调脾益肾生长汤联合重组人生长激素治疗特发性矮小症临床研究

Clinical Study on Tiaopi Yishen Shengzhang Decoction Combined with Recombinant Human Growth Hormone for Idiopathic Short Stature

摘要:

目的：观察调脾益肾生长汤联合重组人生长激素（rhGH） 治疗特发性矮小症的临床疗效及对生长激素释放激素（GHRH） /生长激素（GH） /胰岛素样生长因子-1 （IGF-1） 轴的影响。方法：回顾性选取2023年1月—2025年1月于河南医药大学第三附属医院治疗的特发性矮小症患儿120例，根据治疗方法不同分为对照组和研究组各60例。2组均行常规治疗，对照组采用rhGH治疗，研究组在对照组基础上采用调脾益肾生长汤治疗。2组均连续治疗6个月。评价2组临床疗效，比较2组体格发育指标［骨龄、体质量、身高、身高标准差积分（HtSDS）］、血清GHRH/GH/IGF-1轴指标（GHRH、GH、IGF-1） 水平，统计不良反应发生率。结果：研究组总有效率为90.00%（54/60），高于对照组73.33%（44/60）（P＜0.05）。治疗6个月后、治疗结束后6个月，2组骨龄、体质量、身高、HtSDS逐渐升高（P＜0.05），且研究组骨龄、体质量、身高、HtSDS高于同期对照组（P＜0.05）。治疗6个月后、治疗结束后6个月，2组血清GHRH、GH、IGF-1水平逐渐升高（P＜0.05），且研究组血清GHRH、GH、IGF-1水平高于同期对照组（P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：调脾益肾生长汤联合rhGH治疗特发性矮小症患儿的临床疗效较好，能改善GHRH/GH/IGF-1轴功能，改善患儿体格发育，安全性好。

Abstract:

Abstract： Objective： To observe the clinical efficacy of Tiaopi Yishen Shengzhang Decoction combined with recombinant human growth hormone （rhGH） in the treatment of idiopathic short stature （ISS），and to explore its effect on the growth hormone-releasing hormone （GHRH）/growth hormone （GH）/insulin-like growth factor-1 （IGF-1） axis. Methods： A retrospective study was conducted on 120 children with ISS treated at The Third Affiliated Hospital of Henan Medical University from January 2023 to January 2025. They were divided into the control group and the study group according to the treatment methods， with 60 cases in each group. Both groups received conventional treatment. The control group was treated with rhGH， while the study group received Tiaopi Yishen Shengzhang Decoction in addition to the treatment given to the control group. Both groups were treated continuously for six months. The clinical efficacy of the two groups was evaluated， and the physical development indicators [bone age， body weight， height， height standard deviation score （HtSDS）]， and serum levels of GHRH/GH/IGF-1 axis indicators （GHRH， GH， IGF-1） were compared between the two groups. The incidence of adverse reactions was also recorded. Results： The total effective rate in the study group was 90.00% （54/60）， higher than that of 73.33% （44/60） in the control group （P＜0.05）. At six months after treatment and six months after the end of treatment， bone age， body weight， height，and HtSDS gradually increased in both groups （P＜0.05），and these indicators in the study group were higher than those in the control group at the same time points （P＜0.05）. At six months after treatment and six months after the end of treatment，serum levels of GHRH，GH，and IGF-1 gradually increased in both groups （P＜0.05），and the levels of these indicators in the study group were higher than those in the control group at the same time points （P＜ 0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P＞ 0.05）. Conclusion： Tiaopi Yishen Shengzhang Decoction combined with rhGH has certain clinical efficacy in the treatment of children with ISS， improving the function of the GHRH/GH/IGF-1 axis and enhancing physical development，with a good safety profile.