滋肾疏肝法对性早熟女童第二性征和生长发育的影响  

Clinical efficacy observation of the impact of tonifying the kidney and dredging the liver-qi method on precocious puberty girls' secondary sex characteristics and growth

作　　者：毕美芬 张雪锋 盛丽 

机构地区：[1]宁波镇海中医医院儿科,浙江宁波315200

出　　处：《中医儿科杂志》2015年第6期23-27,共5页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目研究基金项目(20120166A)

摘　　要：目的观察滋肾疏肝法对性早熟女童第二性征和生长发育的影响,并进行疗效分析。方法将在本院门诊辨证为阴虚火旺证或肝郁化火证的120例性早熟女童随机分为治疗组和对照组,治疗组80例以滋肾疏肝法(早熟合剂)治疗,对照组40例以大补阴丸治疗,疗程为6月。观察2组患儿治疗6月后及随访6月后的身高、骨龄、子宫、卵巢容积及性激素水平的变化。结果治疗组显效24例,有效52例,无效4例,总有效率为95.0%;对照组显效3例,有效26例,无效11例,总有效率为72.5%。经Radit检验,治疗组疗效优于对照组(u=5.20,P<0.05)。2组治疗6月后,治疗组能明显抑制卵巢容积的增长(t=2.30,P<0.05)对照组无明显缩小(t=0.79,P>0.05),与治疗前比较亦无明显增大;2组子宫容积治疗前后变化不明显(t_(治疗组)=0.79,t_(对照组)=0.61,P>0.05),表明2组均能抑制子宫、卵巢的快速增长。卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_2)水平均不同程度降低(t_(FSH)=4.02,t_(LH)=4.76,t_(E_2)=15.10,P<0.05),2组比较,治疗组E_2值降低更为明显(t=10.69,P<0.05);治疗组随访6月后身高增长优于对照组(t=7.09,P<0.05),骨龄增长较治疗前明显抑制(t=3.38,P<0.05),2组骨龄增长值比较,差异无统计意义(t=1.72,P>0.05)。结论滋肾疏肝法能够明显降低性激素水平,有效控制并改善女童第二性征的出现,不减缓身高的增长,在一定程度上抑制了骨龄的快速增长,较单纯大补阴丸疗效更确切。Objective To observe and analyze the therapeutic effect of the impact of on precocious puberty girls＇ secondary sex characteristics and growth. Methods 120 girls clinically diagnosed as precocious puberty of yin deficiency or stagnation of liver-qi leading to fire syndrome were randomly divided into 2 groups. The 80 cases in the treatment group were treated with tonifying the kidney and dredging the liver-qi method （Zaoshu Heji）. 40 cases in the control group were treated with Dabuyin Wan, six months as a course of treatment. The changes of the height, the bone age, the volume of the uterus and the sex hormone levels of six months after treatment and follow-up six months were observed. Results In the treatment group, 24 cases was significantly effective, 52 cases effective, and 4 cases no effect, with the overall response rate of 95.0%. In the control group, 3 cases significantly effective, 26 cases effective and 11 cases no effect, with the overall response rate of 72.5%. After the Radit test, the therapeutic effect of the treatment group was better than that of the control group （u=5.20 ,P〈0.05 ）. After the treatment of six months, the ovary volume of the treatment group shrinks obviously comparing with that before the treatment （t = 2.30, P〈0.05）. There were no obvious shrinks in the control group （P〉0.05）, and there were no obvious enlargement comparing to that before the treatment. There were no obvious changes in the volumes of the uterus in two groups （ t treatment group = 0. 79, tcontrol group = 0. 61, P〉0.05 ）, showing that both groups could restrain the rapid enlargement of the uterus and the ovary. The levels of FSH, LH, E2 deceased to different extents （ tFSH = 4.02, tLH=4.76,tE2 = 15. 10, P〈0.05）. After a comparison, the treatment group had more obvious shrinks in E2 level （t = 10.69, P〈0.05 ） ; after follow-up six months, the height growth of the treatment group was better than that of the control group（ t=7.09 ,P〈0.05 ）, and the increase of the bone a

关 键 词：性早熟女童 第二性征 生长发育 中医干预 滋肾疏肝法 疗效观察 

分 类 号：R586.23[医药卫生—内分泌]