平亢消瘿汤治疗Graves病的临床疗效观察及对sFas的影响

发布时间：2018-04-27 19:10

本文选题：平亢消瘿汤 + Graves病　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:观察平亢消瘿汤治疗心肝火旺型Graves病患者FT3、FT4、TSH、sFas的变化和临床症状改善情况,并探讨平亢消瘿汤治疗Graves病的作用机理可能是通过调节外周血sFas,减轻了甲状腺细胞凋亡的抑制。方法:将符合本试验病例纳入标准的68例患者采用随机分组法分成治疗和对照两组,两组各34例。基础治疗,即甲巯咪唑10mg,Qdpo,盐酸普萘洛尔片10mg,Tidpo。对照组给予基础治疗;治疗组在基础治疗的同时给予平亢消瘿汤,每天1剂,水煎取300ml,每次150ml,Bidpo。临床观察周期为4周,FT3、FT4、TSH、外周血sFas、肾功能、心电图治疗前后各检测一次,TPOAb、TGAb、TRAb在治疗前检测一次,肝功能每两周检查一次,血常规每周检查一次,中医临床症状积分试验前后各记录一次,并用统计学进行分析处理。结果:1.中医疗效比较,P0.05。2.中医总证候积分比较,两组治疗前进行组间对比P0.05;两组治疗前与治疗后分别进行组内对比,均为P0.05;两组证候积分的差值进行对比,P0.05。3.中医单项症状积分比较,各项症状积分治疗前进行组间对比,均为P0.05。对于甲状腺肿、目涨突眼、消瘦,两组分别进行治疗前后组内对比,均为P0.05。对于头晕目眩、舌痛、少寐多梦、倦怠乏力、口渴多饮,两组分别进行治疗前后组内对比,均为P0.05;两组治疗前后积分差值进行对比P0.05。对于心悸、烦躁易怒、手指震颤、口苦、胸胁胀痛、多食、恶热,两组分别进行治疗前后组内对比,均为P0.05;两组治疗前后积分差值进行对比P0.05。4.西医临床疗效比较,P0.05。5.血清甲状腺激素变化比较,两组治疗前FT3、FT4、TSH的值进行组间对比P0.05。两组FT3、FT4治疗前后进行组内对比,均为P0.05;两组治疗前后差值进行组间对比P0.05。两组TSH治疗前后进行组间对比,均为P0.05;两组治疗前后差值进行组间对比P0.05。6.外周血sFas变化比较,两组治疗前sFas的值进行组间对比P0.05;两组治疗前后分别进行组内对比,均为P0.05;两组前后差值进行组间对比 P0.05。7.不良反应观察,出现不良反应的例数,分别经χ 2检验,均为P0.05。结论:1.平亢消瘿汤可明显降低中医证候积分,改善临床症状及相应体征,且在心悸不宁、烦躁易怒、手指震颤、口苦、胸胁胀痛、多食、恶热的症状改善方面效果更明显。2.平亢消瘿汤治疗Graves病,可明显降低FT3、FT4,升高TSH。3.平亢消瘿汤可降低外周血sFas含量,其作用机制之一可能是通过降低外周血sFas含量,从而调节甲状腺细胞凋亡,使Graves病得到治疗。
[Abstract]:Objective: to observe the changes and clinical symptoms of FT _ (3) T _ (3) T _ (4) T _ (SHH) SFAS in patients with heart-liver-fire flourishing Graves disease treated with Pingkangxiaoying decoction, and to explore the mechanism of Pingkangxiaoying decoction in the treatment of Graves disease, which may be through regulating the peripheral blood sFasS, and lighten the inhibition of thyroid cell apoptosis. Methods: 68 patients who met the criteria were randomly divided into two groups: treatment group and control group with 34 cases in each group. Basic treatment, namely methimazole 10 mg / g Qdpob, propranolol hydrochloride 10 mg / L Tidpo. The control group was given basic treatment, the treatment group was treated with Pingkangxiaoying decoction at the same time, 1 dose per day, decoction 300 ml, 150ml Bidpo. The clinical observation period was 4 weeks after treatment, the blood sFasA, renal function, electrocardiogram (ECG) were detected once before and after treatment, the liver function was examined once every two weeks, and the blood routine examination was performed once a week before and after the treatment. The clinical symptom integral test of traditional Chinese medicine (TCM) was recorded once before and after the test, and was analyzed by statistics. The result is 1: 1. Comparison of curative effects of traditional Chinese Medicine (P0.05.2). The comparison of TCM total syndrome score before treatment between the two groups compared P0.05; the two groups before and after treatment were compared within the group, both P0.05; the difference between the two groups of syndromes score was compared with P0.05.3. Chinese medicine single symptom integral comparison, each symptom integral carries on the comparison before the treatment, all is P0.05. For goiter, bulge eye, thin, the two groups were treated before and after treatment, the comparison was P0.05. For dizziness, tongue pain, less sleep and more dreams, fatigue, thirst and drink, the two groups were compared before and after treatment, both P0.05; the difference between the two groups before and after treatment was compared P0.05. For palpitations, irritability, finger tremor, bitter mouth, chest and flank pain, more food, evil fever, the two groups were compared before and after treatment, both P0.05. the difference between the two groups before and after treatment was compared (P0.05.4). The clinical curative effect of western medicine was compared with that of P0.05.5. The changes of serum thyroid hormone were compared between the two groups before treatment, and the values of FT3, FT4 and TSH were compared between the two groups (P 0.05). The difference between the two groups before and after treatment was P0.05. the difference between the two groups before and after treatment was P0.05. The difference between the two groups before and after TSH treatment was P0.05.The difference between the two groups before and after treatment was P0.05.6. The changes of sFas in peripheral blood of the two groups were compared before and after treatment (P0.05), the difference between the two groups before and after treatment was P0.05.The difference between the two groups before and after treatment was P0.05.7. The number of adverse reactions were all P 0.05 by 蠂 2 test. Conclusion 1. Pingkangxiaoying decoction can obviously reduce the syndromes integral of traditional Chinese medicine, improve clinical symptoms and corresponding signs, and in the palpitation restlessness, irritability, finger tremor, bitter mouth, chest and flank distended pain, more food, evil fever symptom improvement effect is more obvious. 2. The treatment of Graves's disease with Pingkangxiaoying decoction can obviously reduce FT _ 3 FT _ 4 and increase TSH _ 3. Pingganxiaoying decoction can reduce the content of sFas in peripheral blood, and one of its mechanisms may be to regulate the apoptosis of thyroid cells by reducing the content of sFas in peripheral blood, so that Graves disease can be treated.
【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

【参考文献】