知柏地黄丸辅助治疗儿童中枢性性早熟有效性和安全性的系统评价

Systematic Review on Effectiveness and Safety of Zhibai Dihuang Pills in the Adjuvant Treatment of Children's Central Precocious Puberty

关键词:  知柏地黄丸  中枢性性早熟  儿童  meta分析

Key words:  Zhibai Dihuang pills  central precocious puberty  children  meta-analysis

摘要:

目的 系统评价知柏地黄丸辅助治疗儿童中枢性性早熟（central precocious puberty，CPP）的有效性和安全性。方法 通过检索Embase、Web of Science、Pubmed、Cochrane Library、CNKI、万方数据库、VIP数据库，根据纳入标准收集知柏地黄丸辅助治疗儿童CPP的随机对照试验文献，利用RevMan 5.3软件进行meta分析。结果 共有10篇文献符合纳入标准，总例数862例。Meta分析结果显示，知柏地黄丸不论与其他中成药或者西药联合治疗儿童CPP的临床疗效均高于促性腺激素释放激素拟似药（gonadotropin-releasing hormone analogue，GnRH-a）单独治疗。知柏地黄丸与GnRH-a联合治疗在抑制骨龄和血清促黄体生成素水平上与GnRH-a单独治疗相比无优势，而在减缓子宫、卵巢、卵泡的发育和抑制血清促卵泡激素水平上的疗效更佳。同时，联合治疗可缩短疗程，减轻患者的经济负担。结论 知柏地黄丸辅助治疗儿童CPP安全有效。

Abstract:

OBJECTIVE To systemically review the effectiveness and safety of Zhibai Dihuang pills(ZDP) in the adjuvant treatment of central precocious puberty(CPP) in children. METHODS The databases of Embase, Web of Science, Pubmed, Cochrane Libray, CNKI, Wan Fang, and VIP were retrieved for collecting the randomized controlled trial(RCT) about the adjuvant treatment of CPP in children with ZDP. All the meta-analyses were performed by RevMan 5.3. RESULTS Ten RCTs were included and totally 862 patients. Meta-analysis showed that ZDP were superior to GnRH-a alone in the treatment of CPP whether combined with other proprietary Chinese medicines or western medicines. ZDP combined with gonadotropin-releasing hormone analogue(GnRH-a) had no advantage in inhibiting bone age and the content of luteinizing hormone levels in serum, but it was better in slowing the development level of the uterus, ovarian, follicular and inhibiting the level of follicle stimulating hormone in serum compared with GnRH-a alone. The combined therapy could shorten the course of treatment and reduce the economic burden of patients. CONCLUSION It's safe and reliable in the adjuvant treatment of CPP in children with ZDP.