滋阴化痰方治疗阴虚火旺证性早熟临床研究

Clinical Study of Ziyin Huatan Decoction(滋阴化痰方)in the Treatment of Precocious Puberty with Yin Deficiency and Fire Hyperactivity Syndrome

目的回顾性分析滋阴化痰方治疗阴虚火旺型性早熟女童的临床疗效,观察其对患儿的临床症状、体征及生长发育的影响。方法收集2016年6月—2018年6月在上海中医药大学附属市中医医院、复旦大学附属儿科医院门诊符合纳入标准的性早熟女童,依据用药情况分为暴露组43例(滋阴化痰方治疗)、对照组43例(知柏地黄丸治疗),回顾性分析两组治疗3个月、6个月后临床症状及性激素水平、子宫卵巢容积、最大卵泡直径等水平的变化,以评估滋阴化痰方临床疗效。结果治疗后暴露组总有效率为86%,对照组总有效率为62.8%,差异具有统计学意义(P<0.05)。治疗前两组年龄、身高、体质量、病程、Tanner分期、血清基础性激素水平、子宫、卵巢、卵泡大小、骨龄之间的差别比较均无统计学意义(P>0.05),治疗6月后,两组乳房Tanner分期、乳核大小分期、E2水平均较治疗前改善(P<0.05),且暴露组疗效好于对照组,差异有统计学意义(P<0.05);治疗6月后,暴露组阴毛Tanner分期、FSH、LH、子宫、右卵巢容积、卵泡直径大小等较治疗前改善(P<0.05),对照组未见明显改善(P>0.05);治疗6月后,两组阴道分泌物分期均较治疗前改善(P<0.05),组间比较无统计学意义(P>0.05)。结论滋阴化痰方可有效改善阴虚火旺型性早熟女童的临床症状,降低血清性激素(E_(2)、FSH、LH)水平,缩小子宫、右卵巢容积及卵泡大小。

Objective The clinical effect of Ziyin Huatan Decoction(滋阴化痰方)on the girls with precocious puberty of Yin deficiency and fire hyperactivity type was analyzed retrospectively,and the effects of Ziyin Huatan Decoction on the clinical symptoms,physical signs and growth and development of the children were observed.Methods From June 2016 to June 2018,girls with precocious puberty who met the inclusion criteria in the outpatient department of Shanghai municipal hospital of traditional Chinese medicine affiliated to Shanghai university of traditional Chinese medicine and Fudan university affiliated hospital of pediatrics were collected.According to the medication situation,they were divided into exposure group(43 cases treated with Ziyin Huatan Decoction)and control group[43 cases treated with Zhibai Dihuang Pill(知柏地黄丸)].The clinical symptoms and sexual hormone levels of the two groups after 3 and 6 months of treatment were analyzed retrospectively to evaluate the clinical effect of Ziyin Huatan Decoction.Results After treatment,the total effective rate of exposure group was 86%,and that of control group was 62.8%,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in age,height,weight,course of disease,Tanner stage,serum basic sex hormone level,uterus,ovary,follicle size and bone age between the two group(s P>0.05).After 6 months of treatment,the breast Tanner stage,breast nucleus size stage and E_(2) level in the two groups were improved compared with those before treatment(P<0.05),and the curative effect of the exposure group was better than that of the control group.After 6 months of treatment,the Tanner stage of pubic hair,FSH,LH,uterus,right ovarian volume and follicle diameter in the exposure group were improved compared with those before treatment(P<0.05),but there was no significant improvement in the control group(P>0.05);after 6 months of treatment,the vaginal secretion staging of the two groups was improved compared with that before treatment(P<0.05),and there was no significant difference between the two groups(P>0.05).Conclusion Ziyin Huatan Decoction can effectively improve the clinical symptoms of girls with precocious puberty of yin deficiency and fire hyperactivity syndrome,reduce the level of serum sex hormones(E2,FSH,LH),reduce the volume of uterus,right ovary and follicle size.