异功散加味联合rhGH对特发性矮小症患儿生长发育及IGF-1的影响

Effects of Yigong San combined with rhGH on growth and development and IGF-1 in children with idiopathic short stature

目的 探讨异功散加味联合重组人生长激素(recombinant human growth hormone,rhGH)对脾肾虚弱型特发性矮小症(idiopathic short stature,ISS)患儿生长发育及血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平的影响。方法 选取2020年6月至2021年6月于温州市中心医院就诊的脾肾虚弱型ISS患儿80例,根据随机数字表法将其分为对照组和治疗组,每组各40例。对照组患儿给予rhGH注射液治疗;治疗组患儿在对照组治疗的基础上联合异功散加味治疗。两组患儿连续治疗12个月。比较两组患儿的生长发育情况、脾肾虚弱证单项症状评分、临床疗效、血清IGF-1水平和不良反应发生率。结果 干预12个月后,两组患儿的身高、骨龄、血清IGF-1水平均显著高于本组治疗前,脾肾虚弱证单项症状评分均显著低于本组治疗前(P<0.05);治疗组患儿的身高、骨龄、血清IGF-1水平均显著高于对照组,脾肾虚弱证单项症状评分均显著低于对照组(P<0.05)。治疗组患儿的总有效率显著高于对照组(χ^(2)=4.132,P=0.042)。治疗组患儿的不良反应发生率显著低于对照组(χ^(2)=5.400,P=0.020)。结论 异功散加味联合rhGH治疗脾肾虚弱型ISS患儿的疗效较好,有利于促进患儿生长发育,改善中医证候评分,上调血清IGF-1水平,且安全性良好。

Objective To investigate the effect of Yigong San combined with recombinant human growth hormone(rhGH) on growth and development and insulin-like growth factor-1(IGF-1) in children with idiopathic short stature(ISS) of deficiency of spleen and kidney.Methods A total of 80 children with ISS of deficiency of spleen and kidney treated in Wenzhou Central Hospital from June 2020 to June 2021 were selected and divided into control group and treatment group according to random number table method,with 40 cases in each group.Control group was treated with rhGH injection,on the basis of control group,treatment group was combined with Yigong San flavor treatment.Both groups were treated for 12 months.The growth and development,single symptom score of deficiency of spleen and kidney,the clinical efficacy,serum IGF-1 level and incidence of adverse reactions were compared between the two groups.Results After 12 months of intervention,the height,bone age and serum IGF-1 level of children in two groups were significantly higher than before treatment,and the single symptom scores of deficiency of spleen and kidney were significantly lower than before treatment(P<0.05).The height,bone age and serum IGF-1level of the children in treatment group were significantly higher than those in control group,and the single symptom scores of deficiency of spleen and kidney were significantly lower than those in control group(P<0.05).The total effective rate of treatment group was significantly higher than that of control group(χ^(2)=4.132,P=0.042).The incidence of adverse reactions was significantly lower in treatment group than in control group(χ^(2)=5.400,P=0.020).Conclusion The combination of Yigong San and rhGH in the treatment of ISS children with deficiency of spleen and kidney has good efficacy,which is conducive to promoting the growth and development of the children,improving the TCM syndrome score,and increasing the serum IGF-1 level,with good safety.