目的评价中医药治疗儿童特发性矮小(idiopathic short stature,ISS)的效果。方法选择2008年1月—2012年8月诊断为ISS的患儿80例,随机分为中药组、穴位组、耳穴组和对照组各20例,中药组根据中医辨证分为脾胃虚弱、肾气不足及脾肾两虚三型给予相应中药口服治疗,免煎中药,每日量分2次口服。穴位组每晚按摩足三里、涌泉、关元及肾俞各3-5 min。耳穴组主穴取肾、内分泌、皮质下,配穴取肾上腺、甲状腺、心、脾等,以胶布贴王不留行籽,施以轻柔按压手法,每穴2 min,每日3-5次,两耳交替。对照组指导儿童合理饮食,每天有氧运动半小时,保证充足的睡眠。以上均治疗6个月。治疗前后均测身高、体重、骨龄(bone age,BA)及进行生长激素激发试验。比较年生长速度(height velocity,HV)、身高标准差数值(height standard deviation score,HSDS)、HSDS差值、HV差值、BA差值。计量资料组间比较采用方差分析,方差分析前进行方差齐性检验,治疗前后数据比较采用t检验,P<0.05为差异有统计学意义。结果中药组、穴位组及耳穴组治疗后HV[(6.10±0.81)、(5.12±0.69)、(6.64±0.68)cm/年]、HSDS(-1.97±0.48、-2.30±0.71、-1.82±0.28、-2.32±0.82)均较治疗前[HV(4.04±0.75)、(3.84±0.43)、(3.81±0.25)cm/年,HSDS-2.48±0.46、-2.77±0.72、-2.45±0.20、-2.71±0.79]明显升高,组内比较差异均有统计学意义(均P<0.05);对照组治疗前后HV、HSDS比较差异均无统计学意义(均P>0.05)。四组HSDS差值(0.52±0.20、0.43±0.11、0.63±0.18、0.39±0.07)、HV差值[(2.02±1.07)、(1.18±0.42)、(2.83±0.56)、(0.03±0.17)cm/年]比较差异均有统计学意义(均P<0.05),四组BA差值比较差异均无统计学意义(均P>0.05)。结论中药、穴位及耳穴按摩治疗ISS效果确切,值得推广,且耳穴治疗效果最好,值得临床推广。 Objective To evaluate the effect of traditional Chinese medicine (TCM) on idiopathic short stature (ISS) in children. Methods Eighty children with ISS diagnosed from January 2008 to August 2012 were randomly divided into TCM group, acupoint group, ear acupoint group and control group with 20 cases each. According to TCM syndrome differentiation, TCM group was divided into spleen and stomach, Insufficient and spleen and kidney deficiency three types of oral administration of the corresponding Chinese medicine, free fried medicine, daily oral dose of 2 times. Acupuncture points Zusanli night massage, Yongquan, Guan Yu and Shenshu each 3-5 min. Main points of the ear acupuncture group take the kidney, endocrine, subcortical, with adrenal gland, thyroid, heart, spleen and so on, to tape the king without leaving seed row, gentle pressure method, each hole 2 min, 3-5 times a day , Alternating ears. Control group to guide children with proper diet, aerobic exercise for half an hour a day to ensure adequate sleep. The above treatment for 6 months. Before and after treatment were measured height, weight, bone age (bone age, BA) and growth hormone challenge test. High velocity (HV), height standard deviation score (HSDS), HSDS difference, HV difference and BA difference were compared. Measurement data were compared between groups using analysis of variance, variance analysis before homogeneity of variance test, before and after treatment data using t test, P <0.05 for the difference was statistically significant. Results After treatment, the HV (6.10 ± 0.81), (5.12 ± 0.69), (6.64 ± 0.68) cm / year, HSDS (-1.97 ± 0.48, -2.30 ± 0.71, -1.82 ± 0.28 and -2.32 ± 0.82) were significantly higher than those before treatment [HV (4.04 ± 0.75), (3.84 ± 0.43), (3.81 ± 0.25) cm / year, HSDS-2.48 ± 0.46, -2.77 ± 0.72, -2.45 ± 0.20, -2.71 ± 0.79] in the control group were significantly higher than those in the control group (all P <0.05). There was no significant difference in HV and HSDS before and after treatment in the control group (all P> 0.05). The differences of HSDS among the four groups (0.52 ± 0.20,0.43 ± 0.11,0.63 ± 0.18,0.39 ± 0.07), HV difference [(2.02 ± 1.07), (1.18 ± 0.42), (2.83 ± 0.56), (0.03 ± 0.17) cm / year] were significantly different (all P <0.05). There was no significant difference in BA difference between the four groups (all P> 0.05). Conclusion Chinese medicine, acupuncture points and auricular massage ISS exact effect, it is worth promoting, and the ear acupuncture treatment is the best, worthy of clinical promotion.