| 摘要: |
| 目的:探讨知柏地黄方加减颗粒对特发性性早熟女童骨密度、骨代谢指标和性激素、性腺体积的影响。方法:选取我院儿童生长发育门诊收治的150例女性患儿,按就诊顺序随机分为颗粒剂治疗组、传统丸剂治疗组和西药治疗组各50例,并选取同期来我院体检的同龄健康儿童20例为空白对照组。颗粒剂治疗组患儿给予口服知柏地黄方加减颗粒,传统丸剂治疗组给予口服知柏地黄丸,西药治疗组初期3个月每4周注射一次醋酸曲普瑞林(达必佳),第4个月起减量至60-80 µg/kg,剂量按生长速率及性征发育情况调整,观察治疗12个月。比较治疗前、治疗6个月后患儿骨密度、骨碱性磷酸酶及血清骨钙素、血清性
激素和性腺体积的变化情况。结果:治疗后,颗粒剂治疗组、传统丸剂治疗组、西药治疗组患儿血清性激素促卵泡生成素(FSH)、黄体生成素(LH)及雌二醇(E2)水平均降低(P均<0.05);颗粒剂治疗组、传统丸剂治疗组、西药治疗组患儿治疗后子宫容积、卵泡直径均降低,卵巢容积均增大(P均<0.05);颗粒剂治疗组治疗后骨密度均升高,骨碱性磷酸酶和骨钙素指标水平均下降,颗粒剂治疗组血清骨代谢指标治疗后均改善,与空白对照组的水平接近,且颗粒剂治疗组均优于传统丸剂治疗组和西药治疗组(P均<0.05)。结论:知柏地黄方加减颗粒可有效改善性早熟女童骨密度及骨代谢指标的异常,抑制第二性征提前发
育,降低过高的性激素水平。 |
| 关键词: 知柏地黄方 特发性性早熟 骨密度 骨代谢 性激素 性腺体积 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2019.06.004 |
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| 基金项目:温州市科技计划项目,编号Y20150121 |
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| Effects of Zhibai Dihuang Jiajian Granules on Bone Mineral Density, Bone Metabolism Index, Sex Hormone and Gonad Volume in Female Children with Idiopathic Precocious Puberty |
| Cai Chengsi |
| (Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang Wenzhou 325000, China) |
| Abstract: |
| Objective: To probe into the effects of Zhibai Dihuang Jiajian granules on bone mineral density, bone metabolism index,sex hormone and gonad volume in female children with idiopathic precocious puberty. Methods: Totally 150 female children admitted into
children's growth and development clinic were extracted to be divided into the granule treatment group, the traditional pill treatment group and the western medicine treatment group according to the admission sequence, with 50 cases in each group, and 20 healthy children of the same age who were admitted to our hospital for physical examination during the same period were selected as the blank control group. Children in granule treatment group were given oral Zhibai Dihuang Jiajian granules, while the traditional pill treatment group received oral Zhibai Dihuang pills. In the western medicine treatment group, tripryline acetate (triptorelin) was injected once every 4 weeks for the first 3 months, and the dose was reduced to 60-80 µg/kg from the fourth month, the dose was adjusted according to the growth rate and sexual development, and the treatment was observed for 12 months. Changes of bone mineral density, bone alkaline phosphatase, serum osteocalcin, serum sex hormone and gonadal volume in children were compared before and 6 months after treatment. Results: After treatment, the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) decreased significantly in the granule treatment group, the traditional pill treatment group and the western medicine treatment group (P<0.05). After treatment, the uterine volume and follicular diameter of the children in the granule treatment group, the traditional pill treatment group and the western medicine treatment group decreased significantly, while the ovarian volume increased (P<0.05). After treatment, the bone mineral density of bone metabolism in the granule treatment group increased significantly, and the levels of bone alkaline phosphatase and osteocalcin decreased significantly, the serum bone metabolism index of the granule treatment group was significantly improved after treatment, which was close to the level of the blank control group, the granule treatment group was significantly better than the traditional pill treatment group and the western medicine treatment group (P<0.05). Conclusion: Zhibai Dihuang Jiajian granules can effectively improve the abnormal bone mineral density, bone metabolism index in female children with idiopathic precocious puberty, inhibit the development of secondary sexual characteristics in advance, and reduce the high level of sex hormones. |
| Key words: Zhibai Dihuang precocious puberty bone mineral density bone metabolism sex hormone gonadal volume |
