针刺联合耳穴贴压治疗3~8岁不完全性性早熟女童:随机对照试验  

Acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty:a randomized controlled trial

作　　者：刘莉莉[1] 万乃君[2] 孙慧慧[2] 张亚妹[2] LIU Li-li;WAN Nai-jun;SUN Hui-hui;ZHANG Ya-mei(Department of Acupuncture and Moxibustion,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Pediatrics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院针灸科,北京100035 [2]北京积水潭医院儿科,北京100035

出　　处：《中国针灸》2023年第7期776-780,共5页Chinese Acupuncture & Moxibustion

基　　金：北京市属医院科研培育计划项目:PZ2018002、PZ2019004。

摘　　要：目的:观察针刺联合耳穴贴压治疗3~8岁不完全性性早熟女童的疗效及安全性。方法:将60例不完全性性早熟女童随机分为观察组(30例,脱落2例)和对照组(30例,剔除2例)。对照组采取健康饮食结合适当运动的生活方式干预12周。在对照组健康生活方式宣教基础上,观察组采用针刺联合耳穴贴压治疗,针刺穴取三阴交(双侧)、关元、归来(双侧)等,留针20 min,每周治疗2次(间隔3 d治疗1次);耳穴贴压穴取双侧卵巢、内生殖器、内分泌、缘中等,每周换贴2次,均治疗12周。于治疗前后及治疗结束后12周随访时,观察两组患儿乳房Tanner分期、血清性激素[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))]含量,采用腹部彩色多普勒超声检测两组患儿卵巢容积、直径>4 mm的卵泡数量、子宫容积,并评价观察组安全性。结果:治疗后及随访时,观察组患儿乳房Tanner分期较治疗前改善(P<0.05),观察组患儿乳房Tanner分期优于对照组(P<0.05)。随访时,观察组患儿血清LH、E_(2)含量较治疗前升高(P<0.05),两侧卵巢容积较治疗前增大(P<0.05)。治疗后及随访时,对照组患儿血清LH、FSH、E_(2)含量较治疗前升高(P<0.05),两侧卵巢容积较治疗前增大(P<0.05),卵泡数量较治疗前增多(P<0.05);观察组患儿血清LH、FSH、E_(2)含量均低于对照组(P<0.05),两侧卵巢容积小于同侧对照组(P<0.05),卵泡数量少于对照组(P<0.05)。随访时,两组患儿子宫容积较治疗前增大(P<0.05);两组治疗后及随访时子宫容积比较差异无统计学意义(P>0.05)。在治疗期间,观察组3例患儿出现腹部轻微疼痛和皮下淤血,未发生严重不良反应。结论:针刺联合耳穴贴压治疗能够改善不完全性性早熟女童的乳房Tanner分期,降低性激素水平,减缓卵巢及卵泡的发育和成熟,控制其性发育程度和速度。Objective To observe the efficacy and safety of acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty(IPP).Methods Sixty girls with IPP were randomly divided into an observation group(30 cases,2 cases dropped off)and a control group(30 cases,2 cases were eliminated).The girls in the control group were treated with healthy diet and proper exercise for 12 weeks.On the basis of the treatment in the control group,the girls in the observation group were treated with acupuncture combined with auricular point sticking.The acupuncture was applied at Sanyinjiao(SP 6),Guanyuan(CV 4),Guilai(ST 29),etc.,the needles were retained for 20 min,acupuncture was given twice a week(once every 3 days).The auricular point sticking was applied at Luanchao(TF_(2)),Neishengzhiqi(TF_(2)),Neifenmi(CO_(18)),Yuanzhong(AT_(234)),etc.,twice a week.The treatment was given for 12 weeks.Before treatment,after treatment and in follow-up after 12 weeks of treatment completion,the Tanner stage of breast,serum contents of sex hormone(luteinizing hormone[LH],follicle-stimulating hormone[FSH],estradiol[E_(2)]) were observed.The ovarian volume,the number of follicles with diameter>4 mm,and the uterine volume were measured by abdominal color Doppler ultrasound.In addition,the safety of the observation group was evaluated.Results Compared with before treatment,the Tanner stage of breast in the observation group was improved after treatment and in follow-up(P<0.05);after treatment and in follow-up,the Tanner stage of breast in the observation group was better than that in the control group(P<0.05).Compared with before treatment,the serum levels of LH and E_(2) in the observation group were increased(P<0.05),and the volume of bilateral ovaries was larger(P<0.05)in follow-up.Compared with before treatment,the serum contents of LH,FSH and E,in the control group were increased(P<0.05),the volume of bilateral ovaries was larger(P<0.05),and the number of follicles was increased(P<0.05)after treatment and i

关 键 词：不完全性性早熟 女童 针刺 耳穴贴压 随机对照试验 

分 类 号：R246.4[医药卫生—针灸推拿学]