儿童性早熟中医辨证用药研究

Studies on TCM Differentiation and Administrations for Precocious Puberty

目的:通过对近25年来性早熟中医证型及治疗用药的有关报道文献,对收集的数据进行统计描述。方法:在知网、万方、维普等数据库搜索近25年来性早熟中医证型及治疗用药的有关报道,运用统计学方法进行整理、统计、分析。结果:性早熟中医证型中阴虚火旺型有4 726例、肝郁化火型有1 971例、痰热壅盛型有1 018例。其中阴虚火旺型常用中药为知母、生地黄、黄柏、牡丹皮、泽泻等,分别占了7.4%、7.4%、7.0%、6.0%、4.8%;肝郁化火型常用中药为柴胡、白芍、夏枯草、当归等,分别占了6.8%、5.6%、5.3%、3.7%;痰热壅盛型常用中药为茯苓、半夏、陈皮、夏枯草等,分别占了5.7%、4.9%、4.9%、4.2%。结论:在性早熟中医证型中,以阴虚火旺型最为多见,其次为肝郁化火型,痰热壅盛型,与《儿童性早熟中医诊疗方案》一致;在用药方面,阴虚火旺型的治疗用药以清热为主,兼以补阴药和利水渗湿药;肝郁化火型的治疗用药主要为清热药、理气药及补血药;痰热壅盛型的治疗用药为化痰药、清热药及理气药,此与所制定的《方案》不完全一致,告诫我们中医辨治疾病有其灵活性,选方用药不是一成变。

Objective：To collect researches on precocious puberty about traditional Chinese medicine（ TCM） syndromes and medication in recent 25 years,then analyze and discuss the data.Methods：Searching CNKI,Wan Fang,VIP and other databases in recent 25 years for researches on precocious puberty about its TCM syndrome and medication,then analyze the data by statistical methods.Results：Among cases of precocious puberty,there are 4 726 cases belong to yin deficiency and fire excessive,1 971 cases of liver stagnation transforming to fire,1 018 cases of dampness-phlegm abundance.The common used herbs in treating yin deficiency and fire excessive are Zhimu（ Anemarrhenae Rhizoma）,Shengdihuang（ Rehmanniae Radix）,Huangbo（ Phellodendron Chinense Cortex）,Mudanpi（ Moutan Cortex）,Zexie（ Alismatis Rhizoma） are common in which take 7.4%,7.4%,7.0%,6.0%,and 4.8% respectively;in treating liver depression transforming into fire syndrome the common used herbs are Chaihu（ Bupleuri Radix） 6.8%,Baishao（ Paeoniae Radix Alba） 5.6%,Xiakucao（ Prunellae Spica） 5.3%,and Danggui（ Angelicae Sinensis Radix） 3.7% respectively;in treating dampness-phlegm abundance,the common used herbs are Fuling（ Poria） 5.7%,Banxia（ Pinelliae Rhizoma） 4.9%,Chenpi（ Citri Reticulatae Pericarpium） 4.9%,Xiakucao（ Prunellae Spica） 4.2% respectively.Conclusion：Among TCM syndromes of precocious puberty,yin deficiency and fire excessive is most common,followed by liver depression transforming into fire syndrome,then dampness-phlegm abundance,which is consistent with ＂The Precocious Puberty of TCM Diagnosis and Treatment Program＂.In terms of medication,clearing heat drug is the core in treating yin deficiency and fire excessive,accompanied by nourishing yin drugs and clearing damp drugs;in treating liver depression transforming into fire syndrome,clearing heat-fire drugs,regulating qi drugs and replenishing blood drugs are mainly used;in treating dampness-phlegm abundance syndrome,removing phlegm,clearing heat-fire,and regulating qi drug are mainly used.This is not entirely consistent with the the program,which implies that TCM diagnosis and treatment and medications are flexibile.