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针刺联合耳穴贴压治疗3 - 8岁女童不完全性性早熟:一项随机对照试验

[Acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty: a randomized controlled trial].

作者信息

Liu Li-Li, Wan Nai-Jun, Sun Hui-Hui, Zhang Ya-Mei

机构信息

Department of Acupuncture and Moxibustion, Beijing Jishuitan Hospital, Beijing 100035, China.

Department of Pediatrics, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Zhongguo Zhen Jiu. 2023 Jul 12;43(7):776-80. doi: 10.13703/j.0255-2930.20220915-k0004.

Abstract

OBJECTIVE

To observe the efficacy and safety of acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty (IPP).

METHODS

Sixty girls with IPP were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases were eliminated). The girls in the control group were treated with healthy diet and proper exercise for 12 weeks. On the basis of the treatment in the control group, the girls in the observation group were treated with acupuncture combined with auricular point sticking. The acupuncture was applied at Sanyinjiao (SP 6), Guanyuan (CV 4), Guilai (ST 29), etc., the needles were retained for 20 min, acupuncture was given twice a week (once every 3 days). The auricular point sticking was applied at Luanchao (TF), Neishengzhiqi (TF), Neifenmi (CO), Yuanzhong (AT), etc., twice a week. The treatment was given for 12 weeks. Before treatment, after treatment and in follow-up after 12 weeks of treatment completion, the Tanner stage of breast, serum contents of sex hormone (luteinizing hormone [LH], follicle-stimulating hormone [FSH], estradiol [E]) were observed. The ovarian volume, the number of follicles with diameter>4 mm, and the uterine volume were measured by abdominal color Doppler ultrasound. In addition, the safety of the observation group was evaluated.

RESULTS

Compared with before treatment, the Tanner stage of breast in the observation group was improved after treatment and in follow-up (<0.05); after treatment and in follow-up, the Tanner stage of breast in the observation group was better than that in the control group (<0.05). Compared with before treatment, the serum levels of LH and E in the observation group were increased (<0.05), and the volume of bilateral ovaries was larger (<0.05) in follow-up. Compared with before treatment, the serum contents of LH, FSH and E in the control group were increased (<0.05), the volume of bilateral ovaries was larger (<0.05), and the number of follicles was increased (<0.05) after treatment and in follow-up. The serum levels of LH, FSH and E in the observation group were lower than those in the control group (<0.05), the volume of bilateral ovaries was smaller than that in the control group (<0.05), and the number of follicles was lower than that in the control group (<0.05). Compared with before treatment, the uterine volume in the two groups was larger in follow-up (<0.05). There was no statistically significant difference between the two groups after treatment and in follow-up (>0.05). During the treatment, 3 cases in the observation group had slight abdominal pain and subcutaneous blood stasis, without serious adverse reactions.

CONCLUSION

Acupuncture combined with auricular point sticking could improve the Tanner stage of breast, reduce the level of sex hormone, slow down the development and maturation of ovary and follicle, and control the degree and speed of sexual development in girls aged 3-8 years with IPP.

摘要

目的

观察针刺联合耳穴贴压治疗3 - 8岁女童不完全性性早熟(IPP)的疗效及安全性。

方法

将60例IPP女童随机分为观察组(30例,脱落2例)和对照组(30例,剔除2例)。对照组女童采用健康饮食和适当运动治疗12周。观察组女童在对照组治疗基础上,采用针刺联合耳穴贴压治疗。针刺选取三阴交(SP 6)、关元(CV 4)、归来(ST 29)等穴位,留针20分钟,每周针刺2次(每3天1次)。耳穴贴压选取卵巢(TF)、内生殖器(TF)、内分泌(CO)、缘中(AT)等穴位,每周2次。治疗12周。观察治疗前、治疗后及治疗结束后12周随访时乳房 Tanner分期、性激素(黄体生成素[LH]、卵泡刺激素[FSH]、雌二醇[E])血清含量。采用腹部彩色多普勒超声测量卵巢体积、直径>4 mm卵泡数量及子宫体积。此外,对观察组安全性进行评价。

结果

与治疗前比较,观察组治疗后及随访时乳房 Tanner分期改善(<0.05);治疗后及随访时,观察组乳房 Tanner分期优于对照组(<0.05)。与治疗前比较,观察组随访时血清LH和E水平升高(<0.05),双侧卵巢体积增大(<0.05)。与治疗前比较,对照组治疗后及随访时血清LH、FSH和E含量升高(<0.05),双侧卵巢体积增大(<0.05),卵泡数量增多(<0.05)。观察组血清LH、FSH和E水平低于对照组(<0.05),双侧卵巢体积小于对照组(<0.05),卵泡数量低于对照组(<0.05)。与治疗前比较,两组随访时子宫体积均增大(<0.05)。治疗后及随访时两组间比较差异无统计学意义(>0.05)。治疗期间,观察组3例出现轻微腹痛及皮下淤血,无严重不良反应。

结论

针刺联合耳穴贴压可改善3 - 8岁IPP女童乳房 Tanner分期,降低性激素水平,减缓卵巢及卵泡发育成熟,控制性发育程度及速度。

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