Basic definition of precocious puberty Precocious puberty is an endocrine disorder in which secondary sexual characteristics appear before the age of 8 for girls and 10 for boys, or the first menstruation of girls occurs before the age of 10. The common influencing factors of precocious puberty There is a difference between true and false precocious puberty. True precocious puberty is due to the premature action of hypothalamic-pituitary-gonadal axis, which is central precocious puberty and complete precocious puberty, while pseudo precocious puberty, also known as incomplete precocious puberty, is due to sex hormones stimulating the development of sexual characteristics. The etiology of precocious puberty is not completely clear yet, but some information shows that frequent consumption of nutritional supplements, frequent consumption of animal food, mother’s age of menarche, and frequent use of skin care products are all influencing factors. In summary, there are several general aspects: first, food-related factors, such as the consumption of excessive animal-based foods, anti-seasonal vegetables and fruits, health care products and supplements, beverages, and foreign fast food. Secondly, environmental factors. There are many reports in the literature that substances and their decomposition products released into the environment by detergents, pesticides and plastic industries may also produce some hormone-like substances. There are also some causes that may induce precocious puberty, such as excessive light is one of the important causes of precocious puberty in children, especially prolonged light at night will affect the normal work of the pineal gland, an endocrine organ in the brain, which may lead to the early secretion of gonadotropins, thus leading to precocious puberty. The extensive use of cosmetics and the proliferation of bad information (including written information, media information, network information, cell phone information, language information, etc.) are also important reasons for the increase of precocious puberty. There are also some children who take contraceptive pills by mistake, etc. can also lead to precocious puberty. In the past decade or so, with the improvement of living standard and the adjustment of diet structure, the developmental age of children has advanced from 14 or 5 years old to 11 or 12 years old. Along with the advancement of the developmental age, the number of patients with precocious puberty in children is also increasing. In clinical practice, the ratio of girls to boys is about 10:1. The clinical manifestations of precocious puberty include the appearance of secondary sexual characteristics before the age of 8 for girls and 10 for boys. Generally, girls have breast development first, followed by pubic hair, or even menstruation, and breast development is Tanner stage II, III, and IV. Boys show premature enlargement of the penis and testicles at the same time, and later may have penile erection, pubic hair, acne and low voice, and may have sperm maturation and nocturnal emission of sperm, and are physically stronger than their peers. The main harm of precocious puberty and growth period of children with precocious puberty are early, and their stature will be taller than children of the same age at the early stage of development, but due to early closure of bones, their height is often not ideal in adulthood. In addition to affecting the final height of the child, precocious puberty can also give rise to various psychological problems. The problem that is easily overlooked by parents is that it can cause potential harm to the child’s personality and psychology. Girls who have early menstruation are often very nervous, which affects their normal life and studies. As a parent, you should pay close attention to your child’s early abnormalities and precocious puberty, the earlier it is detected and treated, the better the results. Diagnosis of precocious puberty The diagnosis of precocious puberty in children is based on the following aspects: (1), early appearance of secondary sexual characteristics: before the age of 8 for girls and before the age of 10 for boys; (2), elevated serum gonadotropin levels up to the level of puberty: gonadotropin-releasing hormone (GnRH) excitation test, the peak of its excitation can be used as a basis for diagnosis; (3), enlarged gonads: girls are seen under the B ultrasound ovarian volume >1m1 and multiple follicles ≥4mm in diameter are seen under ultrasound; in boys, testicular volume ≥4ml and progressive enlargement with disease duration; (4), accelerated linear growth; (5), X-ray orthopantomograph of wrist bone: bone age is 1 year or more older than actual age; (6), elevated serum sex hormone levels to pubertal levels: serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol ( E2) levels are elevated. Treatment of precocious puberty 1. The treatment of precocious puberty is aimed at improving the adult height of the affected children, and attention should also be paid to preventing the psychological problems brought about by precocious puberty and early menarche. The GnRHa can effectively inhibit the secretion of LH, suspend the development of the gonads and return the secretion of sex hormones to the prepubertal state, thus delaying the growth and fusion of the epiphysis and prolonging the growth years and improving the final adult height as much as possible. The purpose is to extend the growth years and improve the final height in adulthood. However, these drugs are expensive and take a long time to administer (the course of treatment usually takes at least 2 years), which is difficult for families to afford. 2, Chinese medicine treatment Chinese medicine does not have the name of “precocious puberty”, according to its clinical manifestations, it is mostly classified as “mammary scrofula”. It is believed that the causes of precocious puberty are mainly related to kidney and liver, which are mostly caused by yin deficiency, fire, liver stagnation, liver fire, or spleen deficiency, phlegm knot, and damp-heat injection. For different causes, the treatment methods and medications are also different. Common identification and treatment methods are as follows: (1) Kidney yin deficiency: mainly manifests as breast development and early menstruation in girls and enlarged genitals and penile erection in boys. With zygomatic redness and hot flashes, night sweats, dizziness, irritability, red tongue with little coating and fine pulse. The treatment is to nourish Yin and lower fire. The formula is Zhi Bai Di Huang Wan plus or minus, commonly used drugs: Zhi Mu, Huang Bai, Sheng Di Huang, Gentian grass, Ze Di, Mudan Pi, Shan Yao, Xuan Shen, Tortoise Board, Fu Ling, etc. (2), liver stagnation and fire evidence: the main manifestations are the development of secondary sexual characteristics such as breast and menstruation in girls; in boys, the penis and testicles increase in size, voice becomes low, facial acne, penile erection and ejaculation. It is accompanied by chest congestion, irritability, belching and sighing, constipation, red tongue with yellow coating and slippery pulse. The treatment is to dredge the liver and clear the heat and disperse the knots. The formula is Dan Gardenia Free and Easy San with addition and subtraction, commonly used drugs: peony peel, gardenia, angelica, white peony, Chai Hu, gentian grass, Xia Gu Cao, Citrus aurantium, peppermint, etc. (3), phlegm-heat interconnection evidence: the main manifestations are breast development in girls, vaginal discharge increases, and even early menstruation; boys with enlarged penis and testicles, obvious throat nodes, and penile erection. With fat body, little movement and lazy speech, vomiting and vomiting, thick and greasy tongue coating and slippery pulse. The treatment is to resolve phlegm and clear heat, strengthen the spleen and relieve dampness. The formula is Er Chen Tang combined with Er Miao San plus or minus. Clinical application and experimental studies have shown that Chinese medicine has greater advantages in treating precocious puberty, which is not only reliable, but also safe and economical. It can stop or delay the development of secondary sexual characteristics, decrease the level of sex hormones, restore the volume of uterus, ovaries and follicles to normal level or reduce them to different degrees, and slow down the maturation of bone age, which is beneficial to the growth of final height. However, it should be noted that Chinese medicine treatment for precocious puberty must be based on the specific circumstances of the child in order to achieve better results. Four suggestions to prevent precocious puberty: (1) Avoid: artificially raised poultry (instant chicken, etc.), anti-seasonal vegetables, soybean products, sweet potatoes and other foods containing phytoestrogens, supplements (snapper, crow’s nest, pollen, royal jelly, etc.), synthetic foods, high-protein supplements, etc. (2) Avoid: cosmetics containing vitamin E and placenta (sunscreen, skin whitening and rejuvenation products, etc.), brightly colored TV programs, video game programs, etc. (to prevent early activation of the gonadal system through retinal stimulation). Try to avoid plastic toys, plastic drinking bottles, etc. (3), attention: put away the birth control pills used by parents, read the side effects of drugs used by children, and pay attention to the ingredients of baby baths. (4), strengthen physical activity to help growth and prevent overweight.