泻火化痰消瘿方治疗甲状腺功能亢进症痰火内扰证的临床研究

发布时间：2018-05-26 23:34

本文选题：泻火化痰消瘿方 + 甲状腺功能亢进症　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：探讨中西医学对甲状腺功能亢进症的认识,观察导师经验方——泻火化痰消瘿方治疗甲状腺功能亢进症痰火内扰证的疗效,探讨该方防治本病的作用机理。方法：采用随机平行对照的研究方法,将符合甲亢痰火内扰证的患者,随机分为治疗组和对照组。在对照组西药常规治疗的基础上,治疗组给予中药水煎剂每日1剂,分早晚两次服用,疗程12周。观察两组治疗前后甲状腺激素(TT3、TT4、FT3、FT4、TSH)及相关抗体(TRAb)、甲状腺B超、中医证候积分等指标变化,以及其安全性。全部数据以SPSS20.0统计软件进行统计学分析。结果：甲状腺功能亢进症患者60例,随机分为2组。治疗组与对照组各30例,治疗前两组的性别、年龄、病程、主要症状和体征等基线数据经统计学分析均无显著性差异,具有可比性。治疗后：①疾病总疗效比较：治疗组总有效率达96.67%,对照组为73.33%,经卡方检验P0.05,说明治疗组优于对照组；②证候疗效及症状积分比较：在证候疗效方面治疗组总有效率为96.67%,对照组为70.00%,治疗组优于对照组(P0.05),在症状积分方面两组治疗前后比较均见明显改善,差异有统计学意义(P0.01),且治疗组效果明显优于对照组(组间比较P0.05)；③心率比较：组内比较,两组患者心率均有所降低,统计分析有显著性差异(P0.01),组间比较P0.05,提示两组在改善患者心率方面疗效相近；④甲状腺激素比较：两组患者治疗后TT3、TT4、FT3、FT4均见显著下降,TSH显著升高(P0.01),且治疗组下降和上升的幅度优于对照组,有统计学意义(P0.05)；⑤TRAb比较：两组患者TRAb均较治疗前见显著下降(P0.01),组间比较P0.05,提示两组降低TRAb疗效相近；⑥甲状腺肿比较：组间比较,两组患者治疗后的甲状腺体积均比治疗前缩小,统计分析P0.01,有显著差异,组间比较提示治疗组甲状腺缩小程度高于对照组(P0.05,有统计学意义)；⑦安全性比较：对照组出现了2例白细胞减少和2例肝功能轻度异常的患者,经常规治疗后均恢复正常,治疗组未见不良反应。结论：从初步临床研究看来,泻火化痰消瘿方合用西药治疗甲状腺功能亢进症痰火内扰证,可明显改善患者的临床症状和证候积分；在西医学检测指标方面,其可以调节甲状腺激素水平和甲状腺相关抗体滴度、减慢心率、降低症状积分及甲状腺肿大,并且安全有效,应用前景广泛,值得进一步深入研究。但由于条件限制,本病例研究数相对较少,观察指标比较简单,研究周期较短,确切疗效仍需进一步大样本、长周期、多中心观察。
[Abstract]:Objective: to explore the understanding of hyperthyroidism in Chinese and western medicine, to observe the curative effect of Xiehuhuatanxiaoying prescription on hyperthyroidism with phlegm and fire disturbance, and to explore the mechanism of prevention and treatment of hyperthyroidism. Methods: the patients with hyperthyroidism were randomly divided into treatment group and control group. On the basis of the routine treatment of western medicine in the control group, the treatment group was given 1 dose of Chinese medicine decoction daily, divided into two times in the morning and evening, the course of treatment was 12 weeks. Before and after treatment, the changes of thyroid hormone TT _ 3T _ 3T _ 4T _ 4T _ 4T _ 4T _ (4) T _ (4) T _ (4) T _ (4) T _ (TSHH), thyroid B ultrasound, TCM syndromes score, and its safety were observed. All the data were analyzed by SPSS20.0 statistical software. Results: 60 patients with hyperthyroidism were randomly divided into two groups. There were 30 cases in the treatment group and 30 cases in the control group. There was no significant difference in baseline data such as sex, age, course of disease, main symptoms and signs between the two groups before treatment. The total effective rate of the treatment group was 96.677.The total effective rate of the control group was 73.33. The chi-square test showed that the treatment group was superior to the control group. 2 comparison of syndromes curative effect and symptom score: the total effective rate of the treatment group was 96.677.The control group was 70.00. the treatment group was superior to the control group (P0.05A), and the two groups were obviously improved before and after treatment. The difference was statistically significant (P 0.01), and the effect of the treatment group was significantly better than that of the control group (compared with the control group). The statistical analysis showed that there was significant difference between the two groups (P 0.01) and the difference between the two groups (P 0.05), which indicated that the curative effect of the two groups in improving the heart rate of the patients was similar. 4 comparison of thyroid hormone: after treatment, there was a significant decrease in TSH in both groups, and the decrease and increase of TSH in the treatment group was better than that in the control group. There were significant differences in TRAb between two groups compared with before treatment (P 0.01) and between groups (P 0.05), suggesting that the two groups had similar effect in reducing TRAb and the comparison of goiter: comparison between two groups, there was no significant difference between the two groups. The volume of thyroid gland in the two groups after treatment was smaller than that before treatment, and there was a significant difference between the two groups in the statistical analysis (P0.01). The comparison between groups indicated that the degree of thyroid contraction in the treatment group was higher than that in the control group (P 0.05), and there was a significant difference in the safety of the treatment group. There were 2 cases of leukopenia and 2 cases of mild abnormal liver function in the control group, all of them returned to normal after routine treatment. There was no adverse reaction in the treatment group. Conclusion: from the preliminary clinical study, the treatment of hyperthyroidism with Xiehuo Huatan Xiaoying decoction combined with western medicine can obviously improve the clinical symptoms and syndromes of patients with hyperthyroidism. It can regulate thyroid hormone level and thyroid-associated antibody titer, slow down heart rate, reduce symptom score and goiter, and is safe and effective. However, due to the limitation of conditions, the number of cases is relatively small, the observation index is relatively simple, the research period is relatively short, the exact curative effect still needs to be further large sample, long period, multi-center observation.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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