知柏地黄丸联合达菲林治疗儿童性早熟的效果及对血清激素水平的影响

Effect of Zhibai Dihuang pills combined with Diphereline in the treatment of childhood precocious puberty and their effect on serum hormone levels

目的:探讨达菲林联合知柏地黄丸治疗儿童性早熟的临床效果及对血清胰岛素样生长因子-1(IGF-1)、Ⅰ型前胶原氨基端肽(P1NP)水平的影响。方法:本研究对象为我院2014年10月-2016年10月收治的66例性早熟患儿,依照治疗方法的不同分为达菲林治疗(对照)组和达菲林联合知柏地黄丸治疗(观察)组,每组患儿33例,比较两组治疗效果及患儿治疗前后血清黄体生成激素(LH)、卵泡生成激素(FSH)、雌二醇(E2)、Tanner分期、骨龄指数、β-胶原降解产物(β-CTX)、骨钙素N端中分子片段(N-MID)、P1NP、IGF-1等的变化情况;并统计两组不良反应发生情况。结果:观察组的治疗总有效率为93. 9%,对比于对照组的总有效率75. 8%显著较高(P<0. 05)。治疗后,两组患儿β-CTX无明显变化(P>0. 05),且两组间比较无显著差异(P>0. 05);两组患者的血清LH、FSH、E2、Tanner分期、骨龄指数、N-MID、P1NP及IGF-1水平均显著降低(P<0. 05),且观察组较对照组各指标治疗后降低更加显著(P<0. 05)。两组患儿的呕吐、恶心、注意力降低、记忆力降低、情绪变化、阴毛发育、肌肉痛等不良反应发生率比较无显著差异(P>0. 05)。结论:达菲林联合知柏地黄丸治疗儿童性早熟效果显著,能够明显改善患儿骨骼发育和体内激素水平,且不增加不良反应。

Objective:To explore the clinical effect of Diphereline combined with Zhibai Dihuang pills,a traditional Chinese medicine,in the treatment of childhood precocious puberty and their effect on serum insulin-like growth factor-1(IGF-1)and typeⅠprocollagen amino terminal peptide(P1 NP1)lev-els.Methods:The subjects involved 66 children with precocious puberty admitted to our hospital from October 2014 to October 2016.According to the different methods of treatment,they were divided into Diphereline group and combined treatment group,with 33 children in each group.The ther-apeutic effects of the two groups and the changes of serum luteinizing hormone(LHH),follicle form-ing hormone(FSH),estradiol(E2)and Tanner stage were compared between the two groups before and after treatment.Changes of bone age index,β-CTXN,N-MIDD,P1 NP1,IGF-1 of procollagen typeⅠ,β-CTX,N-terminal osteocalcin N-terminal fragments,andβ-CTX,N-terminal osteocalcin N-terminal fragments,P1 NP1,insulin growth factor-1(IGF-1),etc,were also compared.Then,the occurrence of adverse reactions in the two groups were also analyzed.Results:The total effective rate of the combined group was 93.9%,which was significantly higher than that of the control group(75.8%,P<0.05).After treatment,there was no significant difference in the changes ofβ-CTX be-tween the two groups(P>0.05).After treatment,the serum LH,FSH,E2,Tanner stage,bone age index,N-MID,P1 NP,and IGF-1 levels in the two groups were significantly decreased(P<0.05),and the changes in the combined group were much more significant than in the control group(P<0.05).There was no significant difference between the two groups in the incidence of adverse reac-tions,such as vomiting,nausea,decreased attention,memory loss,emotional change,pubic hair de-velopment,and muscle pain(P>0.05).Conclusion:The effect of Diphereline combined with Zhibai Dihuang Pills was significant in the treatment of children precocious puberty.It could obviously improve the bone development and hormone level in the body,and did not significantly increase the adverse reactions.