超声评价知柏地黄丸联合大补阴丸治疗女童中枢性性早熟的临床疗效

Ultrasonic evaluation of clinical efficacy of Zhibai Dihuang Wan(知柏地黄丸) combined with Dabuyin Wan(大补阴丸) on central pubertas praecox in girls

目的应用超声检查评价知柏地黄丸联合大补阴丸治疗女童中枢性性早熟(CPP)的临床疗效。方法选取2017年1月至2018年12月在浙江中医药大学附属温州市中医院儿科门诊收治的CPP女童84例,按照随机数字表法分为对照组和治疗组,各42例。对照组采用知柏地黄丸口服,治疗组在对照组治疗方法的基础上联合大补阴丸治疗。2组均3个月为1个疗程,连续治疗2个疗程后统计疗效。结果治疗前2组乳房分期比较,差异无统计学意义(P>0.05),具有可比性。治疗后2组乳房均有明显缩小,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组缩小更显著(P<0.05)。治疗前2组乳腺腺体回声及乳腺中央低回声比较,差异无统计学意义(P>0.05),具有可比性。治疗后2组乳腺腺体回声及中央低回声均显著减少,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组减少更显著(P<0.05)。2组治疗前子宫及卵巢容积、最大卵泡直径、黄体生成素(LH)峰值/卵泡刺激素(FSH)峰值比较,差异均无统计学意义(P>0.05),具有可比性(P>0.05)。治疗后2组上述指标均明显改善,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组改善更显著(P<0.05)。对照组总有效率为83.33%(35/42),治疗组为100.00%(42/42),2组比较,差异有统计学意义(P<0.05)。结论采用知柏地黄丸联合大补阴丸治疗女童CPP疗效显著,能明显改善患儿体内激素水平。超声检查安全无创、操作简便、价格低廉,是诊断女童CPP重要的辅助检查之一。

Objective To evaluate the clinical efficacy of Zhibai Dihuang Wan(知柏地黄丸) combined with Dabuyin Wan(大补阴丸) in the treatment of girls with central pubertas praecox(CPP) by ultrasonography.Methods From January 2017 to December 2018,84 girls with CPP admitted into the pediatric outpatient department of Wenzhou Hospital of TCM Affiliated to Zhejiang University of Chinese Medicine were divided into treatment group and control group according to random number table method,with 42 cases in each.The control group was given oral administration of Zhibai Dihuang Wan,on this basis,the treatment group was combined with Dabuyin Wan.Three months constituted 1 course of treatment for both groups,and we kept statistics about the curative effects after 2 consecutive courses.Results Before treatment,the difference was not statistically significant in stages of mammary development between the 2 groups(P>0.05),and they were comparable.After treatment,the breasts all significantly reduced in the 2 groups,and the difference was statistically significant compared with the same group before treatment(P<0.05),moreover,the treatment group reduced more significantly(P<0.05).Before treatment,the difference was not statistically significant between echo of mammary glands and hypoecho of central mammary glands in the 2 groups(P>0.05),and they were comparable.After treatment,echo of mammary glands and hypoecho of central mammary glands all significantly decreased,and the difference was statistically significant compared with the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).Before treatment,the difference was not statistically significant among uterine and ovarian volume, the maxim follicle diameter and luteinizing hormone(LH) peak/follicle-stimulating hormone(FSH) peak(P>0.05),and they were comparable.After treatment,the above-mentioned indexes of the 2 groups all significantly improved,and the difference was statistically significant compared with the same group before treatment(P<0.05),moreover,the treatment group improved more significantly(P<0.05).The total effective rate of the control group was 83.33%(35/42),that of the treatment group was 100.00%(42/42),and the difference was statistically significant between the 2 groups(P<0.05).Conclusion It has marked curative effect to use Zhibai Dihuang Wan combined with Dabuyin Wan in the treatment of girls with CPP,and it can markedly improve the hormone levels in children patients. Ultrasound examination is safe,noninvasive,easy to operate and cheap,which is one of the important auxiliary examinations for diagnosing CPP in girls.