解郁通络消瘿汤治疗桥本氏甲状腺炎甲减期（肝郁脾虚痰瘀阻络证）临床观察

发布时间：2018-03-27 11:58

本文选题：桥本氏甲状腺炎　切入点：疏肝健脾　出处：《长春中医药大学》2016年硕士论文

【摘要】：目的:本课题观察中医药解郁通络消瘿汤治疗桥本氏甲状腺炎(Hashimoto Thyroiditis,HT)甲减期(肝郁脾虚,痰瘀阻络证)的安全性和临床有效性,为更进一步提高祖国医学治疗HT临床效果提供新思路和新方法。方法:本研究遵循随机、对照原则,观察72例HT伴甲状腺功能减退症(hypothyroidism,简称甲减)的患者,且中医辨证为肝郁脾虚,痰瘀阻络证。将入组患者依据随机数字表法分为治疗组、对照组,各36例。其中对照组在休息、心理调节等基础治疗基础上,给予左甲状腺素钠片(优甲乐)口服;治疗组在对照组基础上,联合口服解郁通络消瘿汤加减治疗。观察3个疗程,即12周。所有患者均测定治疗前后甲状腺相关激素水平(FT3、FT4、TSH)、甲状腺自身抗体滴度(TPO-Ab、TG-Ab)、甲状腺肿大程度及中医证候积分评定。试验结束后进行安全性及疗效性评定。结果:解郁通络消瘿汤加减联合优甲乐治疗HT甲减期在降低TPO-Ab、TG-Ab、TSH,升高FT4,缩小甲状腺体积,改善临床症状,减少优甲乐用量等方面较对照组(单纯应用优甲乐)有明显优势(P0.05)。其治疗效果好,且研究过程中未见不良反应事件发生。结论:解郁通络消瘿汤在改善临床症状、降低甲状腺相关激素水平、降低TPO-Ab、TG-Ab水平、缩小甲状腺体积方面明显优于西药对照组。临床观察中未见毒副作用。以疏肝健脾,理气化痰通络法治疗HT,能够减少自身免疫,进而延缓病情,但仍有待于进一步完善。通过该项临床观察证实,解郁通络消瘿汤可以为中医药治疗HT提供新思路和新方法。
[Abstract]:Objective: This study observed the TCM Jieyu Tongluo Xiaoying Decoction in the treatment of Hashimoto's thyroiditis (Hashimoto Thyroiditis, HT) in group 2 (liver stagnation and spleen deficiency, phlegm and blood stasis) clinical safety and effectiveness, to further improve the clinical effect of Chinese medicine treatment of HT to provide new ideas and methods: this method. The followrandom, control principle, observation of 72 cases of HT patients with hypothyroidism (hypothyroidism, referred to as hypothyroidism) in patients with qi stagnation and spleen deficiency, phlegm and blood stasis. The patients were according to randomly divided into treatment group and control group, each of 36 cases. The control group at rest adjust the psychological foundation, based on the treatment given Levothyroxine Sodium Tablets (euthyrox) oral; treatment group in the control group based on the combined oral Jieyu Tongluo Xiaoying Decoction. Observe 3 treatment, or 12 weeks. All the patients were measured before and after treatment of thyroid The level of related hormones (FT3, FT4, TSH gland), thyroid autoantibody titers (TPO-Ab, TG-Ab), the degree of goiter and TCM syndrome integral evaluation. After the test of safety and efficacy evaluation. Results: Jieyu Tongluo Xiaoying Decoction Combined with euthyrox treatment HT a reduction in TPO-Ab reduction TG-Ab, TSH, FT4, increase, reduction of thyroid volume, improve clinical symptoms, reduce the amount of euthyrox compared with the control group (simple euthyrox) has obvious advantage (P0.05). The treatment effect is good, and in the course of the study, no adverse events occurred. Conclusion: Jieyu Tongluo Decoction in Xiaoying improve clinical symptoms, reduce the levels of thyroid hormone related to reduce TPO-Ab, TG-Ab level, reduction of thyroid volume was significantly better than the control group of Western medicine. The clinical observation showed no toxicity. The liver and spleen, Qi and phlegm Tongluo treatment can reduce HT, autoimmunity, and But it still needs further improvement. Through this clinical observation, it is confirmed that Jieyu Tongluo Xiaoying Decoction can provide new ideas and new methods for TCM treatment of HT.

【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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解郁通络消瘿汤治疗桥本氏甲状腺炎甲减期（肝郁脾虚 痰瘀阻络证）临床观察

解郁通络消瘿汤治疗桥本氏甲状腺炎甲减期（肝郁脾虚痰瘀阻络证）临床观察