柔肝健脾法治疗脾虚肝旺型性早熟患儿的回顾性分析

doi:10.20274/j.cnki.issn.1674-3865.2025.03.004

Abstract

Abstract:

Objective To explore the clinical efficacy and the treatment mechanism of liver?softening and spleen?strengthening therapy for children with precocious puberty of spleen?deficiency and liver?hyperactivity type. Method A total of 62 children with central precocious puberty of spleen?deficiency and liver?hyperactivity type were selected as research subjects, who visited Children’s Hospital of Fudan University from October 2023 to May 2024, including 38 girls and 24 boys. The 62 pediatric patients were treated with liver?softening and spleen?strengthening therapy, orally taking Siwu decoction combined with Baizhu Ointment with modification for 6 months. The efficacy of liver?softening and spleen?strengthening therapy was evaluated by analyzing growth rate of body height, changes in bone age?chronological age(BA-CA) ratio, level of sex hormone and changes in growth factor level before and after treatment. Result (1) After treatment with liver?softening and spleen?strengthening therapy, the BA-CA ratio significantly reduced compared with before treatment（reducing by 6%–9%), and the growth rate increased significantly compared with before treatment (P<0.05). (2) There was no significant enlargement in uterine, ovary, follicle or testicle after treatment (P>0.05). (3) After treatment estradiol level in girls and testosterone level in boys were lower than before treatment, while FSH in girls was higher than before treatment (all P<0.05); LH and PRL levels in boys and girls and FSH level in boys had no obvious changes before and after treatment (P>0.05). (4) After treatment, serum IGF-1 and IGFBP-3 levels increased significantly compared with before treatment (P<0.05). Conclusion The liver?softening and spleen?strengthening therapy can not only reduce the level of sex hormones effectively and inhibit the rapid progress of bone age, but also increase the levels of growth factors and the growth rate of the child patients.

Key words: Central precocious puberty, Softening the liver and strengthening the spleen, Bone age, Body height, Child

CLC Number:

R585

Junchao LIU, Jiaojiao LIU, Hong XU. Retrospective analysis of liver⁃softening and spleen⁃strengthening therapy for children with precocious puberty of spleen⁃deficiency and liver⁃hyperactivity type[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(3): 208-212.

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References 36

[1]	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专家共识(2022)[J]. 中华儿科杂志, 2023,61(1)：16-22.
[2]	Carel JC, Eugster EA, Rogol A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children[J]. Pediatrics, 2009, 123(4): e752-762.
[3]	De Sanctis V, Soliman AT, Di Maio S, et al. Long⁃term effects and significant Adverse Drug Reactions (ADRs) associated with the use of Gonadotropin⁃Releasing Hormone analogs (GnRHa) for central precocious puberty: a brief review of literature[J]. Acta Biomed, 2019, 90(3): 345-359.
[4]	姜美琳, 董文迪, 莫珊. 儿童性早熟的中医证型分布和体质特点分析研究进展[J]. 河北中医, 2023, 45(7): 1195-1198.
[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]	Soriano⁃Guillén L, Tena⁃Sempere M, Seraphim CE, et al. Precocious sexual maturation: unravelling the mechanisms of pubertal onset through clinical observations[J]. J Neuroendocrinol, 2022, 34(2): e12979.
[7]	Mahachoklertwattana P, Kaplan SL, Grumbach MM. The lutei⁃nizing hormone⁃releasing hormone⁃secreting hypothalamic hamar⁃toma is a congenital malformation: natural history[J]. J Clin Endocrinol Metab, 1993, 77(1): 118-124.
[8]	Temelturk RD, Ekici GI, Beberoglu M, et al. Managing preco⁃cious puberty: a necessity for psychiatric evaluation[J]. Asian J Psychiatr, 2021, 58: 102617.
[9]	Moslehi N, Asghari G, Mirmiran P, et al. Longitudinal association of dietary sources of animal and plant protein throughout childhood with menarche[J]. BMC Pediatr, 2021, 21(1): 206.
[10]	Calcaterra V, Verduci E, Magenes VC, et al. The role of pediatric nutrition as a modifiable risk factor for precocious puberty[J]. Life (Basel), 2021, 11(12): 1353.
[11]	Robilliard R, Lee PA, Topor LS. Diagnosis, treatment, and out⁃comes of males with central precocious puberty[J]. Endocrinol Metab Clin North Am, 2024, 53(2): 239-250.
[12]	Krishna KB, Klein KO, Eugster EA. Treatment of central precocious puberty with a focus on girls[J]. Endocrinol Metab Clin North Am, 2024, 53(2): 229-238.
[13]	韩兴绘,孙艳艳,汪永红,等.滋阴泻火方联合甲地孕酮治疗快进展型性早熟女童61例随机对照研究[J].中医杂志,2023,64(13):1336-1342.
[14]	杨春华, 赵天兰, 任盛, 等. 知柏地黄丸对性早熟女童身高、骨龄及下丘脑-垂体-性腺轴的调节效应分析[J]. 中国性科学, 2023, 32(6): 113-116.
[15]	刘栋, 杨玲玲, 马韩铮, 等. 健脾化痰通络方治疗女童单纯性乳房发育50例临床观察[J]. 中国中西医结合儿科学, 2023, 15(1): 52-55.
[16]	张晓莹, 马书鸽, 潘碧琦, 等. 疏肝滋阴降火方治疗女童特发性中枢性性早熟阴虚火旺兼肝郁证的疗效及对中医证候、子宫卵巢容积、性激素的影响[J]. 中医研究, 2022, 35(11): 22-25.
[17]	郑隽姝. 夏枯草消乳方治疗性早熟患儿的效果及对血清性激素水平的影响[J]. 医学理论与实践, 2022, 35(14): 2447-2449.
[18]	郭春彦, 柳静, 张萌, 等. 基于整合药理学探究复幼合剂治疗性早熟的“中药-化学成分-关键靶标-通路”[J]. 中国临床药理学杂志, 2021, 37(5): 572-575.
[19]	Brabant G, von zur Mühlen A, Wüster C, et al. Serum insulin⁃like growth factor I reference values for an automated chemilumine⁃scence immunoassay system: results from a multicenter study[J]. Horm Res, 2003, 60(2): 53-60.
[20]	Elmlinger MW, Kühnel W, Weber MM, et al. Reference ranges for two automated chemiluminescent assays for serum insulin⁃like growth factor I (IGF-I) and IGF⁃binding protein 3 (IGFBP-3)[J]. Clin Chem Lab Med, 2004, 42(6): 654-664.
[21]	Chanson P, Arnoux A, Mavromati M, et al. Reference values for IGF⁃I serum concentrations: comparison of six immunoassays[J]. J Clin Endocrinol Metab, 2016, 101(9): 3450-3458.
[22]	Seppä S, Tenhola S, Voutilainen R. Association of serum total osteocalcin concentrations with endogenous glucocorticoids and insulin sensitivity markers in 12⁃year⁃old children: a cross⁃sectional study[J]. Front Endocrinol (Lausanne), 2019, 10: 798.
[23]	Gao Y, Chen L, Du Z, et al. Glutamate decarboxylase 65 signals through the androgen receptor to promote castration resistance in prostate cancer[J]. Cancer Res, 2019, 79(18): 4638-4649.
[24]	Li M, Tan SY, Wang XF. Paeonol exerts an anticancer effect on human colorectal cancer cells through inhibition of PGE₂ synthesis and COX-2 expression[J]. Oncol Rep, 2014, 32(6): 2845-2853.
[25]	Banskota S, Kang HE, Kim DG, et al. In vitro and in vivo inhibitory activity of 6⁃amino⁃2, 4, 5⁃trimethylpyridin⁃3⁃ols against inflammatory bowel disease[J]. Bioorg Med Chem Lett, 2016, 26(19): 4587-4591.
[26]	Li Y, Orahoske CM, Urmetz SM, et al. Identification of estrogen receptor down⁃regulators for endocrine resistant breast cancer[J]. J Steroid Biochem Mol Biol, 2022, 224: 106162.
[27]	Spade DJ, Hall SJ, Saffarini CM, et al. Differential response to abiraterone acetate and di⁃n⁃butyl phthalate in an androgen⁃sensitive human fetal testis xenograft bioassay[J]. Toxicol Sci, 2014, 138(1): 148-160.
[28]	Wen CJ, Wu LX, Fu LJ, et al. Preferential induction of CYP1A1 over CYP1B1 in human breast cancer MCF-7 cells after exposure to berberine[J]. Asian Pac J Cancer Prev, 2014, 15(1): 495-499.
[29]	Chang TKH, Chen J, Yeung EYH. Effect of Ginkgo biloba extract on procarcinogen⁃bioactivating human CYP1 enzymes: identi⁃fication of isorhamnetin, kaempferol, and quercetin as potent inhibitors of CYP1B1[J]. Toxicol Appl Pharmacol, 2006, 213(1): 18-26.
[30]	Liu Y, Yu C, Ji K, et al. Quercetin reduces TNF-α⁃induced mesan⁃gial cell proliferation and inhibits PTX3 production: involvement of NF-κB signaling pathway[J]. Phytother Res, 2019, 33(9): 2401-2408.
[31]	Upadhayay S, Kumar P. Mitochondrial targeted antioxidants as potential therapy for Huntington’s disease[J]. Pharmacol Rep, 2024, 76(4): 693-713.
[32]	Minamino M, Oka T, Kanouchi H. Growth suppression and cell death by pyridoxal is dependent on p53 in the human breast cancer cell line MCF-7[J]. Biosci Biotechnol Biochem, 2015, 79(1): 124-129.
[33]	Anitha M, Abraham PM, Paulose CS. Striatal dopamine receptors modulate the expression of insulin receptor, IGF-1 and GLUT-3 in diabetic rats: effect of pyridoxine treatment[J]. Eur J Pharmacol, 2012, 696(1-3): 54-61.
[34]	Nakari M, Kanouchi H, Oka T. High dose of pyridoxine induces IGFBP-3 mRNA expression in MCF-7 cells and its induction is inhibited by the p53⁃specific inhibitor pifithrin⁃α[J]. J Nutr Sci Vitaminol (Tokyo), 2011, 57(4): 280-284.
[35]	Senthilkumar K, Elumalai P, Arunkumar R, et al. Quercetin regulates insulin like growth factor signaling and induces intrinsic and extrinsic pathway mediated apoptosis in androgen independent prostate cancer cells (PC-3)[J]. Mol Cell Biochem, 2010, 344(1-2): 173-184.
[36]	Vijayababu MR, Kanagaraj P, Arunkumar A, et al. Quercetin induces p53⁃independent apoptosis in human prostate cancer cells by modulating Bcl-2⁃related proteins: a possible mediation by IGFBP-3[J]. Oncol Res, 2006, 16(2): 67-74.

性别	n	骨龄-年龄比值
性别	n	治疗前	治疗后	t值	P值
女孩	38	1.23±0.02	1.13±0.02	4.03	<0.05
男孩	24	1.17±0.02	1.10±0.02	2.60	<0.05
性别	n	生长速度（cm/年）
性别	n	治疗前	治疗后	t值	P值
女孩	38	6.95±0.32	8.81±0.44	3.34	<0.05
男孩	24	6.86±0.67	12.65±1.05	3.96	<0.05

项目	女孩（n=38）			男孩（n=24）
项目	子宫体积（mL）	卵巢体积（mL）	卵泡大小（mm）	睾丸体积（mL）
治疗前	3.05±0.26	2.48±0.99	4.29±0.13	4.23±0.41
治疗后	2.84±0.17	2.71±0.15	4.28±0.16	4.24±0.44
t值	0.62	1.30	0.07	0.02
P值	>0.05	>0.05	>0.05	>0.05

性别	n	LH（IU/L）				PRL（IU/L）
性别	n	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
女孩	38	1.78±0.25	2.15±0.41	0.81	>0.05	220.40±16.53	194.60±20.58	0.84	>0.05
男孩	24	2.10±0.21	2.02±0.11	0.38	>0.05	172.20±18.53	161.30±12.44	0.46	>0.05
性别	n	FSH（IU/L）				雌二醇/睾酮（pmol/L）
性别	n	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
女孩	38	4.06±0.25	5.35±0.49	2.45	<0.05	121.50±9.87	89.74±10.01	2.14	<0.05
男孩	24	3.67±0.32	3.94±0.29	0.63	>0.05	5.33±0.57	3.31±0.59	2.34	<0.05

性别	n	IGF-1				IGFBP-3
性别	n	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
女孩	38	189.70±7.88	273.60±23.58	4.19	<0.05	5.03±0.09	6.50±0.26	6.27	<0.05
男孩	24	265.80±18.09	329.80±19.48	2.35	<0.05	5.56±0.19	6.43±0.26	2.68	<0.05

Retrospective analysis of liver⁃softening and spleen⁃strengthening therapy for children with precocious puberty of spleen⁃deficiency and liver⁃hyperactivity type

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