疏肝活血法治疗肝郁血瘀型甲状腺功能亢进症临床研究

发布时间：2018-11-11 17:45

【摘要】：目的:通过观察运用疏肝活血法治疗原发性甲状腺功能亢进症中医辨证为肝郁血瘀型患者的临床症状、体征、理化检查指标,评价其治疗效果及临床意义。方法:病例来源为2016年1月-2016年12月北京中医药大学东直门医院内分泌科门诊及住院患者符合纳入标准者50例。采用随机对照方法分为治疗组25例,对照组25例,治疗组采用基础治疗加疏肝活血中药加减治疗,对照组只用基础治疗。疗程为8周,观察患者临床症状、体征、及相关理化检查,记录病例报告表。将资料建立数据库,使用SPSS21.0软件进行统计分析,比较两组治疗前后症状、体征、甲状腺功能及中医证候量化评分以评估临床疗效。结果:(1)中医证候疗效比较:治疗组总疗效92%,25例患者中痊愈2例、显效14例、有效7例、无效2例,对照组总疗效80%,25例患者中痊愈0例、显效4例、有效16例、无效5例,两组相比差异有统计学意义(P0.05)。(2)主要症状改善程度比较:两组治疗后症状均有明显改善,其中烦躁易怒、胸胁胀满、心悸、神疲乏力、多汗改善程度组间比较差异有统计学意义(P0.05)。(3)对甲状腺功能改善情况比较:两组FT3、FT4均有降低,TSH均有升高,治疗后组间比较差异无统计学意义(P0.05)。(4)对甲状腺肿大改善比较:治疗组治疗前后甲状腺肿大程度比较差异有统计学意义(P0.05),对照组治疗前后甲状腺肿大程度比较差异无统计学意义(P0.05)。(5)两组安全性比较:治疗组25例中出现肝功能异常者1例、白细胞减少者1例,对照组25例中出现肝功能异常者2例、白细胞减少者3例,组间比较差异无统计学意义(P0.05)。结论:(1)疏肝活血法联合西药治疗甲状腺功能亢进症疗效优于单纯西药治疗。(2)疏肝活血法在改善甲状腺肿大及烦躁易怒、胸胁胀满、心悸、神疲乏力、多汗等症状方面更具优势。(3)疏肝活血法联合西药治疗甲状腺功能亢进症在改善甲功及副作用方面与单纯西药治疗相比疗效相当。
[Abstract]:Objective: to observe the clinical symptoms, signs, physical and chemical indexes of patients with primary hyperthyroidism treated with the method of soothing liver and activating blood circulation, and to evaluate its therapeutic effect and clinical significance. Methods: from January 2016 to December 2016, 50 patients in the Department of Endocrinology and Endocrinology of Dongzhimen Hospital, Beijing University of traditional Chinese Medicine, met the inclusion criteria. 25 cases were divided into treatment group (n = 25) and control group (n = 25). The treatment group was treated with basic treatment plus traditional Chinese medicine for dispersing liver and activating blood circulation, while the control group was treated only with basic therapy. The course of treatment was 8 weeks. The clinical symptoms, signs, physical and chemical examinations were observed, and case report forms were recorded. The data base was set up and SPSS21.0 software was used for statistical analysis. The symptoms, signs, thyroid function and TCM syndromes were compared between the two groups before and after treatment to evaluate the clinical efficacy. Results: (1) comparison of TCM syndromes efficacy: in the treatment group, 2 cases were cured, 14 cases were effective, 7 cases were effective and 2 cases were ineffective. In the control group, the total curative effect was 80%. There were significant differences between the two groups (P0.05). (2). The main symptoms of the two groups were improved after treatment, including irritability, fullness of chest and flank, palpitation, fatigue, and so on. There was significant difference in the degree of hyperhidrosis between the two groups (P0.05). (3). The results showed that FT3,FT4 was decreased and TSH was increased in both groups. There was no significant difference between the groups after treatment (P0.05). (4) on the improvement of goiter: there was significant difference in the degree of thyroid enlargement before and after treatment in the treatment group (P0.05). There was no significant difference in the degree of thyroid enlargement between the two groups before and after treatment (P0.05). (5). In the treatment group, there were 1 case of abnormal liver function, 1 case of leukopenia, 1 case of abnormal liver function and 1 case of leukopenia. There were 2 cases of abnormal liver function and 3 cases of leukopenia in the control group. There was no significant difference between the two groups (P0.05). Conclusion: (1) the curative effect of soothing liver and activating blood circulation method combined with western medicine in treating hyperthyroidism is better than that of western medicine alone. (2) soothing liver and activating blood circulation method can improve goiter and irritability, chest distention, palpitation and fatigue. Hyperhidrosis and other symptoms have more advantages. (3) the treatment of hyperthyroidism with the method of soothing liver and activating blood circulation combined with western medicine is the same as that of western medicine alone in improving thyroid function and side effects.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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