Is Zhibai Dihuang Wan effective for treating early puberty in children?

Patient's question:

No

Doctor's answer:

Traditional Chinese Medicine (TCM) holds that the etiopathogenesis of premature thelarche in girls is due to an imbalance of yin and yang in the "kidney" [3], specifically the condition of "kidney yin deficiency with hyperactivity of ministerial fire," which is considered a manifestation of regulatory dysfunction of the "kidney" in growth, development, and reproductive functions. In TCM, the term "kidney" primarily refers not to the Western medical concept of the kidneys but to the human neuroendocrine regulatory system, including axes such as the hypothalamic-pituitary-gonadal axis and the hypothalamic-pituitary-adrenal axis. The essence of "kidney yin deficiency with hyperactivity of ministerial fire" is the hyperactivity of these regulatory axes.
According to the principles of TCM syndrome differentiation, corresponding treatment principles are established, employing methods such as "nourishing kidney yin and draining ministerial fire." The formula for Dabuyin Pill consists of prepared rehmannia, tortoise shell, cinnabar, anemarrhena, and pig spinal cord, while the formula for Zhipaidihuang Pill includes prepared rehmannia, mountain dogwood, peony root, Chinese yam, poria, alisma, anemarrhena, and cinnabar. Their functions are to nourish yin and subdue fire. Based on the theory of "yin is often deficient, while yang is often excessive," prepared rehmannia is used to nourish yin and tonify the kidney, replenish blood and essence, while tortoise shell tonifies yin and anchors yang, and pig spinal cord replenishes essence and nourishes marrow. These serve as the primary herbs. Cinnabar, anemarrhena, poria, and alisma, with their bitter and cold properties, reinforce the nourishment of yin and drain the excess fire to preserve yin fluids, acting as auxiliary herbs. The combination of these herbs nourishes the deficient yin and drains the hyperactive fire, achieving the overall goal of strengthening the root and purifying the source.
Dabuyin Pill and Zhipaidihuang Pill are prescribed based on syndrome differentiation and are pharmacologically aligned with the condition of premature thelarche in girls, which is why they are effective.