丹栀逍遥散联合亮丙瑞林对特发中枢性性早熟患儿第二性征骨龄发育及安全性的影响  

Effects of Danzhi Xiaoyao Powder combined with leuprolide acetate on the secondary sexual characteristics,bone age development,and safety in girls with idiopathic central precocious puberty

作　　者：李双 林晓波 干烨 Li Shuang;Lin Xiaobo;Gan Ye(Department of Pediatrics,Ninghai County Maternal and Child Health Hospital,Ningbo,Zhejiang 315600,China)

机构地区：[1]宁海县妇幼保健院儿科,浙江宁波315600

出　　处：《中国药物与临床》2024年第19期1241-1246,共6页Chinese Remedies & Clinics

摘　　要：目的研究丹栀逍遥散联合亮丙瑞林对特发中枢性性早熟(ICPP)患儿第二性征及骨龄发育的影响。方法选取浙江省宁海县妇幼保健院2020年1月至2023年12月门诊诊治的196例ICPP患儿作为回顾性研究对象,接受丹栀逍遥散联合亮丙瑞林治疗的104例患儿为观察组,接受亮丙瑞林治疗的92例患儿为对照组。统计分析2组患儿第二性征指标(乳核面积、子宫容积、卵巢容积)、性激素指标[黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)]、骨龄、预测最终成年身高(FAH)、25-羟基维生素D3(25-OH-D3)及不良反应数据。结果2组治疗6个月、12个月后乳核面积、子宫容积和卵巢容积均变小(P<0.001),但观察组乳核面积、子宫容积和卵巢容积小于对照组,差异有统计学意义(t=7.319、2.951、3.901,P均<0.01);2组治疗6个月、12个月后LH、FSH及E2水平均降低(P<0.001),观察组LH、FSH及E2水平低于对照组,相比差异有统计学意义(t=3.007、4.952、9.911,P<0.01);2组治疗6个月、12个月后骨龄增长均得到明显遏制(P<0.05),预测FAH明显提高(P<0.001),观察组骨龄及预测FAH与对照组相比差异有统计意义(t=2.36、3.209,P=0.017、0.001);2组治疗后25-OH-D3水平均升高(P<0.001),2组治疗后25-OH-D3水平相比差异有统计学意义(t=8.316,P<0.001);观察组不良反应总发生率为14.4%,对照组不良反应总发生率为51.1%,相比差异有统计学意义(χ2=7.931,P=0.009)。结论丹栀逍遥散联合亮丙瑞林利于改善ICPP女童的第二性征,优化骨龄发育,值得临床予以推广应用。Objective To explore the effects of Danzhi Xiaoyao Powder combined with leuprorelin on the development of secondary sexual characteristics and bone age in girls with idiopathic central precocious puberty(ICPP).Methods A total of 196 female children with ICPP who received outpatient treatment in Ninghai County Maternal and Child Health Hospital from January 2020 to December 2023 were selected as a retrospective study cohort and divided into an observation group(104 cases)and a control group(92 cases).The observation group received Danzhi Xiaoyao Powder combined with leuprolide acetate treatment,while the control group received leuprolide acetate treatment alone.The secondary sexual characteristics indicators(breast development score,ovarian volume),sex hormone indicators[luteinizing hormone(LH),follicle-stimulating hormone(FSH),and estradiol(E2)],bone age,predicted final adult height(FAH),25-hydroxyvitamin D3(25-OH-D3),and adverse reaction data of the two groups were statistically analyzed.Results After 6 and 12 months of treatment,the breast nucleus area,uterine volume,and ovarian volume of both groups significantly decreased(P<0.001).However,the breast nucleus area,uterine volume,and ovarian volume of the observation group were significantly smaller than those of the control group,and the differences were statistically significant(t=7.319,2.951,3.901,all P<0.01).After 6 and 12 months of treatment,the levels of LH,FSH,and E2 in both groups were significantly reduced(P<0.01),but the levels of LH,FSH,and E2 in the observation group were significantly lower than those in the control group,and the difference was statistically significant(t=3.007,4.952,9.911,all P<0.01).After 6 and 12 months of treatment,bone age growth was significantly suppressed in both groups(P<0.05),and the predicted FAH was sig-nificantly improved(P<0.001).However,the observation group had significantly better bone age and predicted FAH than the control group,and the difference was statistically significant(t=2.361,3.209,P=0.017,0.001).The level

关 键 词：青春期 早熟 加味逍遥散 亮丙瑞林 性征 骨骼年龄测定 

分 类 号：R725.8[医药卫生—儿科]