姜桂益瘿汤对桥本氏甲减的临床疗效观察及对SOD、MDA的影响

发布时间：2018-06-15 09:09

本文选题：姜桂益瘿汤 + 脾肾阳虚　；参考：《黑龙江中医药大学》2015年硕士论文

【摘要】：目的：观察姜桂益瘿汤联合小剂量左甲状腺素钠治疗脾肾阳虚型桥本氏田状腺炎合并甲状腺机能减退患者的临床疗效及对SOD、MDA的影响。方法：将66例符合纳入标准的脾肾阳虚型桥本氏甲状腺炎合并甲状腺机能减退患者按照随机表随机分为两组：治疗组,33例,对照组,33例。对照组：服用左甲状腺素钠片每日25 μ g,每日1次,每2周增加12.5μg剂量,观察4周共一疗程。治疗组：在对照组的用药基础上加服姜桂益瘿汤。药物组成：干姜20g,肉桂20g,熟地黄15g,山药15g,茯苓15g,泽泻10g,夏枯草15 g,玄参15g,黄芪20g,白术20g,当归15g,川芎15g,青皮10g,陈皮15g。用法：早晚各1次,饭后30分钟温服。观察4周共1疗程。结果：试验过程中,治疗组1例因主动要求退出,实际完成32例,其中男2例,女30例；对照组1例因外出而退出,2例因未及时复查,实际完成30例,其中男1例,女29例。治疗组中医证候疗效总有效率优于对照组,P0.05,差异具有统计学意义。两组在中医单项症状积分方面比较,治疗后主要症状方面均有改善,P0.05,但治疗组面浮肢肿、腰膝酸软、畏寒肢冷、颈部肿大方面明显优于对照组,P0.01,差异具有统计学意义。在甲状腺功能方面比较,两组组内比较FT3、FT4、TSH指标均显著改善,P0.01,差异有统计学意义,组间比较FT3、FT4有改善,P0.05,表明治疗组在升高FT3、FT4的作用方面优于对照组。在氧化指标SOD、MDA方面,组内治疗前后,P0.01,治疗组治疗前后比较有显著差异性,说明效果显著；治疗后组间比较,P0.05,说明治疗组与对照组比较具有差异性,治疗组效果优于对照组。结论：1.姜桂益瘿汤联合左甲状腺素钠片治疗脾肾阳虚型HT在中医证候疗效方面有明显改善作用。2.可以明显改善脾肾阳虚型HT的中医单项症状尤其是面浮肢肿、腰膝酸软、畏寒肢冷、颈部肿大方面。3.可以明显改善脾肾阳虚型HT的甲功指标：FT3、FT4、TSH。4.可能通过本作用机制来升高SOD水平,降低MDA水平,提高患者整体状态,安全无副作用。
[Abstract]:Objective: to observe the clinical effect of Jianggui Yiying decoction combined with low dose left thyroxine sodium in treating patients with Hashimoto's farmland adenositis complicated with hypothyroidism with deficiency of spleen and kidney yang. Methods: 66 patients with Hashimoto's thyroiditis complicated with hypothyroidism were randomly divided into two groups: treatment group (n = 33) and control group (n = 33). In the control group, 25 渭 g levothyroxine sodium tablets were taken daily, once a day, and 12.5 渭 g / d was added every 2 weeks. The course of treatment was observed for 4 weeks. Treatment group: in the control group on the basis of medication plus Jiang Gui Yi Ying Tang. Drug composition: ginger 20g, cinnamon 20g, cooked Rehmannia 15g, yam 15g, Poria cocos 15g, alisma 10g, Prunella subtilis 15g, Radix Xuanshen 15g, Astragalus Astragali 20g, Atractylodes macrocephala 20g, Angelica sinensis 15g, Chuanxiong 15g, Qingpi 10g, Chen Pei 15g. Usage: 1 time each morning and evening, 30 minutes after meal warm clothes. A course of treatment was observed for 4 weeks. Results: in the course of the experiment, 32 cases were actually completed in the treatment group (2 males and 30 females) due to active withdrawal, while in the control group (1 case), 2 cases were withdrawn because of going out, 30 cases were actually completed, including 1 male and 29 female. The total effective rate of TCM syndrome in the treatment group was better than that in the control group (P 0.05), the difference was statistically significant. The main symptoms of the two groups were improved after treatment (P0.05), but the treatment group was significantly better than the control group in the aspects of surface floating limb swelling, weak waist and knee, cold chilled limbs and swelling of neck. The difference was statistically significant. In terms of thyroid function, the indexes of TSH of FT3 and FT4 in the two groups were significantly improved (P 0.01), the difference was statistically significant, and the comparison of FT3 FT 4 between the two groups improved P0.05, which indicated that the treatment group was superior to the control group in increasing the effect of FT3 FT 4. In the oxidation index of SOD MDA, there were significant differences before and after treatment in the treatment group (P 0.01), which indicated that the effect was significant, and the comparison between the treatment group and the control group showed that there were differences between the treatment group and the control group, and the effect of the treatment group was better than that of the control group. Conclusion 1. Jiang Gui Yi Ling Tang combined with left thyroxine sodium tablets in the treatment of spleen and kidney yang deficiency type HT has a significant improvement in TCM syndromes. Can obviously improve the spleen and kidney yang deficiency type HT single symptoms, especially the face floating limb swelling, waist and knee sore soft, cold, neck swelling. 3. It can obviously improve the index of thyroid function of HT of spleen and kidney yang deficiency type: t FT 3 + FT 4 and TS H. 4. This mechanism may increase the level of SOD, reduce the level of MDA, improve the overall state of patients, safety and no side effects.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581

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