本文選題：健脾益腎方 + 生長激素　； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本課題旨在研究健脾益腎方聯(lián)合生長激素治療脾腎不足型矮小兒童的臨床療效,觀察其對促進(jìn)患兒身高增長的效果,以及在調(diào)節(jié)體重、改善飲食、睡眠等中醫(yī)證候積分的療效,并與單純使用生長激素治療脾腎不足型矮小兒童進(jìn)行療效對比,評價(jià)中西醫(yī)結(jié)合治療矮小癥的優(yōu)勢,為現(xiàn)代矮小兒童治療研究提供循證依據(jù)和開拓新的思路。方法:實(shí)驗(yàn)組給予口服中藥免煎顆粒即健脾益腎方,同時聯(lián)合皮下注射重組人生長激素,而對照組則單純給予皮下注射重組人生長激素。治療療程為12個月,比較實(shí)驗(yàn)組與對照組治療前及治療后3個月、6個月、12個月的身高增長的變化、中醫(yī)證候積分改善等差異有無統(tǒng)計(jì)學(xué)意義。結(jié)果:1.實(shí)驗(yàn)組與對照組治療前的身高分別為120.83±4.82、121.20±4.87,差異無統(tǒng)計(jì)學(xué)意義(P0.05),且治療前對照組平均身高較實(shí)驗(yàn)組高;治療后的身高分別為130.40±4.43、129.00±4.70,差異無統(tǒng)計(jì)學(xué)意義(P0.05),但治療后實(shí)驗(yàn)組的平均身高較對照組高。2.實(shí)驗(yàn)組與對照組治療前身高月均增長量分別為0.30±0.09、0.30±0.08,差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療后月均增長量分別為:0.80±0.06、0.65±0.06,有顯著性差異(P0.01),其中治療3個月月均增長量分別為0.67±0.13、0.68±0.13,差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療6個月月均增長量分別為0.73±0.1、0.64±0.07,治療12個月月均增長量分別為0.89±0.14、0.64±0.08,有顯著性差異(P0.01)。3.實(shí)驗(yàn)組與對照組治療前的年均增長速度分別為3.59±1.04、3.60±1.01,差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療后年均增長速度分別為9.57±0.76、7.8±0.71,有顯著性差異(P0.01)。其中治療3個月時的年增長速度分別為8.05± 1.57、8.10± 1.55,差異無統(tǒng)計(jì)學(xué)意義(P0.05);治療6個月時的年增長速度分別為8.79± 1.24、7.66±0.81,治療12個月時的年增長速度分別為10.72±1.65、7.72±0.94,有顯著性差異(P0.01)。4.實(shí)驗(yàn)組與對照組治療前的總中醫(yī)證候積分分別為18.34±1.1、18.35±1.23,而主癥證候積分分別為5.75±0.44、5.78±0.42,次癥證候積分分別為12.59±1.09、12.58± 1.17,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療3個月時的總中醫(yī)證候積分分別為15.48±1.13、15.90±1.08,主癥證候積分分別為3.41±0.76、3.40±0.67,次癥中醫(yī)證候積分分別為12.07±0.93、12.50± 1.11,差異亦無統(tǒng)計(jì)學(xué)意義(P0.05);治療6個月時的總中醫(yī)證候積分分別為11.50±1.23、15.00±1.04,主癥證候積分分別為2.48±0.51、2.88±0.33,次癥中醫(yī)證候積分分別為9.02± 1.09、12.13±0.91,以及治療12個月時的總中醫(yī)證候積分分別為7.32±1.23、14.85±1.31,主癥證候積分分別為1.86±0.35、2.80±0.46,次癥中醫(yī)證候積分分別為5.45±1.21、12.05±1.28,有顯著性差異(P0.01)。結(jié)論:生長激素對矮小癥患兒有明確的增高效果,但其增高程度有限,且在改善患兒體重、飲食、情緒、睡眠、大便等中醫(yī)證候積分項(xiàng)目方面效果欠佳,而健脾益腎方能夠有效改善脾腎不足型矮小癥患兒的這些癥狀,聯(lián)合生長激素治療后促生長功效更佳并以治療6個月及以上顯著。
[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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.8

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