滋肾疏肝泻火方对特发中枢性性早熟女童第二性征和生长发育的影响

目的 探讨滋肾疏肝泻火方对中医辨证为阴虚火旺证特发中枢性性早熟女童第二性征和生长发育的影响。方法 选取2013年6月-2015年6月我院收治的74例特发中枢性性早熟女童，中医辨证为阴虚火旺证，将其按照随机数字法分为对照组和观察组2组，每组37例，观察组给予自拟滋肾疏肝泻火方进行治疗，对照组给予大补阴丸治疗，2组均治疗6月，观察治疗前后中医证候改善情况，血清LH、FSH、E2水平变化，骨龄变化及卵巢、子宫容积的变化，并评价治疗6月后的临床疗效和治疗期间的不良反应。结果 治疗后观察组总有效率为94.6%，显著高于对照组的73.0%（P<0.05）；治疗期间2组血、尿常规及心、肝、肾功能均在正常范围内，未发现明显的不良反应； 2组治疗后中医证候积分均显著下降（P<0.01），但观察组下降更为明显（P<0.01）；治疗后2组骨龄相对实际年龄的增加值（骨龄提前）均显著改善（P<0.01），但观察组改善情况更为明显（P<0.01）；治疗后2组FSH、LH、E2水平均显著改善（P<0.05~0.01），但观察组改善更为明显（P<0.05）；治疗后2组卵巢及子宫容积均显著缩小（P<0.01），但观察组缩小更为明显（P<0.01）。结论 滋阴疏肝泻火方明显降低中医辨证为阴虚火旺证特发中枢性性早熟女童性激素水平，有效控制并改善女童第二性征的出现，抑制骨龄的快速增长，安全性高。 

Influence of Ziyin Shugan Xiehuo Formula on Secondary Sex Characteristics and Growth of Girls with Idiopathic Central Precocious Puberty

OBJECTIVE To study the influence of Ziyin Shugan Xiehuo Formula on secondary sex characteristics and growth of girls with idiopathic central precocious puberty. METHODS 74 cases of idiopathic central type precocious puberty belonging to fire excess from yin deficiency type were selected from June， 2013 to June， 2015 in our hospital and randomly divided into the control group and the observation group， with 37 cases in each group. Patients in the observation group were given Ziyin Shugan Xiehuo Formula for nourishing kidney， soothing liver and purging fire， while those in the observation group was treated with Da Buyin Pill. After 6 months of treatment， TCM symptom improvements and changes of serum LH， FSH， E2， bone age， ovary and uterus volume before and after treatment were observed and compared. The clinical curative effects and adverse reaction of the two groups were evaluated. RESULTS The total effective rate of the observation group was 94.6%， which was significantly higher than 73.0% of the control group(P<0.05). During the treatment， indexes of the two groups including routine urine test， blood urine test， heart， liver and kidney were all within the normal ranges with no obvious adverse being detected. TCM symptom scores of both groups were significantly decreased after treatment(P<0.01)， but the observation group decreased more obviously(P<0.01). Advanced bone ages were notably improved in both groups after treatment(P<0.05~0.01)， with the observation group being more superior to the control group(P<0.01). FSH， LH and E2 levels of two groups after treatment were significantly improved(P<0.05)， but the observation group improved more significantly(P<0.05). Both ovarian and uterine volume of the two groups were significantly reduced after treatment(P<0.05)， but the observation group reduced more obviously(P<0.05). CONCLUSION Ziyin Shugan Xiehuo Formula can obviously decrease sex hormone levels of girls with idiopathic central precocious puberty due to fire excess from yin deficiency， control and improve the occurrence of secondary sex characteristics of the girls， and inhibit the rapid growth of bone age with high safety.