自拟助长方对特发性矮小症脾虚失运证患儿生长及骨代谢指标的影响

Effect of self-formulated Zhuzhang Formula on growth and bone metabolism indicators in spleen deficiency with dysfunction of transportation syndrome children with idiopathic short stature

  • 摘要:
    目的 探讨自拟助长方治疗特发性矮小症(ISS)脾虚失运证的效果及其对患儿生长速率、病情相关指标、骨代谢指标的影响。
    方法 选取80例ISS患儿作为研究对象,采用随机数字表法分为对照组和观察组,每组40例。对照组采用常规西药治疗,观察组在对照组基础上联合应用自拟助长方。比较2组患儿的临床疗效、中医证候积分、生长情况(身高月均增长量、年生长速率)、病情相关指标血清胰岛素样生长因子-1(IGF-1)、骨形态发生蛋白-2(BMP-2)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平、骨代谢指标骨碱性磷酸酶(BAP)、Ⅰ型前胶原氨基端前肽(PⅠNP)、Ⅰ型胶原交联羧基末端肽(β-CTX)水平及不良反应发生率。
    结果 观察组患儿治疗总有效率为97.50%, 高于对照组的80.00%, 差异有统计学意义(P < 0.05); 干预3、6个月后,观察组身材矮小、面色萎黄、不思饮食、少气懒言、四肢乏力、大便稀溏积分及总分低于对照组,差异有统计学意义(P < 0.05); 干预6个月后,观察组身高月均增长量、年生长速率高于对照组,差异有统计学意义(P < 0.05); 干预3、6个月后,观察组IGF-1、BMP-2、IGFBP-3、BAP、PⅠNP水平高于对照组, β-CTX水平低于对照组,差异有统计学意义(P < 0.05); 2组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。
    结论 自拟助长方治疗ISS脾虚失运证效果显著,可通过调节IGF-1、BMP-2、IGFBP-3及骨代谢指标水平减轻临床症状,促进患儿生长发育,且安全性高。

     

    Abstract:
    Objective To explore the efficacy of the self-formulated Zhuzhang Formula in treating the spleen deficiency with dysfunction of transportation syndrome of idiopathic short stature (ISS) and its effects on the growth rate, disease-related indicators, and bone metabolism indicators in affected children.
    Methods A total of 80 children with ISS were enrolled as study subjects. They were randomly assigned to control group and observation group using random number table method, with 40 cases in each group. The control group received conventional western medicine treatment, while the observation group was administered self-formulated Zhuzhang Formula in addition to the treatment of the control group. Comparisons were made between the two groups in terms of clinical efficacy, TCM syndrome scores, growth parameters (monthly average height increment, annual growth rate), levels of disease-related indicatorsserum insulin-like growth factor-1 (IGF-1), bone morphogenetic protein-2 (BMP-2), insulin-like growth factor binding protein-3 (IGFBP-3), levels of bone metabolism indicatorsbone alkaline phosphatase (BAP), type Ⅰ procollagen N-terminal propeptide (PⅠNP), type Ⅰ collagen cross-linked C-terminal telopeptide (β-CTX), and the incidence of adverse reactions.
    Results The overall effective rate in the observation group was 97.50%, which was significantly higher than the 80.00% in the control group(P < 0.05). After 3 and 6 months of intervention, the scores for symptoms such as short stature, sallow complexion, loss of appetite, weak voice and shortness of breath, limb weakness, and loose stools, as well as the total TCM syndrome scores, were lower in the observation group than those in the control group, with statistically significant differences (P < 0.05). After 6 months of intervention, the monthly average height increment and annual growth rate were higher in the observation group than those in the control group, and the differences were statistically significant (P < 0.05). After 3 and 6 months of intervention, the levels of IGF-1, BMP-2, IGFBP-3, BAP, and PⅠNP were higher in the observation group than those in the control group, while the level of β-CTX was lower, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).
    Conclusion The self-formulated Zhuchang Formula demonstrates remarkable efficacy in treating the spleen deficiency with dysfunction of transportation syndrome of ISS. It can alleviate clinical symptoms by regulating the levels of IGF-1, BMP-2, IGFBP-3, and bone metabolism indicators, thereby promoting the growth and development of affected children, and exhibits high safety.

     

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