活血消瘿片联合夏枯草胶囊治疗结节性甲状腺肿的临床疗效观察

发布时间：2018-03-30 17:04

本文选题：活血消瘿片　切入点：夏枯草胶囊　出处：《湖北中医药大学》2017年硕士论文

【摘要】：目的从中医学角度探讨结节性甲状腺肿的病因、病机,观察活血消瘿片联合夏枯草胶囊治疗痰结血瘀型结节性甲状腺肿的临床疗效,探讨其治疗结甲的作用机制,评价其对甲状腺结节、甲状腺形态等方面的作用,了解其对中医临床症状、体征的改善情况,评价其临床应用价值。方法选取自2016年4月至2016年10月至湖北省中医院甲状腺专科门诊就诊,符合西医结甲的诊断、中医痰结血瘀型瘿瘤的患者66例,在治疗过程中,脱落6例,按随机对照法将入组的60例分为治疗组30例,对照组30例。治疗组予以口服活血消瘿片,每次4片,每日3次;夏枯草胶囊,每次2粒,每日2次;对照组予以口服优甲乐片,每次25μg~50μg,每日1次;3个月为一个治疗疗程,观察周期为3个月。比较两组患者的甲状腺结节、甲状腺形态、结节恶变高危因素积分、中医证候积分等方面在治疗前后的变化情况。结果(1)治疗前,将两组患者的性别、年龄、病程等进行对比,P0.05,差异无统计学意义,具有可比性。(2)治疗前后两组临床疗效比较:一个疗程后,治疗组的总有效率为73.33%,对照组为36.67%,两者比较,有显著性差异,说明治疗组疗效明显优于对照组。(3)治疗前后两组中医证候积分比较:治疗组治疗前后中医证候积分比较,P0.01,有显著性差异;对照组治疗前后中医证候积分比较,P0.05,差异有统计学意义;治疗后,两组中医证候积分均下降,两组比较,P0.01,有显著性差异,说明治疗组在改善中医症状、体征方面优于对照组。(4)治疗前后两组中医证候疗效比较:治疗组的总有效率为90.0%,对照组为33.3%,两者比较,有显著性差异。(5)治疗前后两组结节恶变高危因素积分比较:治疗组治疗前后对比,P0.01,有显著性差异;对照组治疗前后对比,P0.05,差异无统计学意义;治疗后两组间比较,P0.01,有显著性差异,即治疗组恶变高危因素积分明显低于对照组。(6)治疗前后两组甲状腺结节最大直径比较:治疗组治疗前后比较,P0.05,治疗后结节的最大直径小于治疗前,差异有统计学意义;对照组治疗前后对比,P0.05,差异无统计学意义;治疗后两组间比较,P0.05,即治疗组甲状腺结节减小程度大于对照组。(7)治疗前后两组甲状腺体积比较:治疗组治疗前后比较,P0.05,治疗后甲状腺体积小于治疗前,差异有统计学意义;对照组治疗前后对比,P0.05,治疗后甲状腺体积小于治疗前,差异有统计学意义;治疗后,两组间比较,P0.05,差异无统计学意义。(8)毒副作用:两组治疗前后甲状腺功能、甲状腺自身免疫性抗体比较,P0.05,差异无统计学意义;两组治疗前后血常规、尿常规、肝功能、肾功能等检查未见异常,均在正常范围内。结论活血消瘿片联合夏枯草胶囊治疗结节性甲状腺肿疗效显著,可以明显改善患者的症状、体征,缩小肿大的甲状腺及结节的最大直径,且可以降低结节恶变的可能性,毒副作用小,值得临床推广。
[Abstract]:Objective to investigate the etiology and pathogenesis of nodular goiter from the perspective of traditional Chinese medicine (TCM), to observe the clinical effect of Huoxue Xiaoying tablet combined with Xiucucao capsule in treating nodular goiter of phlegm and blood stasis type, and to explore its mechanism of treating nodular goiter. To evaluate its effect on thyroid nodule and thyroid shape, and to understand the improvement of clinical symptoms and signs of TCM. Methods from April 2016 to October 2016, from April 2016 to October 2016, 66 patients with sputum and blood stasis type gall tumor of traditional Chinese medicine were selected. Six cases of shedding were divided into treatment group (30 cases) and control group (30 cases) according to the method of random control. The treatment group was given 4 tablets of Huoxue Xiaoying tablet 3 times a day, 2 capsules of Prunella subtilis capsule twice a day; The control group was treated with Utrel tablets, 25 渭 g / time, 50 渭 g / day, 3 months as a course of treatment, and the observation period was 3 months. The thyroid nodule, thyroid shape and the score of high risk factors of nodular malignancy were compared between the two groups. Results before and after treatment, the sex, age and course of disease of the two groups were compared and compared with P0.05. the difference was not statistically significant. Comparison of the two groups before and after treatment: after a course of treatment, the total effective rate of the treatment group was 73.33 and that of the control group was 36.67. There was a significant difference between the two groups. The results showed that the therapeutic effect of the treatment group was significantly better than that of the control group. (3) the comparison of TCM syndrome score before and after treatment in the treatment group was significant (P 0.01). After treatment, the scores of TCM syndromes in the two groups were all decreased, and there was significant difference between the two groups (P 0.01), indicating that the treatment group was improving the symptoms of traditional Chinese medicine. The total effective rate of the treatment group was 90.0 and that of the control group was 33.3.Compared with the control group, it was better than the control group before and after the treatment. There was significant difference between the two groups before and after treatment. The scores of high risk factors of nodule malignancy in the treatment group were significantly higher than those in the control group before and after treatment, and there was no significant difference between the treatment group and the control group before and after treatment, and there was no significant difference between the two groups before and after treatment. There was significant difference between the two groups after treatment. That is, the score of high risk factors of malignant change in the treatment group was significantly lower than that in the control group.) the maximum diameter of thyroid nodule in the treatment group was significantly lower than that in the control group before and after treatment (P 0.05), and the maximum diameter of the nodule after treatment was smaller than that before treatment, and the difference was statistically significant. There was no significant difference between control group and control group before and after treatment (P 0.05). After treatment, the thyroid volume of the treatment group was lower than that of the control group (P 0.05), the thyroid volume of the treatment group was smaller than that of the control group (P 0.05). After treatment, the volume of thyroid gland in the control group was smaller than that before and after treatment, and the difference was statistically significant; after treatment, there was no significant difference between the two groups in terms of thyroid function, and there was no significant difference between the two groups before and after treatment. There was no significant difference in thyroid autoimmune antibodies between the two groups before and after treatment, and no abnormality was found in the examination of blood routine, urine routine, liver function, renal function and so on before and after treatment. Conclusion the curative effect of Huoxue Xiaoying tablet combined with Xixucao capsule on nodular goiter is remarkable, which can obviously improve the symptoms and signs of the patients and reduce the maximum diameter of the enlarged thyroid gland and nodule. And can reduce the possibility of nodule malignancy, the toxicity and side effect is small, worthy of clinical promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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