小柴胡颗粒合逍遥丸治疗桥本氏病的临床疗效观察

发布时间：2018-09-04 11:56

【摘要】：目的:通过与口服西药的对照组进行比较研究,从临床症状的改善和实验室化验指标的变化两方面来观察和评价小柴胡颗粒与逍遥丸联用对桥本氏病患者的治疗疗效,同时对于所选西药和治疗组所选药物的理论依据的来源、现代药理学研究以及目前在临床中的应用进行阐明、论述和分析,为在桥本氏病的治疗过程中中成药所应该发挥的作用提供证明。方法:选取60例临床初诊为桥本氏病的患者,依据临床试验的随机对照原则,随机分为对照组和治疗组,两组各30例。对照组:口服硒酵母胶囊100ug/次,2次/日;治疗组:口服小柴胡颗粒,每次10g,每日两次;逍遥丸,每次3g,每日两次,两种中成药在我院门诊配药。两组均以8周为一个疗程,观察一个疗程,两组患者在治疗前后都要检测TPO-Ab(甲状腺过氧化物酶抗体)和甲功三项包括:TSH(促甲状腺素)、FT3(游离三碘甲状腺原氨酸)、FT4(游离甲状腺素)进行检测,均采用化学发光法,此外,还需比较两组实验对象在治疗前和治疗后的中医证候积分。运用SPSS.21.0统计软件分析所得实验数据。在研究期间有药物过敏等不良反应发生时退出研究。结果:两组患者在治疗前的年龄、性别等一般情况未见统计学差异,组间可比(P0.05),治疗前的血清过氧化物酶抗体(TPO-Ab)以及中医证候积分也无统计学差异,具有可比性(P0.05)。经过8周的治疗,得出:(1)在各自小组内部比较治疗前后的TPO-Ab浓度可见统计学差异(P0.05),在两组之间比较未见差异(P0.05)。(2)在组内对比中医证候积分,可见治疗后两组积分都有明显下降,比较数据具有统计学意义(P0.01);两组之间相比明显可见治疗组改善情况较好,对比数据有统计学意义(P0.01)。(3)中医证候疗效评定,治疗组和对照组的总有效率分别为86.7%和50%,治疗组疗效优于对照组,经秩和检验具有统计学意义(P0.01)。结论:中成药小柴胡颗粒和逍遥丸联用可使桥本氏病患者的TPO-Ab浓度下降,同时研究观察到,硒酵母胶囊在降低TPO-Ab浓度方面也有明显的疗效,但是在改善临床症状方面,治疗组明显优于对照组。
[Abstract]:OBJECTIVE:To observe and evaluate the therapeutic effect of Xiaochaihu Granules combined with Xiaoyao Pills on Hashimoto's disease by comparing with the control group of oral western medicine in terms of the improvement of clinical symptoms and the changes of Laboratory Laboratory Laboratory test indexes. Methods: 60 patients with Hashimoto's disease were randomly divided into control group and treatment group according to the randomized control principle of clinical trial, and each group had 30 cases. The control group: oral selenium yeast capsule 100ug / time, twice a day; the treatment group: oral small Bupleurum granules, 10 g each time, twice a day; Xiaoyao pills, 3 g each time, twice a day, two kinds of Chinese patent medicine in our hospital outpatient dispensing. The body and thyroid function of the three items include: TSH (thyrotropin), FT3 (free triiodothyronine), FT4 (free thyroxine) were detected by chemiluminescence method, in addition, the two groups of experimental subjects before and after treatment of TCM syndrome integrals need to be compared. Result: There was no significant difference in age, sex and other general conditions between the two groups before treatment (P 0.05). There was no significant difference in serum peroxidase antibody (TPO-Ab) and TCM syndrome score between the two groups before treatment (P 0.05). The TPO-Ab concentration in each group before and after treatment showed statistical difference (P 0.05), and there was no difference between the two groups (P 0.05). (2) Compared with the scores of TCM syndromes in the group, the scores of the two groups were significantly decreased after treatment, and the comparison data was statistically significant (P 0.01); The improvement of the treatment group was significantly better than that of the two groups (P 0.01). The total effective rate of the treatment group and the control group were 86.7% and 50%, respectively. The curative effect of the treatment group was better than that of the control group. The rank sum test showed statistical significance (P 0.01). Conclusion: The combination of Xiaochaihu Granule and Xiaoyao Pill can reduce the concentration of TPO-Ab in Hashimoto's disease patients. Selenium yeast capsule was also effective in reducing the concentration of TPO-Ab, but the treatment group was superior to the control group in improving clinical symptoms.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【参考文献】