Medical Center "Proyecto Foltra", Cacheiras (Teo), A Coruña, Spain.
Ther Clin Risk Manag. 2010 Nov 30;6:585-92. doi: 10.2147/TCRM.S14919.
Cerebral palsy is an important health issue that has a strong socioeconomic impact. There is no cure for cerebral palsy, and therapeutic approaches only report small benefits for affected people. In this study we assessed the effects of growth hormone treatment (0.3 μg/kg/day) combined with physical rehabilitation in the recovery of gross motor function in children with growth hormone deficiency and cerebral palsy (four males and six females, mean age 5.63 ± 2.32 years) as compared with that observed in a similar population of cerebral palsy children (five males, five females, mean age 5.9 ± 2.18 years) without growth hormone deficiency treated only with physical rehabilitation for two months. The Gross Motor Function Measure (GMFM-88) and Modified Ashworth Scale were performed before commencing the treatment and after completion thereof. In children with cerebral palsy and growth hormone deficiency, Dimension A (P < 0.02), dimension B (P < 0.02), and dimension C (P < 0.02) of the GMFM-88, and the total score of the test (P < 0.01) significantly improved after the treatment; dimension D and dimension E did not increase, and four of five spastic patients showed a reduction in spasticity. However, in children with cerebral palsy and without growth hormone deficiency, only the total score of the test improved significantly after the treatment period. This indicates that growth hormone replacement therapy was responsible for the large differences observed between both groups in response to physical rehabilitation. We propose that the combined therapy involving growth hormone administration and physical rehabilitation may be a useful therapeutic approach in the recovery of gross motor function in children with growth hormone deficiency and cerebral palsy.
脑性瘫痪是一个重要的健康问题，对社会经济有重大影响。目前还没有治愈脑性瘫痪的方法，治疗方法仅能为患者带来微小的益处。在这项研究中，我们评估了生长激素治疗（0.3μg/kg/天）联合物理康复对生长激素缺乏和脑瘫儿童（4 名男性和 6 名女性，平均年龄 5.63±2.32 岁）总体运动功能恢复的影响，并与接受相同治疗方案（生长激素缺乏但仅接受物理康复治疗 2 个月的脑瘫儿童，5 名男性，5 名女性，平均年龄 5.9±2.18 岁）进行了比较。在开始治疗前和治疗结束后，分别采用粗大运动功能测量量表（GMFM-88）和改良 Ashworth 量表进行评估。在生长激素缺乏和脑瘫儿童中，GMFM-88 的 A 维度（P<0.02）、B 维度（P<0.02）、C 维度（P<0.02）以及测试的总分（P<0.01）在治疗后显著改善；D 维度和 E 维度没有增加，5 名痉挛患者中有 4 名痉挛程度降低。然而，在生长激素缺乏和脑瘫儿童中，只有在治疗期间测试的总分显著增加。这表明生长激素替代治疗是导致两组对物理康复反应存在显著差异的原因。我们提出，生长激素给药联合物理康复的联合治疗可能是生长激素缺乏和脑瘫儿童恢复粗大运动功能的一种有效治疗方法。
