【摘要】 【目的】探讨苍苓化痰抑早方治疗痰湿壅滞证特发性中枢性性早熟(ICPP)女性患儿的临床疗效。【方法】将60例5～8岁痰湿壅滞证ICPP女性患儿随机分为观察组和对照组,每组各30例。2组患儿均给予生活方式干预,在此基础上,观察组给予苍苓化痰抑早方治疗,对照组给予知柏地黄丸治疗,疗程为6个月。观察2组患儿治疗前后体质量指数(BMI)、中医证候积分、性激素水平、乳核直径及卵巢、子宫容积和骨龄差的变化情况,并评价2组患儿的临床疗效和安全性。【结果】(1)治疗6个月后,观察组的总有效率为80.00%(24/30),对照组为73.33%(22/30),组间比较(秩和检验),观察组的总体疗效明显优于对照组(P<0.05)。(2)治疗后,2组患儿的BMI、乳房发育情况和阴道分泌物情况均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.05)。(3)治疗后,观察组的各项中医证候积分均较治疗前改善(P<0.05),而对照组仅口中黏腻、便溏情况较治疗前改善(P<0.05);组间比较,观察组在改善各项中医证候积分方面均明显优于对照组(P<0.05)。(4)治疗后,2组患儿的卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平均较治疗前下降(P<0.05),且观察组的下降作用均明显优于对照组(P<0.05)。(5)治疗后,2组患儿的乳核直径、子宫容积、卵巢容积均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.05),但2组患儿的骨龄差均改善不明显(P>0.05)。(6)治疗期间,2组患儿的血、尿常规及肝、肾功能等安全性指标均未见明显异常。【结论】苍苓化痰抑早方治疗痰湿壅滞证ICPP肥胖型女性患儿疗效确切,能有效降低BMI和相关性激素水平,改善患儿临床症状,减缓患儿第二性征发育进程,且具有较高的安全性。更多还原

【Abstract】 Objective To investigate the clinical efficacy of Cangling Huatan Yizao Prescription on girl-children with idiopathic central precocious puberty(ICPP). Methods Sixty ICPP girl-children aged 5 to 8 years with phlegm-damp obstruction syndrome were randomly divided into the observation group and the control group,with30 cases in each group. Both groups of patients were given lifestyle intervention,and additionally,the observation group was given oral use of Cangling Huatan Yizao Prescription,the control group was given oral use of Zhibai Dihuang Pill treatment,and the course of treatment lasted for 6 months. The changes of body mass index(BMI),traditional Chinese medicine(TCM)syndrome scores, sex hormone level, the diameter of mammary nodule,ovarian and uterine volume,and bone-age difference in the two groups were observed before and after treatment,and the clinical efficacy and safety of the two groups were evaluated. Results(1)After 6 months of treatment,the total effective rate of the observation group was 80.00%(24/30)and that of the control group was 73.33%(22/30).The intergroup comparison by rank-sum test showed that the overall efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,BMI,breast development and vaginal secretion in the two groups were significantly improved compared with those before treatment(P<0.05),and the improvement effect of the observation group was significantly superior to that of the control group(P<0.05).(3)After treatment,the scores of various TCM syndromes in the observation group were improved compared with those before treatment(P<0.05),while in the control group only the scores of sticky and greasy sensation in the mouth and loose stool were improved compared with those before treatment(P<0.05). The intergroup comparison showed that the effect on improving the TCM syndrome scores in the observation group was significantly superior to that in the control group(P<0.05).(4)After treatment, the levels of follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)in the two groups were decreased compared with those before treatment(P<0.05), and the lowering effect of the observation group was significantly superior to that of the control group(P<0.05).(5)After treatment, the diameter of mammary nodule, uterine volume and ovarian volume of the two groups were significantly improved compared with those before treatment(P<0.05),and the improvement effect of the observation group was significantly superior to that of the control group(P<0.05),but the bone-age difference of the two groups was not significantly improved(P>0.05).(6)During the treatment,there were no obvious abnormalities shown in the routine test of blood,urine,and liver and kidney function in the two groups. Conclusion Cangling Huatan Yizao Prescription exerts certain effect in treating ICPP girl-children with phlegm-damp obstruction syndrome. The prescription can effectively reduce BMI and related sex hormone levels,improve the clinical symptoms of children,and slow down the development of secondary sexual characters with higher safety.更多还原