Analysis Of Clinical Efficacy On Treatment Of Premature Thelarche Of Yin Deficiency And Fire Excess Type By Sanru Prescription

ObjectiveThe application of Sanru prescription made by the department to treat Premature Thelarche（PT）in girls with yin deficiency and fire excess type,in order to observe the clinical efficacy of Sanru prescription,analyze the related factors that affecting the efficacy of Sanru prescription,and analyze the factors affecting the transformation of PT into Central Precocious Puberty（CPP）,which is helpful to improve the clinical efficacy of TCM in treating PT.Methods200 children with PT of yin deficiency and fire excess type were selected from the pediatric clinic of the Second People’s Hospital of Fujian Province,and randomly divided into treatment group and control group,100 cases in each group.The treatment group was treated with Sanru Prescription,which was self-designed by pediatrics in our hospital,while no drug intervention was given to the control group.After 6 months of follow-up,the breast regression and transformation of two groups was observed.Univariate and multivariate logistic regression analysis was used to analyze the correlation between the chronological age,bone age,difference between bone age and chronological age,breast Tanner stage,uterine longitudinal diameter,ovarian volume,basal LH,peak LH in Gn RH provocation test,peak LH/peak FSH,and the curative effect of the treatment group.Meanwhile,the influencing factors of PT conversion to CPP was analyzed.Result1.Comparison of general data:there was no significant difference in chronological age,bone age,difference between bone age and chronological age,breast Tanner stage,uterine longitudinal diameter,ovarian volume,estradiol,basic value of LH,peak LH,peak LH/peak FSH between the treatment group and the control group at the first visit.2.Comparison of clinical efficacy:in the treatment group,the overall effective rate was87.6%.In the control group,the overall effective rate was 76.7%.The difference in clinical outcomes between two groups of children was statistically significant（P=0.047）.The conversion rate of the treatment group was 5.1%,the conversion rate of the control group was16.1%.The difference in conversion rate between the treatment group and the control group was statistically significant（P=0.013）.3.Analysis of influencing factors of Sanru prescription:using univariate logistic regression analysis,it was found that the variables with statistical significance included basal LH（P=0.002）,uterine longitudinal diameterer（P=0.003）,breast Tanner stage（P=0.027）,E₂（P=0.018）.Multivariate logistic regression analysis showed that the variables related to curative effect were LH basic value（P=0.003）and uterine longitudinal diameterer（P=0.018）,and their OR values were 9.942 and 11.131.4.Analysis of influencing factors of PT to CPP:univariate logistic regression analysis showed that five variables related to conversion were treatment of Sanru Prescription（P=0.018）,uterine longitudinal diameterer（P=0.005）,breast Tanne rstage（P=0.000）,E₂（P=0.007）,and basal LH（P=0.000）.Multivariate logistic regression analysis showed that the variables related to conversion were treatment of Sanru Prescription（P=0.011）,breast Tanner stage（P=0.000）and basal LH（P=0.000）,and their OR values were 0.148,17.518 and 6.648.Conclusion1.Sanru Prescription is effective in treating PT with yin deficiency and fire excess.2.Sanru Prescription can reduce the conversion rate from PT to CPP in the type of yin deficiency and fire excess.3.The basic value of LH and the uterine longitudinal diameter are the independent risk factors that affect the curative effect of Sanru Prescription on PT of yin deficiency and fire excess,suggested that the lower the basal LH and the smaller the uterine longitudinal diameter,the more likely the Sanru prescription is to be effective.4.Basal LH and breast Tanner stage are the risk factors for the conversionon of PT into CPP.It is suggested that the greater the Tanner stage and the higher the basic value of LH,the easier it is to convert PT into CPP.Sanru prescription is an independent protective factor for the conversion from PT to CPP,and Sanru prescription can reduce the conversion from PT to CPP.