Systematic evaluation of Zhibai Dihuang Pills in adjuvant treatment of central precocious puberty in girls
Objective To analyze and evaluate the clinical efficacy and safety of Zhibai Dihuang Pills in the adjuvant treatment of central precocious puberty(CPP)in girls.Methods Databases such as CNKI,VIP,Wanfang Date,CBM,Cochrane Library,PubMed and Web of Science were searched by computer for randomized controlled trials(RCT)of Zhibai Dihuang Pills combined with gonadotropin-releasing hormone agonist(GnRHa)in the treatment of CPP in girls.Data collection from database establishment to October 25,2023.Meta-analysis was performed using RevMan 5.4 software.Results A total of 14 RCTs were included,including 1101 children.The results of Meta-analysis showed that the clinical response rate of the experimental group was higher than that of the control group[RR=1.19,95％CI(1.13,1.25),P＜0.000 01].Treatment group after treatment of uterine volume[MD=-0.75,95％CI(-0.93,-0.58),P＜0.000 01],after treatment ovarian volume[MD=-0.26,95％CI(-0.34,-0.17)],follicle diameter[MD=-0.68,95％CI(-0.85,-0.50)]and other secondary sex characteristics were better than the control group(P＜0.000 01).After the treatment,the levels of serum luteinizing hormone(LH)[MD=-0.75,95％CI(-0.95,-0.54)],serum follicle-stimulating hormone(FSH)[MD=-1.23,95％CI(-1.53,-0.94)]and serum estradiol(E2)[SMD=-1.07,95％CI(-1.54,-0.59)]in experimental groups were significantly lower than those of the control groups(P＜0.000 01).After the treatment of bone age index(BAI)[MD=-0.12,95％CI(-0.16,-0.08),P＜0.000 01]improved better than that of control group;the adverse reaction rate in the experimental group was lower than that in the control group[RR=0.64,95％CI(0.40,1.03),P=0.07].Conclusion The clinical efficacy of Zhibai Dihuang Pills combined with GnRHa in the treatment of CPP in girls is obviously better than that of GnRHa group alone,and it can more effectively retract the secondary sexual characteristics of children,reduce the level of sex hormones,inhibit the development of hypothalamic-pituitary-gonad axis,effectively delay growth and development,and has good safety without increasing the occurrence of adverse reactions.
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