自拟消瘿瘤方治疗甲状腺肿瘤的临床观察

发布时间：2018-03-28 06:31

本文选题：消瘿瘤方　切入点：甲状腺肿瘤　出处：《河北医科大学》2017年硕士论文

【摘要】：目的:近年来甲状腺肿瘤的发病率逐渐增高,越来越多的甲状腺肿瘤患者愿意尝试安全、有效而无毒副作用的中药。本研究通过观察自拟消瘿瘤方对甲状腺肿瘤的治疗,并与单纯口服小金丸对照1组和单纯口服无碘盐对照2组进行比较,评估其对缩小肿物大小,改善临床疗效,调节甲状腺激素水平,增强免疫功能以及安全性等方面的作用。方法:本研究入选患者为门诊或体检病例,经超声、化验及病理细胞学确诊为结节性甲状腺肿或甲状腺癌,共计100例,治疗组40例患者,采用自拟消瘿瘤方,每周保证服用6付中药,日1剂;对照1组30例患者,服用小金丸每次1.8g,每日2次;对照2组30例患者,改用无碘盐,不服用任何药物。以上三组均治疗6个月后评价临床疗效。结果:1治疗后,肿物改善方面,治疗组痊愈5例,显效12例,有效13例,有效率为75%;对照1组痊愈3例,显效8例,有效10例,有效率为70%;对照2组显效1例,有效3例,其他均无效,有效率仅为13.3%。治疗组与对照1组比较P0.05,统计学无差异;与对照2组比较P0.01,统计学有显著性差异。2甲状腺功能方面,治疗组中患者的促甲状腺激素水平下降明显,有统计学差异P0.05,对照1组中患者的促甲状腺激素水平下降,有统计学差异P0.05,对照2组中患者的游离T4水平明显增长,统计学有差异P0.05;治疗组与对照1组比较,促甲状腺激素水平有统计学差异P0.05;与对照2组比较,各项均有统计学差异P0.05。3免疫功能方面,治疗组中CD3、CD4和CD8阳性T细胞增长显著,均有统计学差异P0.05,对照1组中CD4、CD8明显增长,有统计学差异P0.05,对照2组各项变化不大均没有统计学差异P0.05;治疗组与对照1组比较,CD3、CD4及NK均有统计学差异P0.05;与对照2组比较,各项均有统计学差异P0.05。4安全性方面,血常规中血小板和血红蛋白均有统计学差异P0.05,肝肾功能中的血清学指标均在正常范围之内,且治疗前后变化较小,这就说明对肝肾损伤较小,并且在治疗组未发现不良反应情况的发生。结论:自拟消瘿瘤方对甲状腺肿瘤有良好的治疗作用,不仅可以有效缩小肿物大小,改善临床症状,调节甲状腺功能,同时具有较高的安全性,避免过敏等不良反应的发生,尤其在增强患者免疫功能方面,具有更加突出的优势,值得临床推广使用。
[Abstract]:Objective: in recent years, the incidence of thyroid neoplasms has gradually increased, and more and more patients of thyroid tumors are willing to try Chinese medicine which is safe, effective and without toxic side effects. Compared with the control group 1 and the control group 2 of oral iodized salt alone, the effect of Xiaojin pill on reducing the size of tumor, improving the clinical efficacy and regulating the thyroid hormone level were evaluated. Methods: in this study, 100 patients were diagnosed as nodular goiter or thyroid carcinoma by ultrasound, laboratory and pathological cytology. In the treatment group, 40 patients were treated with self-made Xiaoyingliang recipe, which was guaranteed to take 6 sets of traditional Chinese medicine once a day, 30 patients in the control group took 1.8 g Xiaojin pills twice a day, 30 patients in the control group were treated with iodized salt, and 30 patients in the control group were treated with iodized salt. No drugs were taken. The clinical efficacy was evaluated after 6 months of treatment in the above three groups. Results in the treatment group, 5 cases were cured, 12 cases were effective, 13 cases were effective, and the effective rate was 75% in the control group 1, 3 cases were cured and 8 cases had remarkable effect. The effective rate was 70% in 10 cases, 1 case in the control group, 3 cases in the control group, none in other cases, and the effective rate was only 13.3.There was no statistical difference between the treatment group and the control group (P 0.05). Compared with the control group (P0.01), there was a significant difference in thyroid function between the two groups. 2. The level of thyrotropin in the treatment group was significantly lower than that in the control group (P 0.05), and the thyroid stimulating hormone level in the control group 1 was lower than that in the control group. There was a significant difference (P0.05) in the level of free T4 between the control group and the control group (P0.05), the level of thyrotropin in the treatment group was significantly higher than that in the control group (P0.05), and the level of thyrotropin in the treatment group was significantly higher than that in the control group (P0.05). There were significant differences in immunological function between the two groups (P0.05.3). In the treatment group, CD4 and CD8 positive T cells increased significantly (P 0.05), and CD4 and CD8 increased significantly in the control group 1. There was significant difference between the two groups (P0.05), the difference between the treatment group and the control group (P0.05), the difference between the treatment group and the control group (P0.05), the difference between the treatment group and the control group (P0.05.4), the difference between the treatment group and the control group (P0.05.4), the difference between the two groups was not significant (P0.05). There were significant differences in platelet and hemoglobin in blood routine (P 0.05), serological indexes in liver and kidney function were within normal range, and the changes were small before and after treatment, which indicated that the damage to liver and kidney was less. In the treatment group, no adverse reactions were found. Conclusion: the self-made Xiao-gall tumor prescription has a good therapeutic effect on thyroid neoplasms, which can not only effectively reduce the size of the tumor, improve clinical symptoms, and regulate the thyroid function, but also can effectively reduce the size of the tumor, improve the clinical symptoms, and regulate the thyroid function. At the same time, it has higher safety, avoid the occurrence of adverse reactions such as allergies, especially in enhancing the immune function of patients with more prominent advantages, worthy of clinical use.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

【参考文献】