摘要
目的观察滋阴祛火方辅助治疗特发性性早熟女童阴虚火旺证的临床疗效。方法选取2020年1月至2024年2月就诊于余姚市人民医院中医儿科的特发性性早熟阴虚火旺证女童102例,采用随机数字表法分为对照组和治疗组,各51例。对照组予醋酸曲普瑞林肌内注射,初始剂量为50μg/kg,最大剂量不超过3.75 mg,1个月1次,根据患儿发育情况适当调整剂量。治疗组在对照组治疗方法的基础上给予滋阴祛火方,每日1剂,水煎取汁300 mL,分早晚2次温服。2组均治疗3个月后统计临床疗效。结果治疗前2组血清促卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组血清FSH、LH、E_(2)水平均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组Ⅰ型前胶原氨基端延长肽(PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组PINP水平显著下降,β-CTX水平显著升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组下降或升高更显著(P<0.05)。治疗前2组子宫长度、卵巢容积、卵泡个数、卵泡最大直径比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组卵巢容积、卵泡个数、卵泡最大直径均显著降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。2组治疗前后子宫长度变化不明显,差异无统计学意义(P>0.05)。治疗前2组主症积分、次症积分和总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组主症积分、次症积分和总积分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组骨龄(BA)、生长速度、预测成年身高(PAH)比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组BA、生长速度、PAH均显著增加,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组增加更显著(P<0.05)。2组治疗期间均未发生严重不良反应。结论滋阴祛火方辅助治疗女童特发性性早熟阴虚火旺证,能改善性激素和骨代谢水平,延缓骨龄和性腺发育,疗效显著,值得临床推广应用。
Objective To observe the clinical efficacy of Ziyin Quhuo Fang(滋阴祛火方)as an adjuvant therapy in female children with idiopathic precocious puberty(IPP)of yin deficiency and fire hyperactivity pat-tern.Methods A total of 102 girls with IPP who presented at the Department of TCM Pediatrics,Yuyao People’s Hospital between January2020and February 2024 were selected and randomly divided into a control group and a treatment group,with 51 cases in each group.The control group received intramuscular injections of Triptorelin Acetate.The initial dose was 50μg/kg,with a maximum dose not exceeding 3.75 mg,adminis-tered once monthly.The dose was adjusted appropriately based on the child's developmental status.The treat-ment group received the Ziyin Quhuo Fang in addition to the same treatment as the control group.One dose was administered daily,decocted in water to obtain 300 mL of liquid,divided into two warm doses taken morning and evening.The clinical efficacy was evaluated after 3 months of treatment for both groups.Results Before treatment,there were no statistically significant differences(P>0.05)in serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E_(2))between the two groups,indicating comparabil-ity.After treatment,both groups showed significant decreases in serum FSH,LH,and E?levels compared to their respective pre-treatment levels(P<0.05),with a more significant decrease observed in the treatment group(P<0.05).Before treatment,there were no statistically significant differences(P>0.05)in levels of Pro-collagen type I N-terminal propeptide(PINP)andβ-CrossLaps of type I collagen(β-CTX)between the two groups,indicating comparability.After treatment,PINP levels significantly decreased andβ-CTX levels sig-nificantly increased in both groups compared to their pre-treatment levels(P<0.05),with the treatment group showing more significant changes(P<0.05).Before treatment,there were no statistically significant differences(P>0.05)in uterine length,ovarian volume,number of follicles,or maximum follicle diameter between the two groups,indicating comparability.After treatment,ovarian volume,number of follicles,and maximum follicle diameter significantly decreased in both groups compared to pre-treatment(P<0.05),with a more significant reduction in the treatment group(P<O.05).Uterine length did not show significant changes before and after treatment in either group(P>0.05).Before treatment,there were no statistically significant differences(P>0.05)in the scores for primary symptoms,secondary symptoms,or total scores between the two groups,indicating comparability.After treatment,all scores significantly decreased in both groups compared to pre-treatment(P<0.05),with a more significant decrease in the treatment group(P<0.05).Before treatment,there were no statistically significant differences(P>0.05)in bone age(BA),growth velocity,or predicted adult height(PAH)between the two groups,indicating comparability.After treatment,BA,growth velocity,and PAH significantly increased in both groups compared to pre-treatment(P<0.05),with a more significant increase in the treatment group(P<0.05).No severe adverse reactions occurred in either group during the treatment period.Conclusion As an adjuvant therapy,Ziyin Quhuo Fang effectively improves sex hormone and bone metabolism levels,delays bone age advancement and gonadal development in female children with IPP of yin deficiency and fire hyperactivity pattern.It demonstrates significant clinical efficacy and is worthy of clinical promotion and application.
作者
王咪娜
WANG Mina(Department of Traditional Chinese Medicine Pediatrics,Yuyao People's Hospital,Yuyao,Zhejiang 315400,China)
出处
《中医儿科杂志》
2025年第6期71-77,共7页
Journal of Pediatrics of Traditional Chinese Medicine
基金
余姚市卫生健康科技计划项目(2025YZYB05)。
关键词
特发性性早熟
女童
阴虚火旺证
滋阴祛火方
性激素
骨代谢
临床观察
idiopathic precocious puberty
female children
yin deficiency and fire hyperactivity pattern
Ziyin Quhuo Fang(滋阴祛火方)
sex hormones
bone metabolism
clinical observation
