Abstract:

The arrival of Tiangui marks and triggers sexual maturation in children, and its premature arrival inevitably leads to precocious puberty. In modern pediatric traditional Chinese medicine (TCM) it is believed that "kidney?yin deficiency with hyperactivity of Xianghuo" is the primary pathogenesis of precocious puberty. Professor Wang Shouchuan believes that there exists an intrinsic connection between "premature arrival of Tiangui" and "hyperactivity of Xianghuo", which belong to different stages of precocious puberty. He innovatively proposes a stage?differentiated pathological mechanism theory: the early stage can be referred to as incomplete central precocious puberty, which is caused by factors such as dietary imbalance and emotional stress, leading to liver?kidney?yin deficiency and hyperactivity of Xianghuo; the manifestations include initial signs of secondary sexual characteristics accompanied by irritability, night sweats, etc. the treatment focuses on "nourishing kidney yin and purging Xianghuo". Late stage can be referred to as complete central precocious puberty, in which hyperactivity of Xianghuo triggers the "Junhuo descending to mingle with kidney water", thereby activating the "arrival of Tiangui"; this accelerates sexual maturation, and the treatment must shift to "purging Junhuo and nourishing kidney yin", aiming to block the convergence of the Junhuo and Xianghuo so as to delay the arrival of Tiangui. Exploring the TCM pathogenesis of precocious puberty based on the theories of "Tiangui" and "Xianghuo", and integrating classical theories, renowned physicians' clinical experience and modern medical achievements, helps to optimize TCM diagnosis and treatment strategies for precocious puberty.

Key words: Precocious puberty, Tiangui, Xianghuo, Pathogenesis, Veteran TCM physicians' clinical experience