健脾补肾法对矮小症儿童血清生长发育指标水平的影响

Effect of invigorating spleen and tonifying kidney on the levels of serum growth and development indexes in children with short stature

目的观察自制健脾补肾法结合重组人生长激素(rh GH)对矮小症儿童生长发育及血清生长激素(GH)、胰岛素样生长因子(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)和25羟基维生素D[25(OH)D]水平的影响。方法选取发病原因相近的矮小症儿童100例,随机分为对照组和观察组,各50例,对照组给予重组人生长激素常规治疗,观察组用健脾补肾法结合重组人生长激素治疗,2组患者均连续治疗6个月后随访;分别记录2组患者治疗前后身高及体质量变化,用化学发光法检测治疗前后血清GH、IGF、IGFBP-3、25(OH)D含量,统计治疗前后各指标检测结果是否有显著性差异。结果治疗后2组患者的身高、体质量均较治疗前显著增加(P<0.05),血清GH、IGF、IGFBP-3、25(OH)D含量较治疗前显著增加(P<0.05);且观察组患者身高、体质量及IGF、IGFBP-3增加显著高于治疗前及同期对照组(P<0.05)。结论中西医结合治疗矮小症较单纯应用重组人生长激素治疗效果好,能明显提高血清GH、IGF、IGFBP-3和25(OH)D水平,以更好地促进矮小症患者生长发育,因有中药的调节作用,故中西医结合治疗矮小症无明显不良反应,值得推广应用。

Objective To observe the effects of the self-made decoction for invigorating the spleen and tonifying the kidneys combined with recombinant human growth hormone(rhGH)on the growth and development of children with short stature and the levels of serum growth hormone(GH),insulin-like growth factor(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3)and 25 hydroxyvitamin D(25(OH)D).Methods A total of 100 children with short stature of similar causes were randomly divided into a control group and an observation group,with 50 children in each group.The control group was given a routine treatment with recombinant human growth hormone,while the observation group was given the Jianpi Bushen Decoction on the basis of the control group.They were followed up after 6 months of continuous treatment.The changes of height and body mass of the two groups were recorded respectively before and after treatment.The contents of serum GH,IGF,IGFBP-3 and 25(OH)D were detected by the chemiluminescence method before and after treatment,and the test results of each index were statistically analyzed before and after treatment.Results After treatment,the height and body weight of both groups were significantly increased compared with before treatment(P<0.05),and the contents of serum GH,IGF,IGFBP-3,25(OH)D were significantly increased compared with before treatment(P<0.05).The increases of height,body weight,contents of IGF and IGFBP-3 in the observation group were significantly higher than those before treatment and of the control group at the same period(P<0.05).Conclusion Compared with rhGH alone,the treatment effect of integrated Chinese and western medicine is better,which can significantly improve the levels of serum GH,IGF,IGFBP-3 and 25(OH)D,so as to better promote the growth and development of patients with short stature.Due to the regulating effect of traditional Chinese medicine,the treatment of short stature with integrated Chinese and western medicine has no obvious adverse reactions,and it is worthy of popularization and application.