市售小兒轉骨方之配伍實證分析

Combination analysis for commercially traditional Chinese medicine for children's height growth

臺灣民間對於孩童生長發展，盛行著特有在地的「轉骨」理論。然而，轉骨的知識並未納入正統中醫教育，因此面對琳瑯滿目的轉骨商品，如何應用於臨床治療是極為重要的課題。我們搜集22家轉骨方進行藥物分析統計，並搜尋具有Science Citation Index（SCI）認證的相關文獻，了解商品的適應證型及藥理實證。分析結果顯示，市售轉骨方中，男童用方多以補氣為主，女童則以補血為主。常用中藥為黃耆、杜仲、葛根、山藥、甘草、砂仁、杜仲葉、續斷、黃柏、知母、麥芽、夏枯草等。由文獻可知中醫可藉由益氣健脾、補腎壯骨、滋陰降火等方式來調控孩童的生長發育，而市售轉骨方僅以補益氣血方式試圖幫助孩童長高，缺乏中醫辨證施治的治療法則，其市售轉骨商品則需經由嚴謹的隨機對照臨床試驗來證實其療效。

The traditional Chinese medicine (TCM) theory of “Jhuan Gu” is widespread in Taiwan, and this concept represents the physical and mental changes during adolescence. Many commercial “Jhuan Gu” products composed of TCM are advertised to be capable of increasing height growth of short stature. However, only few clinical studies proved their effectiveness, and these products lacked of absolute indication and contraindication. To investigate the TCM combination among these products, we collected 22 different kinds of commercially available “Jhuan Gu” products and made composition analysis. The results showed these products were designed according to gender. Male version was characterized by tonifying Qi, while female version was characterized by tonifying blood. Available evidence from PubMed database revealed that some kinds of TCM, such as Astragali Radix, Eucommiae Cortex and Eucommiae Folium, Puerariae Lobatae Radix, Dioscoreae Rhizoma, Glycyrrhizae Radix et Rhizoma, Amomi Fructus, Eucommiae Folium, and Phlomidis Radix, Phellodendri Cortex, Anemarrhenae Rhizoma, Prunellae Spica, and Hordei Fructus Germinatus. To summarize, there are many TCM concepts to deal with short stature including “tonifying qi by strengthen spleen”, “strengthen bone by tonifying kidney”, and “removing fire with nourishing yin” validated by lab experiments. However, these products may not be suitable for all children without exact pattern diagnoses made by TCM physicians. In conclusion, those children who want to take “Jhuan Gu” products for adolescent maturation should consult experienced TCM physicians to avoid unexpected side effects and those commercially “Jhuan Gu” products should be proved by rigorous randomized controlled clinical trials.