摘要
目的探究自拟抗早熟复方联合促性腺激素释放激素类似物(GnRHa)治疗儿童中枢性性早熟(CPP)的有效性及安全性。方法选取2021年3月~2023年3月期间在山西医科大学附属运城市中心医院接受诊疗的92例CPP女童,以区组随机法将其分为中药组(n=46)及常规组(n=46)。常规组采用生活管理及饮食、用药指导,并给予GnRHa治疗;中药组在常规组治疗方案基础上应用自拟抗早熟复方进行治疗。比较两组患儿治疗前后骨发育与代谢指标,包括骨龄、血清骨钙素N端中分子片段(N-MID)及25羟维生素D_(3)[25(OH)D_(3)]水平;比较两组患儿治疗前后第二性征发育指标(子宫容积、卵巢容积、乳核直径)水平及心理健康状况[儿童青少年心理健康调查量表(MHS-CA)]差异;观察两组患儿治疗过程中的不良反应发生情况。结果治疗后,中药组骨龄、血清N-MID水平、子宫容积、卵巢容积、乳核直径均较常规组更低(P<0.05),血清25-OH-D3水平及MHS-CA评分均较常规组更高(P<0.05);两组患儿用药期间不良反应总发生率比较,差异无统计学意义(P>0.05)。结论采用自拟抗早熟复方联合GnRHa治疗CPP患儿,能改善骨及第二性征的发育情况,对于患儿心理健康有一定的促进作用,且该联合用药方案不会增加不良反应发生率,安全性较高。
Objective To explore the efficacy and safety of self-made anti-precocious compound formula combined with gonadotropin-releasing hormone analogue(GnRHa)in the treatment of central precocious puberty(CPP)in children.Methods A total of 92 girls with CPP who were treated in Yuncheng Central Hospital Affiliated to Shanxi Medical University from March 2021 to March 2023 were selected and divided into traditional Chinese medicine group(n=46)and conventional group(n=46)by block randomization method.The conventional group received life management,diet and medication guidance and GnRHa treatment,while the traditional Chinese medicine group was treated with self-made anti-precocious compound formula on the basis of the treatment plan of the conventional group.The bone development and metabolic indexes of the two groups were compared before and after treatment,including bone age,serum N-terminal midfragment of osteocalcin(N-MID)and 25-hydroxyvitamin D_(3)[25(OH)D_(3)]levels.Compare the differences in the levels of secondary sexual characteristics development indexes(uterine volume,ovarian volume,mammary nucleus diameter)and mental health status[Mental Health Survey Scale for Children and Adolescents(MHS-CA)]between the two groups before and after treatment.The adverse reactions of the two groups were observed.Results After treatment,the bone age,serum N-MID level,uterine volume,ovarian volume and mammary nucleus diameter in traditional Chinese medicine group were lower than those in the conventional group(P<0.05),and the serum 25(OH)D3 level and MHS-CA score were higher than those in the conventional group(P<0.05).There was no statistically significance in the total incidence rate of adverse reactions during the medication period between the two groups(P>0.05).Conclusion The application of self-made antiprecocious compound formula combined with GnRHa in the treatment of CPP children can improve the development of bone and secondary sexual characteristics,and has a certain promoting effect on the mental health of children.Moreover,the combination regimen will not increase the incidence of adverse reactions and has high safety.
作者
李云
LI Yun(Department of Endocrinology,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,China)
出处
《医师在线》
2025年第7期56-59,共4页
Journal of Doctors Online
基金
运城市科技局基础研究计划项目(YCKJ-2021056-4)。
关键词
中枢性性早熟
自拟抗早熟复方
促性腺激素释放激素
骨龄
安全性
Central precocious puberty
Self-made anti-precocious compound formula
Gonadotropin-releasing hormone
Bone age
Safety
