1.08)cm/年vs.(10.78±0.96)cm/年、(168.32±3.76)cm vs.(163.54±4.02)cm、-1.53±0.25 vs.-1.77±0.19、(23.86±11.25)ng/mL vs.(22.49±10.62)ng/mL、(138.43±33.47)ng/L vs.(130.15±35.21)ng/L、(255.12±46.13)μg/mL vs.(240.67±42.52)μg/mL,P<0.05]。结论肝脾补益法联合rhGH治疗ISS对患儿骨骼增长量及PAH改善长期效果良好。

Objective To observe and compare the effects of Ganpi Buyi method combined with recombinant human growth hormone(rhGH)in treating idiopathic short stature(ISS)and the long term follow up results of skeleton increase amounts.Methods Sixty-four children patients with ISS were selected as the research subjects and randomly divided into the observation group and control group according to age stratification and random numerical method,32 cases in each group.The control group was given subcutaneous injection of rhGH,and the observation group was combined with oral Ganpi Buyi traditional Chinese medicine on the basis of rhGH treatment.Both groups were treated and followed up for 12 months.The corresponding indicators of bone growth amounts in the two groups were observed before and after treatment.Results Before treatment,the indicators such as height,height growth rate(GV),predicted adult height(PAH),height standard deviation integral(HtSDS),vitamin D,osteocalcin and insulin-like growth factor-1(IGF-1)had no statistically significant differences between the two groups(P>0.05).Compared with before treatment,after 12-month treatment,the above indexes were significantly increased in both groups(P<0.05),the indicators of GV,PAH,HtSDS,vitamin D,osteocalcin and IGF-1 in the observation group were better than those in the the control group[(12.13±1.08)cm/year vs.(10.78±0.96)cm/year,(168.32±3.76)cm vs.(163.54±4.02)cm,-1.53±0.25 vs.-1.77±0.19,(23.86±11.25)ng/mL vs.(22.49±10.62)ng/mL,(138.43±33.47)ng/L vs.(130.15±35.21)ng/L,(255.12±46.13)μg/mL vs.(240.67±42.52)μg/mL,P<0.05].Conclusion The Ganpi Buyi method combined with rhGH in treating ISS has good long-term effects on bone growth amounts and PAH improvement.