杨逸凡　陈国策　李瑞珍

摘要 目的：研究探討龙牡壮骨颗粒防治婴儿维生素D缺乏性佝偻病的疗效观察及安全性评价。方法：选取2017年5月至2018年5月在华中科技大学同济医学院附属武汉儿童医院新出生的健康新生儿96例作为研究对象，按照随机数字表法分为对照组和观察组，每组48例。对照组给予维生素AD滴剂进行预防治疗，观察组给予龙牡壮骨颗粒预防治疗。连续治疗12个月后，对2组婴儿的维生素D缺乏性佝偻病的患病率、血液生化指标、骨骼检查、中医症候总积分、随访情况、安全性等进行统计比较。结果：观察组维生素D缺乏性佝偻病患病率低于对照组，组间比较差异有统计学意义（P<0.05）。治疗后观察组25-（OH）D3、钙磷乘积均高于对照组，而血清碱性磷酸酶（ALP）低于对照组，组间比较差异有统计学意义（P<0.05）。经3、6、9、12个月随访观察，观察组中医症候总积分均低于对照组，组间比较差异有统计学意义（P<0.05）。治疗期间观察组不良反应发生率低于对照组，组间比较差异有统计学意义（P<0.05）。结论：龙牡壮骨颗粒可用于婴儿维生素D缺乏性佝偻病的防治，在降低患病率、血清学指标、中医症候积分等方面有显著的改善作用，且不良反应少，治疗安全性好，值得临床推广应用。

关键词 佝偻病;维生素D缺乏性;婴儿;龙牡壮骨颗粒;中医症候积分;血清学指标

Observation on the Curative Effects of Longmu Zhuanggu Granules on Vitamin D Deficiency Rickets in Infants

YANG Yifan，CHEN Guoce，LI Ruizhen

（Wuhan Children′s Hospital（Wuhan Maternal and Child Healthcare Hospital），Tongji Medical College，Huazhong University of Science & Technology，Wuhan 430000，China）

Abstract Objective：To study the efficacy and safety of Longmu Zhuanggu Granules in the prevention and treatment of vitamin D deficiency rickets in infantile.Methods：A total of 96 healthy newborn babies admitted to Wuhan Children′s Hospital，Tongji Medical College，Huazhong University of Science & Technology from May 2017 to May 2018 were selected as the research subjects and were randomly divided into an observation group and a control group according to the random number table method，with 48 cases in each group.The control group was given Vitamin A and D Drops for prevention and treatment，while the observation group was given Longmu Zhuanggu Granules for prevention and treatment.After 12 months of continuous treatment，the incidence of vitamin D deficiency rickets，blood biochemical indicators，bone examination，total score of TCM symptoms，follow-up and safety were compared between the 2 groups.Results：The morbidity of vitamin D deficiency rickets in the observation group was lower than that in the control group.There was a significant difference between the 2 groups（P<0.05）.After treatment，25-（OH）D3 and calcium phosphate product in the observation group were higher than those in the control group，while serum alkaline phosphatase（ALP）was lower than that in the control group，and the difference between the 2 groups was statistically significant（P<0.05）.After 3，6，9 and 12 months follow-up observation，the total score of TCM symptoms in the observation group was lower than that in the control group，and the difference between the 2 groups was statistically significant（P<0.05）.The incidence of adverse reactions in the observation group was lower than that in the control group.There was a significant difference between the 2 groups（P<0.05）.Conclusion：Longmu Zhuanggu Granules can be used for the prevention and treatment of infantile rickets with vitamin D deficiency.It can significantly lower the morbidity，serological indicators and TCM syndrome score etc and has less adverse effects，which is worthy of clinical application.

Keywords Rickets; Vitamin D deficiency; Infantile; Longmu Zhuanggu Granules; TCM syndrome score; Serological indicators

中图分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.15.019

根据流行病统计调查显示[1]，婴儿中佝偻病的发病率约为10%～15%，其中以维生素D缺乏性佝偻病居多，该病是婴幼儿群体中出现的一种常见慢性营养性疾病。其早期临床表现为枕秃、夜惊、汗证、食欲降低、烦躁等，后期临床表现为骨骼钙化异常，严重影响婴幼儿的正常发育状态[2-3]。其发病机制是由于婴幼儿人群在正常的生长过程中维生素D摄入不足导致其在机体内水平的绝对或相对不足，进而引起血液中的钙、磷等物质的代谢紊乱。常规的防治方法以母乳喂养、维生素D补充疗法、鈣剂补充和户外光疗等，但所取效果并不显著，仍有部分婴儿患病[4-5]。为此，我们以新生儿为研究对象，对其进行中、西药对比的预防性用药方案，以期在防治婴儿维生素D缺乏性佝偻病的基础上，减少该病的患病率，为改善婴儿的生长发育提供参考依据，现报道如下。……