知柏地黄丸加大补阴丸联合赖氨酸治疗青春早期矮小女童的临床研究

CLINICAL STUDY ON LITTLE GIRLS AT EARLY PUBERTY TREATED WITH ZHIBAI DIHUANG PILL,DA BUYIN PILL AND LYSINE

目的:观察知柏地黄丸加大补阴丸联合赖氨酸治疗青春早期矮小女童的临床疗效。方法:将158名处于乳房发育B2期的8～9岁矮小女童随机分成3组:单纯赖氨酸组、单纯中成药组及知柏地黄丸、大补阴丸加赖氨酸联合用药组,分组给予相应药物,疗程为6个月。观察身高增速(GV)、身高标准差数值(HtSDS)改变、预测终身高(PAH)改变、性发育水平及骨龄/实际年龄值变化(△BA/△CA)情况。ELISA法检测血清IGF-I含量,B超观察子宫、卵巢大小。结果:联合用药组总有效率为71.7%,中药组为60.38%,两组比较差异有显著性(P<0.05);联合组预测终身高差(△PAH)与其他两组比差异有显著性(P<0.05);联合组及赖氨酸组IGF-I(类胰岛素样生长因子-I)、GV及△HtSDS与中成药组比较差异有显著性(P<0.05);两服用中药组乳房回缩为B1期者分别占70%和71.5%;性腺容积及性激素浓度均回复至接近青春期前水平;△BA/△CA分别为联合组0.90、中药组0.92,与赖氨酸组(1.2)比较差异均有显著性(P<0.05)。结论:知柏地黄丸联合大补阴丸治疗青春早期矮小女童可以减缓性发育及骨龄进展,加用赖氨酸可促进身高增长加速,两者合用使预测终身高增加。

Objective:To observe the curative effect of zhibai dihuang pill,da buyin pill and lysine on little girls at early puberty.Methods:158 little girls at the age of 8～9 years old were randomly divided into three groups,whose breast development were at B2 stage,simple lysine group,simple Chinese medicine group(zhibai dihuang pill and da buyin pill) and combining group(zhibai dihuang pill,da buyin pill and lysine),the three groups were respectively given the corresponding treated,six months was one treatment course.Growth velocity(GV),change of height standard deviation score(HtSDS) and predicted adult height(PAH),sexual development and change of bone age(△BA/△CA) were observed,Serum LH and E2 were examined by chemical luminescence method,serum IGF-I content was determined by ELISA,volume of uterus and ovaries was determined by B-ultrasound.Results:The total effectiveness rate of combining group was 71.70%,that was 60.38% in the simple Chinese group,there was obvious difference between the two groups.There was significant difference between combining group and the other two groups on △PAH ;the changes of IGF-I,GV and △HtSDS in combining group and lysine group were significantly different from simple Chinese group;breast development of 70% little girls in combining group was lowered to B1 stage,breast development of 70.75% little girls in simple Chinese group was lowered to B1 stage;gonad volume and sexual hormone concentration in the two Chinese medicine groups dropped to the level of early adolescence,the ratio of △BA/△CA in combining group was 0.90,that was 0.92 in simple Chinese group,all these were obvious different from those in lysine group.Conclusion:Zhibai dihuang pill,da buyin pill is able to slow down sexual development and bone age acceleration of little girls at early puberty,combined with lysine can stimulate growth and improve predicted adult height.