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Article(id=1322926652015124990, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.09.038, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339892629, onlineDateStr=2026-10-30, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339892629, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339892629, creator=13701087609, updateTime=1793339892629, updator=13701087609, issue=Issue{id=1322926492627378659, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='9', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1757433600000', pubDateStr='2025-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339854628, creator='13701087609', updateTime=1793340762858, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930302095590169, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930302095590170, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=206, endPage=209, ext={EN=ArticleExt(id=1322926653239861759, articleId=1322926652015124990, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Effect of Ziyin Xiehuo Prescription（滋阴泻火方）on Central Precocious Puberty with Simple Obesity in Girls, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the clinical effectof Ziyin Xiehuo Prescription（滋阴泻火方）on girlswith precocious puberty and simple obesity.

Methods

A total of230 girlswith central precocious puberty accompanied by simple obesity admitted from June 2020 to June2023 were included in the study. The patients were divided into control group and observation group by random number table method，with 115 cases in each group. The girls in the control group were treated with leuprorelin acetate microspheres，while those in the observation group were treated with leuprorelin acetate microspheres combined with Ziyin Xiehuo Prescription. The treatment lasted for 6months. During the treatment，5 cases fell off in the observation group and 4 cases fell off in the controlgroup. The data of allgroupswas compared，including the efficacy，traditional Chinese medicine syndrome score before treatment and 6 months after treatment，the levels of serum estradiol（E2），luteinizing hormone（LH）and follicle-stimulating hormone（FSH），uterine length and ovarian volume，breast stage，bone age，body mass index（BMI）and adverse reactions.

Results

The total effective rate of girls in the observation group was higher than that in the control group. Before treatment，the traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH，uterine length，ovarian volume，breast stage，bone age and BMI of all groupswere not significant（P>0.05）. After treatment，the traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH，uterine length，ovarian volume and breast stage of girls in both groupswere decreased（P<0.05）. After treatment，the levels of traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH in the observation group were lower than those in the control group，the values of uterine length，ovarian volume，breast stage and bone age were lower than those in the control group，and BMI in the observation group was lower than that in the control group. The adverse reaction rate of girls in observation group and controlgroup was low（P>0.05）.

Conclusion

In the treatment of central precocious puberty with simple obesity girls，Ziyin Xihuo Prescription can regulate the levels of sex hormones，delay the development of breast，uterus and ovary，do not aggravate the trend of obesity，and inhibit the growth of bone age to a certain extent.

, authors=Dongguang ZHANG, Wenbing WEN, Qiao SHI, Haiying ZOU, Li YANG, Yu YANG, authorsList=Dongguang ZHANG, Wenbing WEN, Qiao SHI, Haiying ZOU, Li YANG, Yu YANG, authorCompany=null, correspAuthors=Yu YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322926655093744140, articleId=1322926652015124990, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童疗效观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

观察滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童临床效果。

方法

研究纳入中枢性性早熟伴单纯性肥胖女童合计230例（2020年6月—2023年6月收治），以随机数字表法将患者分为对照组与观察组，各组115例，对照组患者采取醋酸亮丙瑞林微球治疗，观察组患者采取醋酸亮丙瑞林微球治疗同时，联合滋阴泻火方治疗，治疗过程中观察组脱落5例，对照组脱落4例。比较各组疗效：治疗前及治疗6个月后中医证候积分、雌二醇（E2）及促黄体生成素（LH）、血清促卵泡生成素（FSH）水平、子宫长度及卵巢体积、乳房发育分期情况、骨龄、体质指数（BMI）及不良反应情况。

结果

观察组女童治疗总有效率高于对照组女童治疗总有效率；治疗前，各组患者中医证候积分、E2及LH、FSH水平、子宫长度以及卵巢体积、乳房发育分期、骨龄、BMI比较，均P>0.05，治疗后各组女童中医证候积分、E2及LH、FSH水平、子宫长度以及卵巢体积、乳房发育分期均下降，P<0.05，观察组女童治疗后中医症候积分、E2及LH、FSH水平低于对照组、子宫长度以及卵巢体积、乳房发育分期、骨龄小于对照组，观察组女童治疗后BMI较对照组更低；观察组与对照组女童不良反应率均较低，P>0.05。

结论

滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童能调节女童性激素水平，延缓乳房、子宫及卵巢发育进程，不加重肥胖趋势，一定程度上抑制骨龄增长。

, authors=张东光, 文文兵, 石乔, 邹海英, 杨利, 杨玉, authorsList=张东光, 文文兵, 石乔, 邹海英, 杨利, 杨玉, authorCompany=null, correspAuthors=杨玉, authorNote=

张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

, correspAuthorsNote=
杨玉（1964-），女，江西南昌人，主任医师，硕士，研究方向：儿童内分泌遗传代谢病。E-mail：。
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张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

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张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

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articleTitle=特发性性早熟女童的中西医治疗研究进展, refAbstract=null), Reference(id=1322926664166023780, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2021, volume=40, issue=12, pageStart=1302, pageEnd=1309, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=耿利娜, 薛征, 俞建, journalName=山东中医杂志, refType=null, unstructuredReference=耿利娜，薛征，俞建，等. 儿童性早熟危险因素调查及中医证型分布特点研究［J］. 山东中医杂志，2021，40（12）：1302-1309., articleTitle=儿童性早熟危险因素调查及中医证型分布特点研究, refAbstract=null), Reference(id=1322926664224744037, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=14, issue=3, pageStart=268, pageEnd=272, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=闫文月, 吴正雪, 刘维, journalName=中国中西医结合儿科学, refType=null, unstructuredReference=闫文月，吴正雪，刘维，等. 从“女子以肝为先天”论治女童性早熟［J］. 中国中西医结合儿科学，2022，14（3）：268-272., articleTitle=从“女子以肝为先天”论治女童性早熟, refAbstract=null), Reference(id=1322926664312824422, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=42, issue=3, pageStart=457, pageEnd=464, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=徐海霞, 张菲菲, 孙海英, journalName=湖南中医药大学学报, refType=null, unstructuredReference=徐海霞，张菲菲，孙海英，等. 滋阴泻火颗粒治疗特发性中枢性性早熟（阴虚火旺证）女童的临床研究［J］. 湖南中医药大学学报，2022，42（3）：457-464., articleTitle=滋阴泻火颗粒治疗特发性中枢性性早熟（阴虚火旺证）女童的临床研究, refAbstract=null), Reference(id=1322926664392516199, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=44, issue=10, pageStart=1133, pageEnd=1137, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=王秀萍, 刘建忠, 黄田田, journalName=国际中医中药杂志, refType=null, unstructuredReference=王秀萍，刘建忠，黄田田，等. 九味楮实方对中枢性性早熟大鼠性激素及Kisspeptin蛋白表达的影响［J］. 国际中医中药杂志，2022，44（10）：1133-1137., articleTitle=九味楮实方对中枢性性早熟大鼠性激素及Kisspeptin蛋白表达的影响, refAbstract=null), Reference(id=1322926664455430760, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=42, issue=11, pageStart=1259, pageEnd=1263, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=段娟, 刘莱莱, journalName=吉林中医药, refType=null, unstructuredReference=段娟，刘莱莱. 从郁、热、虚、损演变规律认识性早熟［J］. 吉林中医药，2022，42（11）：1259-1263., articleTitle=从郁、热、虚、损演变规律认识性早熟, refAbstract=null), Reference(id=1322926664543511145, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=39, issue=1, pageStart=110, pageEnd=115, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=高静, 王彦红, 许邦礼, journalName=天津中医药, refType=null, unstructuredReference=高静，王彦红，许邦礼. 知母总皂苷对雌性性早熟SD大鼠性激素水平的影响及对HPGA轴的作用研究［J］. 天津中医药，2022，39（1）：110-115., articleTitle=知母总皂苷对雌性性早熟SD大鼠性激素水平的影响及对HPGA轴的作用研究, refAbstract=null), Reference(id=1322926664610620010, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2022, volume=44, issue=6, pageStart=892, pageEnd=895, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=陆爱芳, 吴婉琳, 王盼盼, journalName=河北中医, refType=null, unstructuredReference=陆爱芳，吴婉琳，王盼盼，等. 国医大师周仲瑛教授应用相火理论辨治性早熟经验［J］. 河北中医，2022，44（6）：892-895., articleTitle=国医大师周仲瑛教授应用相火理论辨治性早熟经验, refAbstract=null), Reference(id=1322926664677728875, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, doi=null, pmid=null, pmcid=null, year=2011, volume=29, issue=3, pageStart=603, pageEnd=604, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=尹蔚萍, 夏杰, journalName=中华中医药学刊, refType=null, unstructuredReference=尹蔚萍，夏杰. 中医药治疗性早熟配伍用药规律分析［J］. 中华中医药学刊，2011，29（3）：603-604., articleTitle=中医药治疗性早熟配伍用药规律分析, refAbstract=null)], 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AuthorCompanyExt(id=1322926655328625167, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, companyId=1322926655311847949, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=江西省儿童医院，江西 南昌 330038)])], figs=[ArticleFig(id=1322926659409683002, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
例数痊愈显效有效无效总有效率
对照组11161（54.95）29（47.54）12（10.81）9（8.11）（91.89）
观察组11088（80.00）10（9.09）10（9.09）2（1.82）（98.18）
χ2值-----4.621 5
P值-----0.031 6
), ArticleFig(id=1322926659485180475, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表1, caption=

两组中枢性性早熟伴单纯性肥胖女童临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
例数痊愈显效有效无效总有效率
对照组11161（54.95）29（47.54）12（10.81）9（8.11）（91.89）
观察组11088（80.00）10（9.09）10（9.09）2（1.82）（98.18）
χ2值-----4.621 5
P值-----0.031 6
), ArticleFig(id=1322926659543900732, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间主症总积分次症总积分舌脉总积分
对照组111治疗前18.23±1.5217.23±1.233.25±0.23
治疗后6.23±1.23*4.95±0.56*0.62±0.15*
观察组110治疗前18.06±2.0116.99±1.423.33±0.19
治疗后2.73±0.76*#2.01±0.26*#0.20±0.04*#
), ArticleFig(id=1322926659611009597, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表2, caption=

两组中枢性性早熟伴单纯性肥胖女童治疗前后中医证候积分变化（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间主症总积分次症总积分舌脉总积分
对照组111治疗前18.23±1.5217.23±1.233.25±0.23
治疗后6.23±1.23*4.95±0.56*0.62±0.15*
观察组110治疗前18.06±2.0116.99±1.423.33±0.19
治疗后2.73±0.76*#2.01±0.26*#0.20±0.04*#
), ArticleFig(id=1322926659694895678, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间E2/（pg/mL）LH/（mIU/mL）FSH/（mIU/mL）
对照组111治疗前28.62±3.140.85±0.086.45±0.16
治疗后19.13±1.15*0.60±0.05*3.46±0.14*
观察组110治疗前28.61±2.990.87±0.066.39±0.20
治疗后15.94±1.07*#0.41±0.04*#2.11±0.25*#
), ArticleFig(id=1322926659770393151, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表3, caption=

两组中枢性性早熟伴单纯性肥胖女童治疗前后性激素指标变化（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间E2/（pg/mL）LH/（mIU/mL）FSH/（mIU/mL）
对照组111治疗前28.62±3.140.85±0.086.45±0.16
治疗后19.13±1.15*0.60±0.05*3.46±0.14*
观察组110治疗前28.61±2.990.87±0.066.39±0.20
治疗后15.94±1.07*#0.41±0.04*#2.11±0.25*#
), ArticleFig(id=1322926659837502016, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间子宫/（mm）左侧卵巢/（mL）右侧卵巢/（mL）
对照组111治疗前36.32±0.482.77±0.302.99±0.21
治疗后32.76±0.36*1.95±0.20*2.10±0.16*
观察组110治疗前36.28±0.512.79±0.283.00±0.19
治疗后30.25±0.39*#1.58±0.19*#1.68±0.15*#
), ArticleFig(id=1322926659963331137, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表4, caption=

两组中枢性性早熟伴单纯性肥胖女童治疗前后子宫长度以及卵巢体积变化（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间子宫/（mm）左侧卵巢/（mL）右侧卵巢/（mL）
对照组111治疗前36.32±0.482.77±0.302.99±0.21
治疗后32.76±0.36*1.95±0.20*2.10±0.16*
观察组110治疗前36.28±0.512.79±0.283.00±0.19
治疗后30.25±0.39*#1.58±0.19*#1.68±0.15*#
), ArticleFig(id=1322926660047217218, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组1111.69±0.161.41±0.2011.517 70.000 0
观察组1101.70±0.141.28±0.1819.317 20.000 0
t值-0.494 35.077 5--
P值-0.621 60.000 0--
), ArticleFig(id=1322926660126908995, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表5, caption=

两组中枢性性早熟伴单纯性肥胖患者治疗前后乳房发育分期评分比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组1111.69±0.161.41±0.2011.517 70.000 0
观察组1101.70±0.141.28±0.1819.317 20.000 0
t值-0.494 35.077 5--
P值-0.621 60.000 0--
), ArticleFig(id=1322926660194017860, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组11120.65±0.4718.23±0.6133.109 30.000 0
观察组11020.59±0.5017.23±0.5547.409 90.000 0
t值-0.919 212.795 3--
P值-0.359 00.000 0--
), ArticleFig(id=1322926660252738117, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表6, caption=

两组中枢性性早熟伴单纯性肥胖患者治疗前后BMI指数比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组11120.65±0.4718.23±0.6133.109 30.000 0
观察组11020.59±0.5017.23±0.5547.409 90.000 0
t值-0.919 212.795 3--
P值-0.359 00.000 0--
), ArticleFig(id=1322926660315652678, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组1118.74±0.139.23±0.2021.642 20.000 0
观察组1108.70±0.199.02±0.1713.164 10.000 0
t值-1.824 98.406 7--
P值-0.068 00.000 0--
), ArticleFig(id=1322926661892710983, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=CN, label=表7, caption=

两组中枢性性早熟伴单纯性肥胖患者治疗前后骨龄比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组1118.74±0.139.23±0.2021.642 20.000 0
观察组1108.70±0.199.02±0.1713.164 10.000 0
t值-1.824 98.406 7--
P值-0.068 00.000 0--
), ArticleFig(id=1322926661980791368, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926652015124990, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胃肠道反应肝肾功能异常注射部位反应总不良反应
对照组1111（0.90）1（0.90）2（0.00）（1.80）
观察组1103（0.91）0（0.00）0（0.91）（1.82）
χ2值----0.000 1
P值----0.992 7
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两组中枢性性早熟伴单纯性肥胖女童治疗不良反应比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胃肠道反应肝肾功能异常注射部位反应总不良反应
对照组1111（0.90）1（0.90）2（0.00）（1.80）
观察组1103（0.91）0（0.00）0（0.91）（1.82）
χ2值----0.000 1
P值----0.992 7
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滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童疗效观察
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张东光 , 文文兵 , 石乔 , 邹海英 , 杨利 , 杨玉
中华中医药学刊 | 省级项目平台 2025,43(9): 206-209
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中华中医药学刊 |省级项目平台 2025 , 43 (9) : 206 -209
滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童疗效观察
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张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

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张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

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张东光, 文文兵, 石乔, 邹海英, 杨利, 杨玉
作者信息
  • 江西省儿童医院，江西 南昌 330038
通讯作者:
杨玉（1964-），女，江西南昌人，主任医师，硕士，研究方向：儿童内分泌遗传代谢病。E-mail：。
作者简介:

张东光（1982-），女（满族），辽宁凤城人，副主任医师，硕士，研究方向：儿童内分泌遗传代谢病。

Clinical Effect of Ziyin Xiehuo Prescription（滋阴泻火方）on Central Precocious Puberty with Simple Obesity in Girls
Dongguang ZHANG, Wenbing WEN, Qiao SHI, Haiying ZOU, Li YANG, Yu YANG
Affiliations
  • Jiangxi Provincial Children＇s Hospital，Nanchang 330038，Jiangxi，China
出版时间: 2025-09-10 doi: 10.13193/j.issn.1673-7717.2025.09.038
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摘要
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目的

观察滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童临床效果。

方法

研究纳入中枢性性早熟伴单纯性肥胖女童合计230例（2020年6月—2023年6月收治），以随机数字表法将患者分为对照组与观察组，各组115例，对照组患者采取醋酸亮丙瑞林微球治疗，观察组患者采取醋酸亮丙瑞林微球治疗同时，联合滋阴泻火方治疗，治疗过程中观察组脱落5例，对照组脱落4例。比较各组疗效：治疗前及治疗6个月后中医证候积分、雌二醇（E2）及促黄体生成素（LH）、血清促卵泡生成素（FSH）水平、子宫长度及卵巢体积、乳房发育分期情况、骨龄、体质指数（BMI）及不良反应情况。

结果

观察组女童治疗总有效率高于对照组女童治疗总有效率；治疗前，各组患者中医证候积分、E2及LH、FSH水平、子宫长度以及卵巢体积、乳房发育分期、骨龄、BMI比较，均P>0.05，治疗后各组女童中医证候积分、E2及LH、FSH水平、子宫长度以及卵巢体积、乳房发育分期均下降，P<0.05，观察组女童治疗后中医症候积分、E2及LH、FSH水平低于对照组、子宫长度以及卵巢体积、乳房发育分期、骨龄小于对照组，观察组女童治疗后BMI较对照组更低；观察组与对照组女童不良反应率均较低，P>0.05。

结论

滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童能调节女童性激素水平，延缓乳房、子宫及卵巢发育进程，不加重肥胖趋势，一定程度上抑制骨龄增长。

中枢性性早熟  /  单纯性肥胖  /  滋阴泻火方  /  醋酸亮丙瑞林微球  /  疗效  /  中医证候积分
Objective

To observe the clinical effectof Ziyin Xiehuo Prescription（滋阴泻火方）on girlswith precocious puberty and simple obesity.

Methods

A total of230 girlswith central precocious puberty accompanied by simple obesity admitted from June 2020 to June2023 were included in the study. The patients were divided into control group and observation group by random number table method，with 115 cases in each group. The girls in the control group were treated with leuprorelin acetate microspheres，while those in the observation group were treated with leuprorelin acetate microspheres combined with Ziyin Xiehuo Prescription. The treatment lasted for 6months. During the treatment，5 cases fell off in the observation group and 4 cases fell off in the controlgroup. The data of allgroupswas compared，including the efficacy，traditional Chinese medicine syndrome score before treatment and 6 months after treatment，the levels of serum estradiol（E2），luteinizing hormone（LH）and follicle-stimulating hormone（FSH），uterine length and ovarian volume，breast stage，bone age，body mass index（BMI）and adverse reactions.

Results

The total effective rate of girls in the observation group was higher than that in the control group. Before treatment，the traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH，uterine length，ovarian volume，breast stage，bone age and BMI of all groupswere not significant（P>0.05）. After treatment，the traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH，uterine length，ovarian volume and breast stage of girls in both groupswere decreased（P<0.05）. After treatment，the levels of traditional Chinese medicine syndrome scores，the levels of E2，LH and FSH in the observation group were lower than those in the control group，the values of uterine length，ovarian volume，breast stage and bone age were lower than those in the control group，and BMI in the observation group was lower than that in the control group. The adverse reaction rate of girls in observation group and controlgroup was low（P>0.05）.

Conclusion

In the treatment of central precocious puberty with simple obesity girls，Ziyin Xihuo Prescription can regulate the levels of sex hormones，delay the development of breast，uterus and ovary，do not aggravate the trend of obesity，and inhibit the growth of bone age to a certain extent.

central precocious puberty  /  simple obesity  /  Ziyin Xihuo Prescription（滋阴泻火方）  /  leuprorelin acetate microspheres  /  curative effect  /  TCM syndrome score
张东光, 文文兵, 石乔, 邹海英, 杨利, 杨玉. 滋阴泻火方治疗中枢性性早熟伴单纯性肥胖女童疗效观察. 中华中医药学刊, 2025 , 43 (9) : 206 -209 . DOI: 10.13193/j.issn.1673-7717.2025.09.038
Dongguang ZHANG, Wenbing WEN, Qiao SHI, Haiying ZOU, Li YANG, Yu YANG. Clinical Effect of Ziyin Xiehuo Prescription（滋阴泻火方）on Central Precocious Puberty with Simple Obesity in Girls[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (9) : 206 -209 . DOI: 10.13193/j.issn.1673-7717.2025.09.038
正文
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女童性早熟是指女童7.5岁前出现第二性征，是由于体内甾体激素水平提前升高并作用于靶器官所致[1-3]。近年世界范围内青春期发育年龄提前及多国报道中枢性性早熟的患病率增加，影响儿童的身心健康[4-5]。儿童肥胖已成为我国重要的公共问题之一，既往研究显示肥胖女童性发育年龄显著低于正常体质指数儿童[6-7]。肥胖儿童本身存在内分泌、心血管等多系统并发症风险，治疗依从性参差不齐，抗性早熟药物疗程相对较长，对于共患病儿童如何优化治疗方案成为临床凸显问题[8-9]。中医将性早熟归属于“月经先期”“乳疠”等范畴，对该病亦积累了丰富的治疗经验[10-11]，临床以滋阴泻火方治疗取得较好效果，但在性早熟伴肥胖女童中的应用效果及安全性值得进一步探讨。本研究通过对我院230例中枢性性早熟伴单纯性肥胖女童使用不同治疗方案的疗效及安全性进行分析，以期为寻求更优的临床干预方案提供依据。
1　资料与方法
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1.1　一般资料
研究纳入中枢性性早熟伴单纯性肥胖女童合计230例（2020年6月—2023年6月收治），采取随机数字表法将纳入女童分为对照组（115例）和观察组（115例），治疗过程中观察组脱落5例，对照组脱落4例。对照组女童资料：111例，年龄5～9岁，平均年龄（6.76±0.47）岁，病程1～12个月（9.45±1.23）个月。观察组女童资料：110例，年龄5～9岁，平均年龄（6.72±0.49）岁，病程1～11个月（9.38±1.19）个月。比较对照组与观察组女童的临床资料，P>0.05。
1.2　诊断标准
西医参照《中枢性性早熟诊断与治疗共识（2015）》以及《小儿内分泌学》[12]诊断标准：女童8岁前出现第二性征发育、线性生长加速、骨龄超前、性腺增大、血清促性腺激素及性激素达青春期水平诊断为中枢性性早熟，儿童的BMI值超过同年龄女童的BMI 95%以上诊断为肥胖。中医参照《中医儿科学》[13]：主症（乳房胀痛、怕热、五心烦热、盗汗）及次症（口渴、面部升火、烦躁易怒、喜肥甘、口臭、目赤胀痛、便秘）、舌脉（舌质红、脉细数或弦数）。
1.3　纳入排除标准
纳入标准：均符合上述诊断标准的5～9岁中枢性性早熟伴单纯性肥胖女童患儿，法定监护人知情，自愿加入研究；经过医院伦理委员会批准进行。排除标准：继发于中枢神经系统异常、先天性肾上腺皮质增生症、甲状腺功能减退等疾病发生的性早熟，外源性雌激素摄入所致性早熟、药物性肥胖、具有肥胖表型的遗传综合征、下丘脑性肥胖，肥胖伴有糖代谢异常、非酒精性脂肪肝病等并发症，有精神病史，既往曾接受抗性早熟药物治疗者。
1.4　治疗方法
两组均采取生活方式干预，进行饮食指导及健康教育，纠正患儿的不良生活习惯，帮助其养成良好的生活习惯；同时予注射用醋酸亮丙瑞林微球（上海丽珠制药有限公司，国药准字H20093852，规格3.75 mg或北京博恩特药业有限公司，国药准字H20093809，规格3.75 mg）治疗。首次剂量为3.75 mg，采取皮下注射治疗，后每4周用药1次，用药量体质量≥30 kg者为3.75 mg，体质量<30 kg者为100 μg/kg，随访6个月。观察组在此基础上结合中医药滋阴泻火方治疗。滋阴泻火方为本院协定方抗性早熟汤剂，药物组成：山药片15 g，茯苓15 g，地黄5 g，知母3 g，玄参3 g，夏枯草10 g等。用量：每次服50 mL，每天2次，3个月为1个疗程，根据病情连用1～2个疗程。
1.5　观察指标
①性早熟疗效标准[14]：痊愈-女童的症状与体征基本消失，性激素恢复青春期前水平，积分减少率95%及以上；显效-女童症状与体征显著改善，性激素水平好转，70%≤积分减少率<95%；有效-女童症状与体征改善，性激素水平一定程度改善，30%≤积分减少率<70%；无效-积分减少率30%内。总有效率＝痊愈率+显效率+有效率。②比较各组女童性早熟中医证候积分变化。女童主要证候包括主症（乳房胀痛、怕热、五心烦热、盗汗）及次症（口渴、面部升火、烦躁易怒、喜肥甘、口臭、目赤胀痛、便秘）、舌脉（舌质红、脉细数或弦数），主症各项积分0、2、4、6分，对应无症状、轻度、中度与重度，次症及舌脉各项积分0、1、2、3分，对应无症状、轻度、中度与重度[15]。③比较各组女童治疗前及6个月后性激素变化，应用化学发光法测定女童E2及LH、FSH水平。④比较各组女童治疗前及6个月后子宫长度以及卵巢体积变化，采用超声诊断仪进行测量。⑤比较各组女童治疗前及6个月后乳房发育情况及BMI。乳房发育情况[16]：应用Tanner乳房分期标准进行评估。Ⅰ期为幼儿型（0分）；Ⅱ期乳头未增大，乳晕无着色，乳房呈芽孢状隆起（1分）；Ⅲ期乳房、乳晕进一步增大，两者在同一丘面上，乳头增大突起于皮面，乳晕开始着色（2分）；Ⅳ期乳晕明显着色，可见乳窦小丘，乳晕在乳房上形成第二个丘面隆起（3分）；Ⅴ期为成人型（4分），积分越高表示乳房发育越成熟。BMI＝体重（kg）/身高2（m2）。⑥比较各组女童骨龄。采用《中国人手腕部骨龄标准—中华05》方法评估治疗前及治疗6个月后骨龄。⑦比较各组女童治疗中不良反应发生情况。
1.6　统计学方法
采用SPSS 26.0软件处理各组女童临床数据，疗效、不良反应率等计数资料采用χ2检验，中医证候积分、E2及LH、FSH水平、子宫长度以及卵巢体积、乳房发育分期、骨龄及BMI等指标计量资料采用t检验，P<0.05，差异具有统计学意义。
2　结果
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2.1　两组女童临床疗效比较
观察组女童治疗总有效率比对照组女童治疗总有效率更高，P<0.05。见表1。
2.2　两组女童治疗前后中医证候积分变化
治疗前各组女童的中医证候积分比较，P>0.05，治疗后各组女童中医证候积分均下降，观察组女童治疗后中医证候积分低于对照组。见表2。
2.3　两组女童治疗前后性激素指标（E2及LH、FSH）变化
治疗前各组女童的性激素指标（E2及LH、FSH）比较，P>0.05，治疗后各组女童性激素指标（E2及LH、FSH）均下降，观察组女童治疗后性激素指标（E2及LH、FSH）比对照组更低，P<0.05。见表3。
2.4　两组女童治疗前后子宫长度以及卵巢体积变化
治疗前各组女童的子宫长度以及卵巢体积比较，P>0.05，治疗后各组女童子宫长度以及卵巢体积均指标均下降，观察组女童治疗后子宫长度以及卵巢体积比对照组更小，P<0.05。见表4。
2.5　两组女童治疗前后乳房发育分期评分变化
治疗前各组女童的乳房发育分期评分比较，P>0.05，治疗后各组女童乳房发育分期评分均下降，观察组女童治疗后乳房发育分期评分比对照组更低，P<0.05。见表5。
2.6　两组女童治疗前后BMI变化
治疗前各组女童的BMI比较，P>0.05，治疗后各组女童年BMI均下降，观察组女童治疗后BMI比对照组更低，P<0.05。见表6。
2.7　两组女童治疗前后骨龄变化
治疗前各组女童的骨龄比较，P>0.05，治疗后各组女童骨龄均增大，观察组增大小于对照组，P<0.05。见表7。
2.8　两组女童治疗不良反应比较
观察组与对照组女童不良反应率均较低，P>0.05。见表8。
3　讨论
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中医中并无“性早熟”病名，将其归属于“乳疬”“月经先期”范畴，多认为是肾阴不足，无以制阳导致发育提前[17-19]。中医关于性早熟相关记载较多[20-21]。《素问·上古天真论篇》记载：“女子七岁，肾气盛，齿更发长；二七而天癸至，任脉通，太冲脉盛……”其详细记载了女子出生到成年期各个阶段生长发育情况，且肾起着重要作用[22]。女童属纯阳之体，中医认为，“阳常有余，阴常不足”[23]。后天环境与饮食等因素导致女童阴阳失衡，阴虚火旺则天癸早至[24-25]。中医认为，性早熟病变与肝肾脾相关，肝肾阴虚，横逆犯脾，脾土受侮，水津失布，酿生痰湿，痰湿之邪堆积化为膏脂，则女童形体肥胖，故而性早熟女童多伴肥胖之症[26]。临床发现，性早熟肥胖女童以阴虚火旺证多见，其次为肝郁化火与痰湿阻滞，故而以滋阴泻火之法治疗可取得较好临床效果[27-30]。
滋阴泻火方治疗性早熟伴单纯性肥胖女童疗效较佳，值得应用。滋阴泻火方是由山药片、茯苓、生地黄、知母、玄参、夏枯草等中药组成，方中茯苓可利水渗湿，健脾，宁心安神；生地黄可滋阴补肾、清热凉血；知母可止渴除烦、通便润燥；玄参可滋阴凉血、泻火解毒、滋肾养阴；夏枯草可清肝泻火、散结消肿。诸药配伍共行健脾疏肝、滋阴泻火、清热解毒、燥湿除烦等功效，可较好改善性早熟伴单纯性肥胖女童病症。本研究数据显示，观察组女童治疗总有效率比对照组女童治疗总有效率更高，P<0.05，提示滋阴泻火方治疗性早熟伴单纯性肥胖女童具有临床效果。性早熟伴单纯性肥胖女童多出现乳房胀痛、怕热、五心烦热、盗汗、口渴、面部升火、烦躁易怒等临床病症[31]，而滋阴泻火方具有健脾疏肝、滋阴泻火、清热解毒、燥湿除烦等功效，可较好改善患儿病症[32]。E2及LH、FSH为性激素指标，女童中枢性性早熟疾病时E2及LH、FSH水平上升，患儿出现相关病症，而患儿经滋阴泻火方治疗后，性激素水平下降，故而患儿病症改善，恢复较好。观察组女童的子宫长度以及卵巢体积小于对照组，乳房发育分期评分低于对照组女童，P<0.05，提示滋阴泻火方可延缓性早熟伴单纯性肥胖女童第二性特征过度发育。观察组女童骨龄及BMI指数均低于对照组，P<0.05，提示滋阴泻火方治疗性早熟伴单纯性肥胖女童可一定程度改善患儿骨龄，改善其肥胖情况。观察组与对照组女童不良反应率均较低，P>0.05，提示滋阴泻火方治疗性早熟伴单纯性肥胖女童较为安全可靠。由于本研究观察期6个月，相对较短，研究结果可能存在一定偏倚，需要积累更长期的疗效及安全性数据进一步研究。
综上所述，滋阴泻火方治疗性早熟伴单纯性肥胖女童临床疗效甚佳，患儿经治疗后性激素水平下降，可抑制第二性特征过度发育，改善患儿病症，同时改善其肥胖之症，治疗安全可靠。
基金
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  • 江西省科学技术厅重点研发计划项目(S2019ZPYFB1947)
  • 江西省中医药管理局科技计划项目(SZYYB20245199)
文献
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2025年第43卷第9期
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doi: 10.13193/j.issn.1673-7717.2025.09.038
  • 首发时间：2026-10-30
  • 出版时间：2025-09-10
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基金
江西省科学技术厅重点研发计划项目(S2019ZPYFB1947)
江西省中医药管理局科技计划项目(SZYYB20245199)
作者信息
    江西省儿童医院，江西 南昌 330038

通讯作者:

杨玉（1964-），女，江西南昌人，主任医师，硕士，研究方向：儿童内分泌遗传代谢病。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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