摘要
目的探讨四君子汤加减联合维生素D治疗维生素D缺乏性佝偻病的效果及对骨代谢指标的影响。方法回顾性分析2021年1月至2024年5月于郑州大学第一附属医院儿童保健门诊治疗的106例维生素D缺乏性佝偻病患儿的病历资料,根据治疗方法的不同分为对照组(n=56)和研究组(n=50),对照组患儿采用维生素D治疗,研究组患儿在对照组治疗的基础上采用四君子汤加减治疗,两组患儿均治疗6个月。治疗6个月后,比较两组患儿的临床效果,以及治疗前、治疗6个月后的骨代谢指标[尿脱氧吡啶啉(DPD)、骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)]、尺骨和桡骨的骨密度,并比较两组患儿治疗期间的不良反应发生情况。结果研究组患儿治疗后的临床总有效率为96.00%,明显高于对照组的82.14%,差异有统计学意义(P<0.05);治疗前,两组患儿的DPD、BGP、BALP比较差异均无统计学意义(P>0.05);治疗6个月后,两组患儿的DPD、BGP、BALP均明显升高,且研究组患儿的DPD、BGP、BALP分别为(30.47±2.12)nmol/mmol、(15.50±1.40)μg/L、(176.17±15.73)U/L,明显高于对照组的(26.61±1.78)nmol/mmol、(11.69±1.23)μg/L、(143.62±13.77)U/L,差异均有统计学意义(P<0.05);治疗前,两组患儿的尺骨、桡骨骨密度比较差异均无统计学意义(P>0.05);治疗6个月后,两组患儿的尺骨、桡骨骨密度水平均升高,且研究组患儿的尺骨、桡骨骨密度分别为(0.54±0.10)g/cm^(2)、(0.60±0.13)g/cm^(2),明显高于对照组的(0.42±0.08)g/cm^(2)、(0.45±0.10)g/cm^(2),差异均有统计学意义(P<0.05);研究组患儿治疗期间的不良反应总发生率为12.00%,略高于对照组的7.14%,但差异无统计学意义(P>0.05)。结论四君子汤加减联合维生素D治疗维生素D缺乏性佝偻病可改善患儿的骨代谢指标水平,增强骨密度,临床应用效果显著且安全性较好。
Objective To investigate the effect of Sijunzi Tang combined with vitamin D in the treatment of vitamin D-deficient rickets and its influence on bone metabolism indexes.Methods The medical records of 106 children with vitamin D-deficient rickets admitted to Children's Health Clinic,the First Affiliated Hospital of Zhengzhou University from January 2021 to May 2024 were retrospectively analyzed.According to different treatment methods,they were divided into a control group(n=56)and a study group(n=50).Patients in the control group were treated with vitamin D,while those in the study group were treated with modified Sijunzi Tang on the basis of the treatment in the control group,all for 6 months.After 6 months of treatment,the clinical effects of the two groups were compared,and the bone metabolic indexes(urinary deoxypyridinoline[DPD],osteocalcin[BGP],bone-specific alkaline phosphatase[BALP]),bone mineral density of ulna and radius were compared before treatment and after 6 months of treatment.The occurrence of adverse reactions in the two groups were recorded.Results The total clinical effective rate of the study group after treatment was 96.00%,significantly higher than the control group's 82.14%(P<0.05).Before treatment,there was no statistically significant difference in DPD,BGP,and BALP between the two groups(P>0.05).After 6 months of treatment,the DPD,BGP,and BALP of both groups were significantly increased,and the DPD,BGP,and BALP of the study group were(30.47±2.12)nmol/mmol,(15.50±1.40)μg/L,and(176.17±15.73)U/L,respectively,which were significantly higher than(26.61±1.78)nmol/mmol,(11.69±1.23)μg/L,and(143.62±13.77)U/L in the control group(P<0.05).Before treatment,there was no statistically significant difference in the bone density of the ulna and radius between the two groups of patients(P>0.05).After 6 months of treatment,the bone density of the ulna and radius in both groups of children increased,and the bone density of the ulna and radius in the study group was(0.54±0.10)g/cm^(2) and(0.60±0.1
作者
张笑聪
高晓霞
ZHANG Xiao-cong;GAO Xiao-xia(Children's Health Clinic,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第23期3366-3370,共5页
Hainan Medical Journal
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20200639)。
