知柏地黄丸联合醋酸亮丙瑞林治疗儿童中枢性性早熟的疗效观察

Clinical observation of Zhibai Dihuang Pills combined with leuprolide acetate in treatment of children central precocious puberty

目的探讨知柏地黄丸联合醋酸亮丙瑞林治疗儿童中枢性性早熟的临床疗效。方法选取2014年10月—2015年10月在绵阳市中心医院治疗的儿童中枢性性早熟患儿86例,根据治疗方案的不同分为对照组（43例）和治疗组（43例）。对照组患儿皮下注射注射用醋酸亮丙瑞林微球,1次/5周,初始剂量为90μg/kg,连续用药3个月后根据治疗反应将剂量调整为60-80μg/kg。治疗组在对照组的基础上口服知柏地黄丸,6 g/次,2次/d。两组患者均连续治疗6个月。评价两组患者临床疗效,同时比较两组患儿子宫体积、卵巢体积,骨龄指数和性激素水平变化。结果治疗后,对照组和治疗组总有效率分别为81.40%、97.67%,两组总有效率比较差异具有统计学意义（P〈0.05）。治疗后,两组患儿的子宫体积、卵巢体积,骨龄指数均明显降低,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗组上述临床指标比对照组更低,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组患儿性激素水平明显降低,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗组的性激素水平显著优于对照组,两组比较差异具有统计学意义（P〈0.05）。结论知柏地黄丸联合醋酸亮丙瑞林治疗儿童中枢性性早熟效果显著,能够有效改善机体性激素水平,延迟发育时间,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Zhibai Dihuang Pills combined with leuprolide acetate in treatment of children central precocious puberty. Methods Children （86 cases） with central precocious puberty in Mianyang Central Hospital from October 2014 to October 2015 were divided into the control （43 cases） and treatment （43 cases） groups according to different treatment. Children in the control group were iv administered with Leuprorelin Acetate Microspheres for injection, once every 5 weeks, the initial dosage was 90μg/kg, and then adjusted to 60 - 80μg/kg after 3 months according to treatment-response. Children in the treatment group were po administered with Zhibai Dihuang Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the change of uterus size, ovarian size, bone age index and sex hormone levels in two groups was compared. Results After treatment, the clinical efficacy in the control and treatment group was 81.40% and 97.67%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, uterus size, ovarian size, bone age index in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And these indicators in the treatment group were lower than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, sex hormone level in two groups was significantly decreased, and there were differences between two groups （P 〈 0.05）. And the sex hormone level in the treatment group was better than that in the control group, with significant difference between two groups （P 〈 0.05）. Conclusion Zhibai Dihuang Pills combined with leuprolide acetate has a significant clinical effect in treatment of children central precocious puberty, can effectively improve hormone level and delayed the development time, which has a certain clinical application value.