健脾益肾方联合生长激素治疗矮小症的临床观察

发布时间：2018-06-07 02:07

本文选题：健脾益肾方 + 生长激素　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:本课题旨在研究健脾益肾方联合生长激素治疗脾肾不足型矮小儿童的临床疗效,观察其对促进患儿身高增长的效果,以及在调节体重、改善饮食、睡眠等中医证候积分的疗效,并与单纯使用生长激素治疗脾肾不足型矮小儿童进行疗效对比,评价中西医结合治疗矮小症的优势,为现代矮小儿童治疗研究提供循证依据和开拓新的思路。方法:实验组给予口服中药免煎颗粒即健脾益肾方,同时联合皮下注射重组人生长激素,而对照组则单纯给予皮下注射重组人生长激素。治疗疗程为12个月,比较实验组与对照组治疗前及治疗后3个月、6个月、12个月的身高增长的变化、中医证候积分改善等差异有无统计学意义。结果:1.实验组与对照组治疗前的身高分别为120.83±4.82、121.20±4.87,差异无统计学意义(P0.05),且治疗前对照组平均身高较实验组高;治疗后的身高分别为130.40±4.43、129.00±4.70,差异无统计学意义(P0.05),但治疗后实验组的平均身高较对照组高。2.实验组与对照组治疗前身高月均增长量分别为0.30±0.09、0.30±0.08,差异无统计学意义(P0.05);治疗后月均增长量分别为:0.80±0.06、0.65±0.06,有显著性差异(P0.01),其中治疗3个月月均增长量分别为0.67±0.13、0.68±0.13,差异无统计学意义(P0.05);治疗6个月月均增长量分别为0.73±0.1、0.64±0.07,治疗12个月月均增长量分别为0.89±0.14、0.64±0.08,有显著性差异(P0.01)。3.实验组与对照组治疗前的年均增长速度分别为3.59±1.04、3.60±1.01,差异无统计学意义(P0.05);治疗后年均增长速度分别为9.57±0.76、7.8±0.71,有显著性差异(P0.01)。其中治疗3个月时的年增长速度分别为8.05± 1.57、8.10± 1.55,差异无统计学意义(P0.05);治疗6个月时的年增长速度分别为8.79± 1.24、7.66±0.81,治疗12个月时的年增长速度分别为10.72±1.65、7.72±0.94,有显著性差异(P0.01)。4.实验组与对照组治疗前的总中医证候积分分别为18.34±1.1、18.35±1.23,而主症证候积分分别为5.75±0.44、5.78±0.42,次症证候积分分别为12.59±1.09、12.58± 1.17,差异均无统计学意义(P0.05);治疗3个月时的总中医证候积分分别为15.48±1.13、15.90±1.08,主症证候积分分别为3.41±0.76、3.40±0.67,次症中医证候积分分别为12.07±0.93、12.50± 1.11,差异亦无统计学意义(P0.05);治疗6个月时的总中医证候积分分别为11.50±1.23、15.00±1.04,主症证候积分分别为2.48±0.51、2.88±0.33,次症中医证候积分分别为9.02± 1.09、12.13±0.91,以及治疗12个月时的总中医证候积分分别为7.32±1.23、14.85±1.31,主症证候积分分别为1.86±0.35、2.80±0.46,次症中医证候积分分别为5.45±1.21、12.05±1.28,有显著性差异(P0.01)。结论:生长激素对矮小症患儿有明确的增高效果,但其增高程度有限,且在改善患儿体重、饮食、情绪、睡眠、大便等中医证候积分项目方面效果欠佳,而健脾益肾方能够有效改善脾肾不足型矮小症患儿的这些症状,联合生长激素治疗后促生长功效更佳并以治疗6个月及以上显著。
[Abstract]:Objective: To study the clinical efficacy of Jianpi Yishen combined with growth hormone in the treatment of small children with spleen and kidney deficiency, to observe the effect on promoting the height growth of children, and to improve the curative effect in regulating body weight, improving diet, sleep and other TCM syndromes, and using growth hormone to treat the dwarf children with spleen and kidney deficiency type. Compare the curative effect, evaluate the advantages of combination of traditional Chinese and Western medicine in the treatment of dwarfism, provide evidence-based evidence and open up new ideas for the treatment of modern dwarf children. Methods: the experimental group was given oral Chinese medicine free Decoction granules, that is, Jianpi Yishen recipe, combined with subcutaneous injection of recombinant human growth hormone, while the control group was given subcutaneous injection of recombinant human growth. The treatment course was 12 months, compared with the experimental group and the control group before and after treatment and 3 months after treatment, 6 months, 12 months of height growth, the difference of TCM syndrome scores were not statistically significant. Results: the height of the 1. experimental group and the control group was 120.83 4.82121.20 + 4.87, respectively, the difference was not statistically significant (P0.05). And the average height of the control group was higher than that of the experimental group before the treatment, and the height after treatment was 130.40 + 4.43129.00 + 4.70 respectively, the difference was not statistically significant (P0.05), but the average height of the experimental group after the treatment was 0.30 + 0.09,0.30 + 0.08, respectively, higher than the control group and the control group before the treatment (P0.0 5): the monthly average growth rate was 0.80 + 0.06,0.65 + 0.06, respectively (P0.01). The average growth rate of 3 months of treatment was 0.67 + 0.13,0.68 + 0.13, respectively, and the difference was not statistically significant (P0.05), and the average growth rate of 6 months was 0.73 + 0.1,0.64 + 0.07 respectively, and the average growth rate of 12 month months was 0.89 + 0.14,0.64 + 0.08, respectively. The average annual growth rate of the.3. experimental group and the control group was 3.59 + 1.04,3.60 + 1.01, respectively, with no significant difference (P0.05). The average annual growth rate after treatment was 9.57 + 0.76,7.8 0.71, respectively (P0.01), and the annual growth rate of treatment for 3 months was 8.05 + 1.57,8.10 + 1.55, respectively. The difference was not statistically significant (P0.05); the annual growth rate of the 6 month treatment was 8.79 + 1.24,7.66 + 0.81 respectively. The annual growth rate of the treatment at 12 months was 10.72 + 1.65,7.72 + 0.94, respectively. There were significant differences (P0.01) the total TCM syndrome scores of the.4. experimental group and the control group were 18.34 + 1.1,18.35 + 1.23 respectively, and the main syndromes were accumulated. The scores of the syndromes were 5.75 + 0.44,5.78 + 0.42 respectively. The scores of the syndromes were 12.59 + 1.09,12.58 + 1.17 respectively, and the differences were not statistically significant (P0.05). The total TCM syndrome scores were 15.48 + 1.13,15.90 + 1.08 respectively for 3 months, and the syndrome scores of the main syndromes were 3.41 + 0.76,3.40 + 0.67 respectively. The TCM syndromes score of the secondary syndrome was 12.07 + 0.93,12.50 + 1.1, respectively. 1, the difference was not statistically significant (P0.05); the total TCM syndrome scores were 11.50 + 1.23,15.00 + 1.04 and 2.48 + 0.51,2.88 + 0.33 respectively for 6 months. The TCM syndrome scores of secondary syndrome were 9.02 + 1.09,12.13 + 0.91 respectively, and the total TCM syndrome scores of the treatment for 12 months were 7.32 + 1.23,14.85 + 1.31, respectively. The syndrome scores of the syndromes were 1.86 + 0.35,2.80 + 0.46 respectively. The TCM syndrome scores of secondary syndrome were 5.45 + 1.21,12.05 + 1.28 respectively. There were significant differences (P0.01). Conclusion: growth hormone has a definite increase effect on children with dwarfism, but its increase is limited, and it is also in improving children's weight, diet, mood, sleep, stool and other TCM syndrome points. The effect is not good, while Jianpi Yishen can effectively improve these symptoms in children with deficiency of spleen and kidney. The effect of combined growth hormone therapy is better and the treatment is more significant for 6 months and more.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.8

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