加减知柏地黄丸对特发性中枢性性早熟患者骨相关指标的影响

Effect of modified Zhibai Dihuang pills on bone related indicators in patients with idiopathic central precocious puberty

目的探讨特发性中枢性性早熟女童骨相关指标异常的规律及加减知柏地黄丸治疗的效果。方法对不同年龄水平的性早熟女童进行N-MID骨钙素片段（N-MIDOCT）、Ⅲ型前胶原氨基末端前肽（P Ⅲ NP）和胃促生长素（Ghrelin）含量的测定，将各项指标与正常同龄儿作比较，以探讨患儿骨骼发育异常的规律。其中60例患儿随机单盲分成两组，分配无差异，经加减知柏地黄丸治疗和亮丙瑞林西药对照组治疗，病情缓解后观察骨相关指标。结果治疗组与对照组治疗前后比较差异无统计学意义（P〉0．05），治疗组治疗前N-MIDOCT、PⅢNP、Ghrelin分别为（110．51±11．16）、（31．73±0．30）、（2．73±0．04），治疗6个月，N-MIDOCT、PⅢNP分别为（92．22±3．80）和（29．46±0．88），都出现下降，差异均有统计学意义（均P〈0．01），Ghrelin为（2．74±0．03），差异无统计学意义（P〉0．05），治疗1年，N-MIDOCT、PINNP分别为（61．49±4．64）和（23．14±1．47），均下降Ghrelin为（2．86±0．03）上升，差异均有统计学意义（均P〈0．01）。结论加减知柏地黄丸可改变ICPP患儿骨相关指标N-MIDOCT、PHINP、Ghrelin的水平，抑制成骨细胞过度亢进活动。

Objective To investigate the law of bone related indicators in and the effect of modified Zhibai Dihuang pills for girls with idiopathic central precocious puberty. Methods The contents N-MID osteocalcin fragments （N-MID OCT）, Procollagen propeptide of type III procollagen （PⅢNP） and ghrelin （Ghrelin） in precocious girls with different ages were detected to explore the regularity of skeletal dysplasia in the children. Among which, 60 cases were randomly divided into 2 groups. There were no-statistical differences between the two groups. The treatment was treated with modified Zhibai Dihuang pills and the control group leuprorelin. The bone related indicators were observed after disease remission. Results There were no statistical differences between the treatment group and the control group before and after the treatment （P 〉 0.05）. Before the treatment, in the treatment group, the N-MID OCT, PⅢNP, and Ghrelin were （110.51±11.16）, （31.73±0.30）, and （2.73±0.04）; six months after the treatment, the N-MID OCT and PIIINP were （92.22±3.80） and （29.46±0.88）, with statitstical differences （all P 〈 0.01）, and the Ghrelin was （2.74±0.03）, with no statistical difference （P 〉 0.05）; one year the treatment, the N-MID OCT and PⅢNP decreased to （61.49±4.64） and （23.14±1.47） and the Ghrelin increased to （2.86±0.03）, with statistical differences （all P 〈 0.01）. Conclusion Modified Zhibai Dihuang pills can change the bone related indicators, N-MID OCT, PIIINP, and Ghrelin, in children with ICPP and inhibit osteoblast hyperfunction activity.