特发性性早熟患儿肝郁与性发育的相关性
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摘要
目的探讨特发性性早熟患儿肝郁与性发育的相关性。方法选择2018年8月至12月福建中医药大学附属人民医院收治的特发性性早熟女童35例为研究对象,为观察组;选择同龄的健康女童31例作为对照组。参照《证素辨证学》对其进行四诊信息采集,得到肝郁证素积分和肝郁分级,测定两组女童性激素水平,分析肝郁证素积分与性激素水平的相关性;测定特发性性早熟患儿乳核直径、卵巢容积、子宫容积,分析特发性性早熟组女童肝郁证素积分、肝郁分级与乳核直径、卵巢容积、子宫容积的相关性。结果观察组女童的FSH、LH、雌二醇均高于对照组,睾酮低于对照组,差异均有统计学意义(P<0.05);观察组的肝郁证素积分高于对照组,差异有统计学意义(P<0.05)。两组中肝郁证素积分与性激素水平(FSH、LH、雌二醇、睾酮)均无相关性,差异无统计学意义(P>0.05)。观察组女童肝郁证素积分与乳核直径、卵巢容积、子宫容积均呈正相关,差异有统计学意义(P<0.01);肝郁分级越高,乳核直径、卵巢容积、子宫容积值越高,且三者在不同肝郁分级间的差异有统计学意义(P<0.01)。结论肝郁可能参与了特发性性早熟患儿性发育的提早发生。
Objective To study the relationship between liver depression and sexual development in children with idiopathic precocious puberty.Methods Totally 35 girls with idiopathic precocious puberty, who were admitted to People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from August to December, 2018,were selected as the research subjects(observation group). Thirty-one healthy girls of the same age were selected as the control group. According to the "Syndrome Differentiation School", we collect the four diagnosis information to get the integral and grade of liver depression, and the sex hormone levels of the two groups were measured to analyze the correlation between the integral of liver depression and sex hormone levels. The breast diameter, ovarian volume and uterine volume were measured in children with idiopathic precocious puberty, so as to explore their correlation with the integral and grade of liver depression.Results The FSH, LH and estradiol of the girls in the observation group and higher than those in the control group, while testosterone was lower. The difference was statistically significant(P<0.05). The integral of liver depression in the observation group was higher than that in the control group(P<0.05). There was no correlation between the integral of liver depression and the levels of sex hormones(FSH,LH,estradiol,testosterone), and there was no significant difference between the two groups(P>0.05). In the observation group, the integral of liver depression was positively correlated with breast diameter, ovarian volume and uterine volume, and the difference was statistically significant(P<0.01). The higher grade the liver depression, the higher the breast diameter, ovary volume and uterine volume, there were statistical differences among different liver depression grades(P<0.01).Conclusion Liver depression may be involved in the early occurrence of sexual development in children with idiopathic precocious puberty.
Objective To study the relationship between liver depression and sexual development in children with idiopathic precocious puberty.Methods Totally 35 girls with idiopathic precocious puberty, who were admitted to People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from August to December, 2018,were selected as the research subjects(observation group). Thirty-one healthy girls of the same age were selected as the control group. According to the "Syndrome Differentiation School", we collect the four diagnosis information to get the integral and grade of liver depression, and the sex hormone levels of the two groups were measured to analyze the correlation between the integral of liver depression and sex hormone levels. The breast diameter, ovarian volume and uterine volume were measured in children with idiopathic precocious puberty, so as to explore their correlation with the integral and grade of liver depression.Results The FSH, LH and estradiol of the girls in the observation group and higher than those in the control group, while testosterone was lower. The difference was statistically significant(P<0.05). The integral of liver depression in the observation group was higher than that in the control group(P<0.05). There was no correlation between the integral of liver depression and the levels of sex hormones(FSH,LH,estradiol,testosterone), and there was no significant difference between the two groups(P>0.05). In the observation group, the integral of liver depression was positively correlated with breast diameter, ovarian volume and uterine volume, and the difference was statistically significant(P<0.01). The higher grade the liver depression, the higher the breast diameter, ovary volume and uterine volume, there were statistical differences among different liver depression grades(P<0.01).Conclusion Liver depression may be involved in the early occurrence of sexual development in children with idiopathic precocious puberty.
引文
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[13] 张晓洁,杨培蓉,黄晓东.特发性中枢性性早熟病因的研究进展[J].国际内分泌代谢杂志,2010,30(6):418-420.
[14] 柯江维,段荣.性早熟和性早熟危险因素研究进展[J].实验与检验医学,2012,30(3):243-247.
[15] Kim EY,Lee MI.Psychosocial aspects in girls with idiopathic precocious puberty[J].Psychiatry Investig,2012,9(1):25-28.
[16] 张星星,易著文,张建江,等.性早熟儿童及其父母心理卫生状况初步研究[J].中国临床心理学杂志,2005,13(3):348-349.
[17] Joinson C,Heron J,Araya R,et al.Association between pubertal development and depressive symptoms in girls from a UK cohort[J].Psychol Med,2012,42(12):2579-2589.
[18] 张薇,杨琍琦.性早熟女童抑郁情绪与E2、FSH、LH水平的关系[J].安徽医科大学学报,2014,49(5):687-688.
[19] 金卫东.肝郁与抑郁症关系探讨[J].中医研究,2009,22(11):1-3.
[20] 莫珊,邓丽莎,李伟元,等.疏肝养阴法对特发性真性性早熟女孩卵巢容积的影响[J].辽宁中医药大学学报,2007,9(4):4-5.
[2] 朱铭强,傅君芬,梁黎,等.中国儿童青少年性发育现状研究[J].浙江大学学报(医学版),2013,42(4):396-402.
[3] 中华医学会儿科学分会内分泌遗传代谢学组,《中华儿科杂志》编辑委员会.中枢性性早熟诊断与治疗共识(2015)[J].中华儿科杂志,2015,53(6):412-418.
[4] 中华人民共和国卫生部.性早熟诊疗指南(试行)[卫办医政发(195)号][J].中国儿童保健杂志,2011,19(4):390-392.
[5] 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.
[6] 徐正友,华玉双.特发性性早熟的中医研究进展[J].中医儿科杂志,2012,8(5):60-62.
[7] 孙艳艳,黄蓉,俞建,等.200例青春期启动提前女童中医证候的临床调查[J].中国中西医结合杂志,2012,32(6):770-773.
[8] 薛媛媛,林燕燕,俞建,等.性早熟女童中医证候、证型分布规律的研究[J].中国中西医结合儿科学,2013,5(6):481-483.
[9] 朱文锋.证素辨证学[M].北京:人民卫生出版社,2008:11-90.
[10] 戴丽凤,田华,杨群燕,等.儿童性早熟流行病学特征及相关影响因素分析[J].中国公共卫生管理,2017,33(1):136-137.
[11] 周莹,张桂珍.环境内分泌干扰物引致儿童性早熟的临床分析[J].世界最新医学信息文摘,2015,15(75):76,82.
[12] Placzkiewicz D,Puzniak M,Kleinrok A.Prevalence of hypertension and major cardiovascular risk factors in healthy residents of a rural region in south-eastern Poland - 1997-2008/9[J].Ann Agric Environ Med,2016,23(3):476-481.
[13] 张晓洁,杨培蓉,黄晓东.特发性中枢性性早熟病因的研究进展[J].国际内分泌代谢杂志,2010,30(6):418-420.
[14] 柯江维,段荣.性早熟和性早熟危险因素研究进展[J].实验与检验医学,2012,30(3):243-247.
[15] Kim EY,Lee MI.Psychosocial aspects in girls with idiopathic precocious puberty[J].Psychiatry Investig,2012,9(1):25-28.
[16] 张星星,易著文,张建江,等.性早熟儿童及其父母心理卫生状况初步研究[J].中国临床心理学杂志,2005,13(3):348-349.
[17] Joinson C,Heron J,Araya R,et al.Association between pubertal development and depressive symptoms in girls from a UK cohort[J].Psychol Med,2012,42(12):2579-2589.
[18] 张薇,杨琍琦.性早熟女童抑郁情绪与E2、FSH、LH水平的关系[J].安徽医科大学学报,2014,49(5):687-688.
[19] 金卫东.肝郁与抑郁症关系探讨[J].中医研究,2009,22(11):1-3.
[20] 莫珊,邓丽莎,李伟元,等.疏肝养阴法对特发性真性性早熟女孩卵巢容积的影响[J].辽宁中医药大学学报,2007,9(4):4-5.