疏肝滋阴方配合耳穴贴压治疗肝郁阴虚型女童单纯性乳房早发育临床疗效观察
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摘要
背景目前西医对女童单纯性乳房早发育没有针对性药物,国内外均是以定期检查随访以及饮食生活指导作为干预手段,缺乏针对性治疗措施。而中医辨证论治,重视个体化治疗。目的观察疏肝滋阴方配合耳穴贴压治疗肝郁阴虚型女童单纯性乳房早发育的临床疗效。方法选取上海市嘉定区中医医院儿科2016年5月—2017年11月门诊符合研究标准的38例单纯性乳房早发育患儿,将患儿随机分为治疗组21例和对照组17例。治疗组采用疏肝滋阴方配合耳穴贴压治疗,对照组采用知柏地黄丸联合逍遥丸口服。观察并比较两组治疗前后乳房发育分期、中医证候量化评分及临床疗效。结果治疗前两组乳房发育分期、中医证候量化评分比较,差异无统计学意义(P>0.05)。治疗后两组乳房发育分期评分比较,差异无统计学意义(P>0.05);治疗后治疗组中医证候量化评分低于对照组(P<0.05)。治疗组临床疗效优于对照组(P<0.05)。结论疏肝滋阴方配合耳穴贴压是治疗肝郁阴虚型女童单纯性乳房早发育的有效方法,可减轻伴随症状,且耳穴贴压具有无创伤、简便易行、患儿依从性强等优势。
Background At present,there are no targeted drugs for simple premature thelarche(SPT) in girls in Western medicine.Both at home and abroad,regular follow-up and dietary guidance are used as intervention means,lacking of targeted treatment measures.In traditional Chinese medicine,individualized treatment should be emphasized.ObjectiveTo explore the effectiveness of Shuganziyin granules combined with auricular-plaster therapy for SPT in girls with Ganyuyinxu syndrome.Methods Thirty-eight participants with SPT were recruited from Department of Pediatrics,Shanghai Jiading Hospital of Traditional Chinese Medicine from May 2016 to November 2017.They were randomized into the treatment group(21 cases)and control group(17 cases),receiving Shuganziyin granules combined with auricular-plaster therapy,Zhibaidihuang pills combined with Xiaoyao pills via the oral route,respectively.The scores of Tanner stage of breast development in girls and TCMbased Ganyuyinxu syndrome pattern differentiation scale scores before and after treatment,and clinical response were compared between the two groups.Results Two groups showed similar scores of Tanner stage of breast development in girls and TCMbased Ganyuyinxu syndrome pattern differentiation scale before treatment(P>0.05).After treatment,although the scores of Tanner stage of breast development in girls were still similar in both groups(P>0.05),TCM-based Ganyuyinxu syndrome pattern differentiation scale scores decreased significantly in the treatment group(P<0.05).The treatment group demonstrated much better clinical response compared with the control group(P<0.05).Conclusion Auricular-plaster therapy is simple and convenient to use.Moreover,it has no side effects and the adherence to it is high in girls.Shuganziyin granules combined with auricularplaster therapy is effective for SPT in girls with Ganyuyinxu syndrome by reducing the concomitant symptoms.
Background At present,there are no targeted drugs for simple premature thelarche(SPT) in girls in Western medicine.Both at home and abroad,regular follow-up and dietary guidance are used as intervention means,lacking of targeted treatment measures.In traditional Chinese medicine,individualized treatment should be emphasized.ObjectiveTo explore the effectiveness of Shuganziyin granules combined with auricular-plaster therapy for SPT in girls with Ganyuyinxu syndrome.Methods Thirty-eight participants with SPT were recruited from Department of Pediatrics,Shanghai Jiading Hospital of Traditional Chinese Medicine from May 2016 to November 2017.They were randomized into the treatment group(21 cases)and control group(17 cases),receiving Shuganziyin granules combined with auricular-plaster therapy,Zhibaidihuang pills combined with Xiaoyao pills via the oral route,respectively.The scores of Tanner stage of breast development in girls and TCMbased Ganyuyinxu syndrome pattern differentiation scale scores before and after treatment,and clinical response were compared between the two groups.Results Two groups showed similar scores of Tanner stage of breast development in girls and TCMbased Ganyuyinxu syndrome pattern differentiation scale before treatment(P>0.05).After treatment,although the scores of Tanner stage of breast development in girls were still similar in both groups(P>0.05),TCM-based Ganyuyinxu syndrome pattern differentiation scale scores decreased significantly in the treatment group(P<0.05).The treatment group demonstrated much better clinical response compared with the control group(P<0.05).Conclusion Auricular-plaster therapy is simple and convenient to use.Moreover,it has no side effects and the adherence to it is high in girls.Shuganziyin granules combined with auricularplaster therapy is effective for SPT in girls with Ganyuyinxu syndrome by reducing the concomitant symptoms.
引文
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[8]李晓薇,孙婷婷,白晓红.耳穴贴压治疗小儿过敏性紫癜作用机制探析[J].中医临床研究,2014,6(4):75-76.DOI:10.3969/j.issn.1674-7860.2014.04.039.LI X W,SUN T T,BAI X H.Efficacy mechanism analysis of auricular acupuncture on treating pediatric allergic purpura[J].Clinical Journal of Chinese Medicine,2014,6(4):75-76.DOI:10.3969/j.issn.1674-7860.2014.04.039.
[9]朱国香,吴晓萍,高雅文,等.耳穴贴压时长对乳腺增生症患者治疗效果的影响研究[J].中国全科医学,2015,17(19):2357-2360.DOI:10.3969/j.issn.1007-9572.2015.19.027.ZHU G X,WU X P,GAO Y W,et al.Influence of the duration of auricular point plaster therapy on the treatment of cyclomastopathy[J].Chinese General Practice,2015,17(19):2357-2360.DOI:10.3969/j.issn.1007-9572.2015.19.027.
[10]王志敬,琚伟.关于女童特发性性早熟的各种不同治疗方法的现状及进展[J].中医研究,2016,29(8):78-80.DOI:10.3969/j.issn.1001-6910.2016.08.37.WANG Z J,JU W.Current status and progress of various treatments for idiopathic precocious puberty in girls[J].Traditional Chinese Medicinal Research,2016,29(8):78-80.DOI:10.3969/j.issn.1001-6910.2016.08.37.
[11]康明秀,梅妍.针灸治疗精神分裂症的临床研究现状[J].疑难病杂志,2015,14(7):763-766.DOI:10.3969/j.issn.1671-6450.2015.07.035.KANGMX,MEIY.Currentstatusofclinicalresearchon acupuncture and moxibustion in the treatment of schizophrenia[J].Chinese Journal of Difficult and Complicated Cases,2015,14(7):763-766.DOI:10.3969/j.issn.1671-6450.2015.07.035.
[2]中华医学会儿科学分会内分泌遗传代谢学组.中枢性(真性)性早熟诊治指南[J].中华儿科杂志,2007,45(6):426-427.DOI:10.3760/j.issn:0578-1310.2007.06.007.Department of Endocrinology,Metabolism and Metabolism,Chinese Medical Association.Guidelines for diagnosis and treatment of central(true)precocious puberty[J].Chinese Journal of Pediatrics,2007,45(6):426-427.DOI:10.3760/j.issn:0578-1310.2007.06.007.
[3]代薇.中医辨证治疗女童乳房早发育临床研究[D].大连:大连医科大学,2016.DAI W.The clinical research on the traditional Chinese medical treatment of premature thelarche girls[D].Dalian:Dalian Medical University,2016.
[4]张敏青.滋阴疏肝法对单纯性乳房发育相关激素和调节因子的影响[D].广州:广州中医药大学,2010.ZHANG M Q.Influence of nourishing Yin and soothing liver method on hormone insulin-like growth factor and leptin in simple premature thelarche[D].Guangzhou:Guangzhou University of Chinese Medicine,2010.
[5]邹典定.现代儿科诊疗学[M].北京:人民卫生出版社,2002:1045.ZOU D D.Modern pediatrics[M].Beijing:People's Medical Publishing House,2002:1045.
[6]上海市卫生局.上海市中医病证诊疗常规[M].2版.上海:上海中医药大学出版社,2003:160.Shanghai Municipal Health Bureau.Routine diagnosis and treatment of TCM syndrome in Shanghai[M].2nd ed.Shanghai:Shanghai University of Traditional Chinese Medicine Press,2003:160.
[7]林甦,杨文庆,俞建.中医儿科临床诊疗指南·性早熟(修订)[J].中医儿科杂志,2016,12(3):1-5.DOI:10.16840/j.issn1673-4297.2016.03.01.LIN S,YANG W Q,YU J.Guideline for clinical diagnosis and treatment of pediatrics of traditional Chinese medicine·sexual precocity(amendment)[J].Journal of Pediatrics of Traditional Chinese Medicine,2016,12(3):1-5.DOI:10.16840/j.issn1673-4297.2016.03.01.
[8]李晓薇,孙婷婷,白晓红.耳穴贴压治疗小儿过敏性紫癜作用机制探析[J].中医临床研究,2014,6(4):75-76.DOI:10.3969/j.issn.1674-7860.2014.04.039.LI X W,SUN T T,BAI X H.Efficacy mechanism analysis of auricular acupuncture on treating pediatric allergic purpura[J].Clinical Journal of Chinese Medicine,2014,6(4):75-76.DOI:10.3969/j.issn.1674-7860.2014.04.039.
[9]朱国香,吴晓萍,高雅文,等.耳穴贴压时长对乳腺增生症患者治疗效果的影响研究[J].中国全科医学,2015,17(19):2357-2360.DOI:10.3969/j.issn.1007-9572.2015.19.027.ZHU G X,WU X P,GAO Y W,et al.Influence of the duration of auricular point plaster therapy on the treatment of cyclomastopathy[J].Chinese General Practice,2015,17(19):2357-2360.DOI:10.3969/j.issn.1007-9572.2015.19.027.
[10]王志敬,琚伟.关于女童特发性性早熟的各种不同治疗方法的现状及进展[J].中医研究,2016,29(8):78-80.DOI:10.3969/j.issn.1001-6910.2016.08.37.WANG Z J,JU W.Current status and progress of various treatments for idiopathic precocious puberty in girls[J].Traditional Chinese Medicinal Research,2016,29(8):78-80.DOI:10.3969/j.issn.1001-6910.2016.08.37.
[11]康明秀,梅妍.针灸治疗精神分裂症的临床研究现状[J].疑难病杂志,2015,14(7):763-766.DOI:10.3969/j.issn.1671-6450.2015.07.035.KANGMX,MEIY.Currentstatusofclinicalresearchon acupuncture and moxibustion in the treatment of schizophrenia[J].Chinese Journal of Difficult and Complicated Cases,2015,14(7):763-766.DOI:10.3969/j.issn.1671-6450.2015.07.035.
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