性早熟女童阴虚火旺证本质的探讨

Exploring the Substantial Basis of the Features Yinxu Huowang(阴虚火旺)in Girls with Precocious Puberty

对真性性早熟女童进行中医辨证,发现患儿均有不同程度的阴虚火旺证象。下丘脑—垂体—卵巢轴功能测定显示患儿的血清 FSH、LH 及 E_2水平均较正常同龄儿显著升高,LHRH 兴奋试验呈现功能亢进的特征性变化。经滋阴泻火中药治疗病情缓解后,随着阴虚火旺证象的显著改善,血清 FSH、LH 及 E_2水平显著下降,子宫卵巢显著回缩,第二性征明显消退。据此,我们认为下丘脑—垂体—卵巢轴提前发动,功能亢进很可能是真性性早熟女童肾虚相火旺证的物质基础。

Differential diagnosis to 75 girls with true precocious puberty was made using method of TCM. It was observed that each girl had Yinxu Huowang(intense internal heat due to deficiency of vital essence)to a certain extent,these features were very remarkable in most of them.To explore the substantial basis of the features,the functions of hypothalamic-pituitary-ovarian axis were deter- mined.The results showed that the levels of serum FSH,LH,E_2 in the girls rise significantly than those in normal girls of the same age,and LHRH stimulating test displays characteristic changes of excessive activity.Treated with TCM of Ziyin Xiehuo(滋阴泻火),nourish vital essence reducing intense internal heat)and remitted,the levels of serum FSH,LH,E_2 descend significantly,the volume of uterus and ovary reduce markedly,secondary sexual characteristics retrogress evidently, while the features of intense internal heat due to deficiency of vital essence mitigate obviously. According to the above mentioned,the authors consider that thehypothalamic-pituitary-ovarian axis starting beforehand and being hyperfunction are likely to be the substantial basis of the features —that deficiency of Shen Yin(肾阴,vital essence)accompanied with intense Fire of the Vital Gate —of the girls with true precocious puberty.