Effects Of Zhi Bai Di Huang Decoction On Morning Urine Gonadotropin Levels In Girls With Central Precocious Puberty (Yin Deficiency And Excessive Fire Syndrome)

Research purpose:By observing the correlation between the levels of luteinizing hormone(LH)and follicle stimulating hormone(FSH)in morning urine and the peak values of serum LH and FSH in the gonadotropic releasing hormone(Gn RH)stimulation test in girls with central precocious puberty(CPP),to clarify the value of morning urine gonadotropin testing in the diagnosis of CPP and provide scientific basis for noninvasive diagnosis of CPP,and compare and analyze the changes of TCM syndrome scores,morning urine LH,FSH levels,uterus,ovaries,follicles,etc.in children before and after treatment with Zhibai Dihuang Decoction,to evaluate the clinical efficacy of Zhibai Dihuang Decoction in the treatment of CPP.Research methods:The study selected 80 girls from the Pediatric Outpatient Department of the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine who met the diagnostic criteria for CPP in children and the diagnostic criteria for TCM syndromes of yin deficiency and fire hyperactivity type.The children were randomly divided into two groups: a traditional Chinese medicine treatment group(Group A)and a western medicine treatment group(Group B),each with 40 cases.Group A was treated with Zhibai Dihuang Decoction plus or minus oral treatment,while Group B was treated with Liangbingruilin subcutaneous injection,both of which were continuously observed for 12 weeks;Detect the peak serum LH and FSH levels in Gn RH stimulation test before and after treatment,and the morning urine LH and FSH levels before and after treatment in both groups of children.Meanwhile,record the changes of effective indicators such as clinical symptoms,bone age,uterus,ovary,and follicles in both groups of children;SPSS 26.0 statistical software was used to statistically analyze the collected data.Research results:1.Age distribution: with an average age of 7.38 years in group A and 7.53 years in group B.There was no significant difference in the age distribution of children between the two groups(P>0.05).2.Comparison of the difference between bone age and actual age: Group A had a bone age of 8.7±0.59 years,1.28±0.30 years earlier,while Group B had a bone age of 8.9±0.58 years,1.39±0.21 years earlier.There was no significant difference between the bone age and actual age of children in the two groups(P>0.05).3.Correlation analysis: Before treatment,there was a significant positive correlation between the morning urine LH level and the serum LH level in the Gn RHa challenge test in groups A and B(P<0.01);There was a significant positive correlation between morning urine FSH level and serum FSH level in Gn RHa challenge test(P<0.01).4.Comparison of observation indicators before and after treatment: After 12 weeks of treatment,the levels of LH and FSH in the morning urine of children in groups A and B were significantly lower than before treatment(P<0.01),and the LH level in Group B is significantly lower than that in Group A(P<0.05);The uterine size and ovarian volume of children in groups A and B were significantly reduced compared with those before treatment(P<0.01);The number of follicles with a diameter of>4mm in both groups A and B decreased compared to before treatment(P<0.01).5.Comparison of TCM syndrome scores before and after treatment: After 12 weeks of treatment,the main symptom scores,sub symptom scores,and total syndrome scores of both groups A and B decreased significantly compared to before treatment(P<0.01);In terms of reducing the main symptom score,the efficacy of Group B was better than that of Group A(P<0.01);In terms of reducing the sub symptom score,the efficacy of Group A was better than that of Group B(P<0.01).There was no significant difference in the efficacy of Group A and Group B in reducing the total symptom score(P>0.05).6.Comparison of efficacy evaluation results: After 12 weeks of treatment,the effective rates of Group A and Group B were 92.5% and 95%,respectively.There was no significant difference in efficacy between Group A and Group B(P>0.05).Conclusion:The levels of morning urine LH and FSH in children with CPP are significantly positively correlated with the peak values of serum LH and FSH in the Gn RH challenge test,which is expected to become one of the reliable indicators for noninvasive diagnosis of CPP;"Using traditional Chinese medicine to intervene in the treatment of children with CPP due to yin deficiency and fire hyperactivity has significant clinical efficacy.The addition or subtraction of Zhibai Dihuang Decoction may further reduce the level of LH and FSH in the human body,reduce the size of the uterus and ovarian volume,and reduce the number of follicles with a diameter of>4mm,thereby alleviating the clinical symptoms and signs of precocious puberty,and achieving therapeutic purposes.