知柏地黄汤加减对女童中枢性性早熟阴虚火旺证生殖器、骨龄及性激素水平的影响

Effect of modified Zhibai Dihuang Tang on genitalia,bone age and the level of sex hormone in girls with central precocious puberty,yin deficiency and fire hyperactivity syndrome

目的探讨知柏地黄汤加减对女童中枢性性早熟阴虚火旺证生殖器、骨龄及性激素水平的影响。方法选择100例女童中枢性性早熟阴虚火旺证患者,根据家属意愿将患者分为对照组50例为拒绝使用Gn RHa而未予特殊治疗者,观察组50例家属拒绝使用Gn RHa同意给予知柏地黄汤加减治疗;连续给药1年,比较2组治疗前后血清卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)水平和子宫、卵巢、卵泡容积变化及骨龄差值/年龄差值(ΔBA/ΔCA)变化。结果治疗前2组血清LH、FSH、E2水平比较差异无统计学意义(P>0.05);治疗后血清LH、FSH、E2水平差异有统计学意义(P<0.01);治疗前子宫、卵巢、卵泡及骨龄比较差异无统计学意义(P>0.05);治疗后子宫容积、卵巢容积、卵泡直径及骨龄差异有统计学意义(P<0.01)。结论知柏地黄汤能显著抑制中枢性性早熟性发育,通过降低血清LH、FSH、E2水平,从而减少子宫、卵巢、卵泡容积,延缓骨龄增长速度。

Objective Investigate the effect of modified Zhibai Dihuang Tang on genitalia,bone age and the level of sex hormone in girls with central precocious puberty,yin deficiency and fire hyperactivity syndrome.Methods A total of 100 cases girls with central precocious puberty of yin deficiency and fire hyperactivity syndrome were selected and divided into control group(50 cases)and observation group(50 cases)according to the wishes of their parents.50 cases in the control group refused to use Gn RHa without special treatment.50 cases in the observation group whose parents refused to use Gn RHa,agreed to be treated with Zhibai Dihuang Tang;with continuous administration for one year,then the levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)were compared between the two groups before and after treatment,and the changes of bone age difference/age difference(ΔBA/ΔCA)were also observed.Results There was no statistical significance on the difference in the levels of LH,FSH and E2 in serum between the two groups before treatment(P>0.05);and there was statistical significance on the difference in the levels of LH,FSH and E2 levels in serum after treatment(P<0.01);there was no statistical significance on the difference in uterus,ovary,follicle and bone age before treatment(P>0.05),while there was statistical significance on the differences between among uterus volume,ovary volume,follicle diameter and bone age(P<0.01).Conclusion Zhibai Dihuang Tang can significantly inhibit the development of central precocious puberty by reducing the serum levels of LH,FSH and E2,thus reducing the volume of uterus,ovary and follicle and delaying the growth rate of bone age.