知柏地黄加减颗粒联合穴位贴敷治疗女童特发性中枢性性早熟阴虚火旺证35例临床观察OA

Objective To observe the clinical efficacy of modified Zhibai Dihuang Granules(知柏地黄加减颗粒)combined with acupoint application in treating girls with idiopathic central precocious puberty(ICPP).Methods A total of 105 girls with ICPP of yin deficiency leading to fire hyperactivity pattern admit-ted to the pediatric growth and development clinics of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine and Ouhai Hospital of Integrated Traditional Chinese and Western Medicine from April 2023 to April 2024 were selected as the study subjects.They were randomly divided into a traditional pill group,a granule group,and a combination therapy group using a random number table method,with 35 cases in each group.The traditional pill group was treated with Zhibai Dihuang Pills(知柏地黄丸),the granule group was treated with modified Zhibai Dihuang Granules(知柏地黄加减颗粒),and the combination therapy group was treated with modified Zhibai Dihuang Granules combined with acupoint application.One month constituted one course of treatment for all three groups,and the efficacy was evaluated after six consecutive courses.Changes in TCM syndrome scores,secondary sexual characteristics(breast size,uterine volume,ovarian volume,fol-licular diameter),bone age(△ BA/△ CA),and the occurrence of adverse reactions were compared after 3 months and 6 months of treatment.Results Before treatment,there were no statistically significant differences in TCM syndrome scores and △BA/△CA among the three groups(P＞0.05),indicating comparability.After 3 and 6 months of treatment,the TCM syndrome scores in all groups decreased compared to those before treatment within the same group,and the differences among the combination therapy group,granule group,and tradi-tional pill group were statistically significant(P＜0.05).After 6 months of treatment,there was no statistically significant difference in △BA/△CA within each group compared to before treatment(P＞0.05).Before treatment,there were no statistically significant differences in breast size,uterine volume,ovarian volume,and follicular diameter among the three groups(P＞0.05),indicating comparability.After 6 months of treatment,all the above indicators were significantly reduced in each group compared to those before treatment within the same group(P＜0.05).Compared with the traditional pill group,the reduction was more significant in the granule group and the combination therapy group(P＜0.05).There were statistically significant differences in uterine volume,ovarian volume,and follicular diameter between the combination therapy group and the granule group(P＜0.05).The total effective rate was 74.29％(26/35)in the traditional pill group,85.71％(30/35)in the granule group,and 94.29％(33/35)in the combination therapy group.The differences between the combina-tion therapy group and both the traditional pill group and the granule group were statistically significant(P＜0.05),while the difference in total effective rate between the traditional pill group and the granule group was not statistically significant(P＞0.05).Routine blood tests,liver and kidney function tests,and electrocardio-gram examinations were normal in all three groups before and after treatment,with no adverse reactions ob-served.Conclusion Modified Zhibai Dihuang Granules combined with acupoint application yields satisfactory efficacy in treating girls with ICPP of yin deficiency leading to fire hyperactivity pattern.It can not only improve the clinical symptoms of the patients but also significantly inhibit the development of secondary sexual charac-teristics and bone age,without adverse reactions.It is worthy of clinical promotion and application.