疏肝解郁化痰祛瘀法治疗桥本氏甲状腺炎亚临床甲减期的临床研究

发布时间：2018-06-24 15:22

本文选题：桥本氏甲状腺炎 + 亚临床甲减　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：本研究主要通过观察疏肝解郁化痰祛瘀法在治疗桥本氏甲状腺炎亚临床甲减期(TSH10uIU/ml)的临床疗效,旨在阐明中医药在治疗桥本氏甲状腺炎亚临床甲减期的有效性,从而拓展桥本氏甲状腺炎的治疗途径,并为本病的中医药治疗研究积累一定素材。方法：本研究病例来源于成都中医药大学附属医院内分泌科,以60例符合桥本氏甲状腺炎及亚临床甲减(TSH10uIU/ml)诊断标准的门诊患者为研究对象,按就诊时间先后顺序用简单随机化分组方式(随机数字表法)将病例分为对照组和治疗组。其中对照组30例,单纯予以优甲乐口服治疗；治疗组30例,在优甲乐基础上,加用疏肝解郁化痰祛瘀方药口服,一日两次。分别观察治疗前后两组病例的证候积分、中医主症积分及FT3、FT4、TSH、TGAb、TPO-Ab等指标,所有的数据资料采用SPSS19.0统计软件进行分析。结果：治疗前对两组病例的性别、年龄、病程等一般资料进行比较,无统计学差异(P0.05),两组资料具有可比性；中医证候积分、各主症积分、FT3、FT4、TSH、TGAb、TPO-Ab等基线数据经统计学分析,差异无统计学意义(P0.05),组间具有可比性。经治疗后：①FT3、FT4水平组内比较,两组治疗4周、12周后较治疗前均有所升高,组间比较差异无统计学意义(P0.05)；②TSH水平组内比较,两组治疗4周、12周后较治疗前均有所下降,组间比较差异无统计学意义(P0.05);③DTGAb、TPO-Ab水平组内比较,治疗组治疗后较治疗前有所降低,对照组治疗后较治疗前无明显下降,组间比较差异有统计学意义(P0.05)；④中医证候积分水平组内比较,两组治疗后较治疗前均有所降低,组间比较有统计学意义(P0.05)；⑤两组中医各主症(甲状腺肿大、情绪抑郁或烦躁、胸闷、胁下刺痛、喜太息、乏力)积分水平组内比较,治疗后较治疗前均有所下降,各症组间比较差异均有统计学意义(P0.05)；⑥中医证候疗效评价,治疗组有效率92.6%,对照组总有效率为57.1%,两组组间比较差异具有统计学意义(P0.05)结论：疏肝解郁化痰祛瘀法在治疗桥本氏甲状腺炎亚临床甲减期(TSH10uIU/ml)有较好疗效,特别是在改善临床症状及降低TGAb、TPO-Ab滴度等方面具有独特优势,值得进一步探讨与推广。
[Abstract]:Objective: the purpose of this study is to observe the clinical efficacy of the method of removing stagnation and removing phlegm and removing stasis in the treatment of subclinical hypothyroidism (TSH10uIU/ml) of Hashimoto's thyroiditis, aiming at clarifying the effectiveness of Chinese medicine in the subclinical hypothyroidism of Hashimoto thyroiditis, so as to expand the treatment of Hashimoto thyroiditis, and to treat the Chinese medicine for this disease. Methods: This study was derived from the Department of endocrinology in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, and 60 outpatients who met the diagnostic criteria of Hashimoto's thyroiditis and subclinical hypothyroidism (TSH10uIU/ml) were used as the research object. The control group and the treatment group were divided into the control group and the treatment group. 30 cases of the control group were treated with orally orally; 30 cases in the treatment group were taken orally on the basis of you Jia Le, and the prescription was taken with the decoction of dispersing the liver and removing phlegm, removing stasis and removing stasis on the basis of two times. The syndrome scores of the two groups before and after the treatment were observed respectively, the scores of main symptoms of TCM, FT3, FT4, TSH, TGAb, TPO-Ab, etc., all the numbers, and all the numbers. The data were analyzed by SPSS19.0 software. Results: before treatment, the general data of sex, age and course of the two groups were compared, and there was no statistical difference (P0.05), and the data of the two groups were comparable; the baseline data of TCM syndrome, FT3, FT4, TSH, TGAb and TPO-Ab were statistically analyzed, and there was no statistical difference. Significance (P0.05), group has comparability. After treatment: (1) FT3, FT4 level group comparison, two groups of treatment 4 weeks, 12 weeks later than before the treatment, there is no significant difference (P0.05); (2) in the TSH level group, two groups of treatment 4 weeks, 12 weeks later than before the treatment, the difference is not statistically significant (P0.05 DTGAb, TPO-Ab level group comparison, the treatment group after treatment was lower than before treatment, the control group had no significant decrease before treatment, and there was a significant difference between the groups (P0.05); (4) compared with the TCM syndrome score level group, the two groups after treatment were lower than before the treatment (P0.05); 5 Two groups of TCM syndromes (thyroid enlargement, emotional depression or irritability, chest tightness, tingling pain, joy and fatigue, fatigue) were compared in the level group, after treatment, compared with before treatment, the differences were statistically significant (P0.05); 6. The effectiveness of TCM syndrome treatment was 92.6% and the control group was 57.1%, two. The difference between the groups has statistical significance (P0.05) conclusion: the method of removing stagnation of the liver and removing phlegm and removing stasis in the treatment of subclinical hypothyroidism (TSH10uIU/ml) of Hashimoto's thyroiditis (TSH10uIU/ml) has a good effect, especially in improving the clinical symptoms and reducing the titer of TGAb, TPO-Ab titer and so on. It is worth further discussion and promotion.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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