中药清热养阴汤治疗桥本甲亢（心肝火旺证）的临床疗效观察

发布时间：2018-04-20 11:22

本文选题：桥本氏病 + 甲状腺功能亢进症　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:通过观察清热养阴汤治疗桥本甲亢(心肝火旺证)的临床疗效,分析本方治疗桥本甲亢(心肝火旺证)的有效性和安全性,为临床中治疗本病提供更多的思路和方案选择。方法:选择随机对照试验方法,将符合纳入标准的68例桥本甲亢患者分为治疗组和对照组,每组34例。治疗组予清热养阴汤,对照组予甲巯咪唑,观察两组患者中医症候、体征、甲状腺功能、肝功能、肾功能、血常规、尿常规指标的变化,两组均每2周(14天)为一个疗程,共观察6个疗程,共三个月(90土7天)。患者每疗程复诊1次,并分别于治疗前、每次复诊时进行检验和检查并详细记录,进行疗效判断及统计学数据分析。结果:1.治疗组总有效率90.90%,对照组总有效率87.88%,两组比较无显著性差异(P0.05);2.治疗后两组中医证候积分较治疗前明显降低,差异有统计学意义(P0.05),其中,烦躁、心悸症候积分降低治疗组优于对照组,差异具有统计学意义(P0.05);3.治疗后两组甲状腺肿大积分、甲状腺质地积分、脉率积分和突眼积分较治疗前均明显降低,差异具有统计学意义(P0.05);4.治疗后两组FT3、FT4较治疗前明显降低,差异具有统计学意义(P0.05),TSH较治疗前明显升高,差异具有统计学意义(P0.05),治疗后两组TGAb和TPOAb较治疗前有所降低,差异具有统计学意义(P0.05);5.治疗后,两组白细胞计数减少发生率比较无显著性差异(P0.05),两组肝功能损害发生率比较,治疗组低于对照组,差异具有统计学意义(P0.05),治疗后两组均未发生肾功能改变和尿常规改变。结论:1.清热养阴汤能够显著改善桥本甲亢(心肝火旺证)的中医证候,尤其在改善在烦躁、心悸症候上疗效显著。2.清热养阴汤显著降低桥本甲亢(心肝火旺证)的FT3、FT4水平,升高TSH水平,降低TGAb和TPOAb水平。3.清热养阴汤治疗桥本甲亢(心肝火旺证)过程中未见白细胞减少及肝功能损害发生,未见肾功改变,具有可靠的安全性。
[Abstract]:Objective: to observe the efficacy and safety of Qingre Yangyin decoction in treating Hashimoto hyperthyroidism (heart-liver-fire and hyperthyroidism syndrome), and to analyze its efficacy and safety in treating Hashimoto hyperthyroidism. For the clinical treatment of this disease to provide more ideas and options. Methods: 68 patients with Hashimoto hyperthyroidism were divided into treatment group (n = 34) and control group (n = 34). The treatment group was treated with Qingre Yangyin decoction and the control group with methimazole. The changes of TCM symptoms, signs, thyroid function, liver function, kidney function, blood routine and urine routine indexes were observed as a course of treatment in the two groups. A total of 6 courses of treatment were observed for 3 months, 90 days and 7 days. The patients were reviewed once per course of treatment. Before and after each visit, the patients were examined and recorded in detail, and the curative effect was judged and the statistical data were analyzed. The result is 1: 1. The total effective rate was 90.90 in the treatment group and 87.88 in the control group. There was no significant difference between the two groups. After treatment, the scores of TCM syndromes in the two groups were significantly lower than those before treatment, and the difference was statistically significant (P 0.05). The treatment group was better than the control group in reducing the score of fidgety and palpitation symptoms, and the difference was statistically significant (P 0.05). After treatment, the scores of goiter, thyroid texture, pulse rate and exophthalmos in the two groups were significantly lower than those before treatment, and the difference was statistically significant (P 0.05). After treatment, FT3 / FT4 in the two groups was significantly lower than that before treatment, the difference was statistically significant (P 0.05) and the difference was statistically significant (P 0.05). After treatment, the TGAb and TPOAb in the two groups were lower than those before treatment, and the difference was statistically significant (P 0.05). After treatment, there was no significant difference in the incidence of leukopenia between the two groups. The incidence of liver function damage in the treatment group was lower than that in the control group. The difference was statistically significant (P 0.05). There were no changes in renal function and urine routine after treatment. Conclusion 1. Qingre Yangyin decoction can significantly improve the TCM syndromes of Hashimoto hyperthyroidism (heart-liver-fire flourishing syndrome), especially in improving the symptoms of irritability, palpitations. Qingre Yangyin decoction significantly decreased FT3FT-4 level of Hashimoto hyperthyroidism (syndrome of heart-liver-fire flourishing), increased the level of TSH, and decreased the levels of TGAb and TPOAb .3. During the treatment of Hashimoto hyperthyroidism with Qingre Yangyin decoction, leukopenia and liver function damage did not occur.
【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】：2017
【分类号】：R259

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