目的 探讨知柏地黄丸联合健康指导对女童特发性中枢性性早熟(Idiopathic central precocious puberty,ICPP)的临床疗效.方法 选取2021年12月-2022年12月期间河北省迁安市中医医院收治的80例ICPP女患儿,采用随机数字表法分为对照组和观察组,每组各40例.对照组给予常规治疗,观察组在对照组基础上给予知柏地黄丸联合健康指导进行治疗,两组患儿均连续治疗24周.观察比较两组患儿临床疗效,治疗前后乳房发育情况,血清激素[血清黄体生成素(luteinizing hormone,LH)、雌激素(Estradiol,E2)、促卵泡成熟素(Follicle stimulating hormone,FSH)]、胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)及类胰岛素生长因子结合蛋白-3(Recombinant insulin like growth factor binding protein 3,IGFBP-3)水平,卵巢容积、子宫容积、卵泡直径,骨龄/年龄及预测终身高.结果 治疗后对照组患儿Ⅰ期、Ⅱ期及Ⅲ期分别为13、16、11例,Ⅱ期及Ⅲ期占比为67.5％,观察组患儿Ⅰ期、Ⅱ期及Ⅲ期分别为23、14、3例,Ⅱ期及Ⅲ期占比为42.5％,观察组Ⅱ期及Ⅲ期占比明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿E2、LH及FSH水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组E2、LH及FSH水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿血清IGF-1、IGFBP-3水平均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组血清IGF-1、IGFBP-3水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿卵巢容积、子宫容积及卵泡直径均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组卵巢容积、子宫容积及卵泡直径均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿BA/CA较治疗前明显降低,预测终身高较治疗前明显升高,差异有统计学意义(P＜0.05);且观察组BA/CA明显低于对照组,预测终身高明显高于对照组,差异有统计学意义(P＜0.05).治疗后观察组总有效率94.59％(35/37)明显高于对照组81.58％(31/38),差异有统计学意义(P＜0.05).结论 知柏地黄丸联合健康指导能够有效下调ICPP女患儿性激素及血清IGF-1、IGFBP-3水平,抑制第二性征发育,控制早熟症状,提高临床疗效,有利于提高女患儿身高生长潜能,改善成年终身高.
Clinical Efficacy of Zhibai Dihuang Pills Combined with Health Guidance on Idio-pathic Central Precocious Puberty in Girls
Objective To observe the clinical efficacy of Zhibai Dihuang Pills combined with health guidance on idiopathic central precocious puberty(ICPP)in girls.Methods Eighty cases of girls with ICPP admitted to Qian'an Hos-pital of Traditional Chinese Medicine in Hebei Province from December 2021 to December 2022 were selected and divided into a control group and an observation group using the random number table method,with 40 cases in each group.The con-trol group received routine treatment,while the observation group received Zhibai Dihuang Pills combined with health guid-ance on the basis of the control group for both 24 weeks.The clinical efficacy,breast development before and after treat-ment,serum hormones[luteinizing hormone(LH),estradiol(E2),and follicle stimulating hormone(FSH)],and recombi-nant insulin like growth factor binding protein 3(IGFBP-3)levels of the two groups were compared,as well as the ovarian volume,uterine volume,follicle diameter,bone age/age,and predicted height.Results After treatment,there were 13,16,and 11 cases in stages Ⅰ tag,and in t,theretrol group,and the proportion of cases in stages tage inup,and the proportion o16r,bone age/ageotd after trea,and three cases in stages stag,and e nup,and the proportioncases in stages tage inup,and the proportion o16r,bcases in stages tage inup,and the proportion o16r,bone age/ageotd afterthan that in the control group,and the difference was statistically significant(P＜0.05).After treatment,the levels of E2,LH,and FSH in the two groups were lower(P＜0.05),and the levels of E2,LH,and FSH in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the serum levels of IGF-1 and IGFBP-3 in the two groups were significantly lower(P＜0.05),and the serum levels of IGF-1 and IGFBP-3 in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the ovarian volume,uterine volume,and follicle diameter of the two groups were significantly decreased(P＜0.05).The ovarian volume,uterine volume,and follicle diameter in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the BA/CA of the two groups was significantly lower,and the predicted height was significantly higher(P＜0.05).The BA/CA of the obser-vation group was significantly lower than that of the control group,and the predicted height was significantly higher than that of the control group(P＜0.05).After treatment,the total effective rate of the observation group was 94.59％(35/37),which was significantly higher than that of the control group 81.58％(31/38)(P＜0.05).Conclusion Zhibai Di-huang Pills combined with health guidance can effectively downregulate the levels of sex hormones and serum levels of IGF-1 and IGFBP-3 in girls with ICPP,inhibit the development of secondary sexual characteristics,control precocious pu-berty symptoms,improve clinical efficacy,and strengthen the height growth potential of girls,thereby improving their height.
Zhibai Dihuang PillsHealth GuidanceIdiopathic Central Precocious Puberty
万方数据
维普
