临床误诊误治2024，Vol.37Issue(6)：82-88,7.DOI:10.3969/j.issn.1002-3429.2024.06.016
基于PI3K/Akt/mTOR信号通路、性激素、骨代谢探究知柏地黄丸联合治疗女性特发性性早熟的效果及机制
Effect and Mechanism of Combined Treatment with Zhibai Dihuang Pills on Idiopathic Precocious Puberty Based on PI3K/Akt/mTOR Signaling Pathway,Sex Hormones,and Bone Metabolism
摘要
Abstract
Objective To investigate the effects of combined treatment with Zhibai Dihuang pills on sex hormone,bone metabolism and PI3K/Akt/mTOR signaling pathway in children with idiopathic central precocious puberty(CPP).Methods Sixty patients with CPP treated from January 2022 to December 2022 were selected and divided into Western medi-cine group(n=30)and combination group(n=30)by random number table method.The Western medicine group was trea-ted with Triprerelin injection,and the combination group was treated with Zhibai Dihuang pills on the basis of the Western medicine group.The clinical efficacy and safety of the two groups were compared.Uterine volume,ovarian volume,follicle diameter,sex hormone levels[luteinising hormone(LH),LH/follicle-stimulating hormone(FSH),estradiol(E2)],bone metabolism indicators[osteocalcin,bone alkaline phosphatase(BALP),procollagen Ⅰ N-terminal propeptide(PⅠNP),bone mineral density,β-collagen degradation products(β-CTX)],and expression of I3K/Akt/mTOR signaling pathway re-lated proteins before and after treatment were compared.Results The total effective rate of combination group was 96.67%(29/30),which was higher than that of Western medicine group[70.00%(21/30)](P＜0.05).After treatment,uterine volume,ovarian volume and follicle diameter in combination group were lower than those in Western medicine group(P＜0.05).After treatment,serum levels of LH,LH/FSH,E2 osteocalcin,BALP and PⅠNP in combination group were lower than those in Western medicine group,while bone mineral density was higher than that in Western medicine group(P＜0.05).There was no significant difference in serum β-CTX between the two groups after treatment(P＞0.05).The protein expression levels of PI3K,Akt and mTOR in combination group after treatment were lower than those in Western medicine group(P＜0.05).The total incidence of adverse reactions in combination group was not significantly different from that in Western medicine group(P＞0.05).Conclusion Triprerelin injection combined with Zhibai Dihuang pills can reduce the level of sex hormones in CPP children,increase the expression of bone metabolism-related factors,and inhibit the activity of PI3K/Akt/mTOR signaling pathway,thus improving the symptoms of children with CPP.This study has shown definite clini-cal efficacy and certain safety.关键词
特发性性早熟/知柏地黄丸/曲普瑞林/PI3K/Akt/mTOR信号通路/雌二醇/黄体生成激素/骨钙素/骨密度Key words
Idiopathic precocious puberty/Zhibai Dihuang pills/Triptorelin/PI3K/Akt/mTOR signaling pathway/Estradiol/Luteinizing hormone/Osteocalcin/Bone density分类
医药卫生引用本文复制引用
陆影,龙海旭..基于PI3K/Akt/mTOR信号通路、性激素、骨代谢探究知柏地黄丸联合治疗女性特发性性早熟的效果及机制[J].临床误诊误治,2024,37(6):82-88,7.基金项目
湖南省中医药管理局中医药科研项目(B2023148) （B2023148）
