四逆汤对肾阳虚危重症患者甲状腺功能的影响
发布时间：2019-01-24 11:57
【摘要】：目的：本研究旨在研究四逆汤对肾阳虚危重症患者甲状腺功能的影响。通过研究患者外周血甲状腺激素及血清白蛋白的变化情况,初步评价四逆汤对肾阳虚危重症患者甲状腺功能的影响,并探讨其可能的机制,可为中医药微观治疗肾阳虚危重症患者提供新的思路和参考。方法：采用前瞻、随机、单盲、对照研究,对2015年3月-2016年3月入住广州中医药大学第一附属医院ICU、CCU 46名住院危重症患者进行调查,按照纳入标准、排除标准1：1随机分成对照组及治疗组。所有纳入研究的患者在血流动力学稳定、内环境趋于稳态、无肠内营养禁忌症的情况下,早期开始鼻饲肠内营养(24-48小时),治疗组同时用胃管／鼻空肠管灌入四逆汤50ml bid,疗程共7天。分别收集患者的四诊资料,并记录患者予以四逆汤干预前一天和第七天外周血甲功五项(TSH、FT3、FT4、 TT3、TT4)、白蛋白、急性生理学与慢性健康状况Ⅱ (APACHE Ⅱ)评分,采用SPSS20.0统计软件包进行数据处理。计量资料用均数±标准差表示(X±s),两组均数的比较用t检验,组内治疗前后比较用配对t检验,计数资料采用秩和检验,相关性比较采用直线相关分析,P0.05.为差异有统计学意义。通过相关统计学计算,评估四逆汤对肾阳虚危重症患者甲状腺功能的影响。结果：治疗组23例,对照组23例。研究前治疗组与对照组的性别构成比、年龄、APACHE Ⅱ评分等指标差异无统计学意义,治疗前治疗组与对照组所测得TT3、TT4、FT3、FT4、TSH和ALB的变化无明显差异。治疗7天后,研究组与治疗组TT3、TT4、FT3和FT4的变化均明显提升,治疗组高于对照组。治疗组总体疗效优于对照组,并且肠内营养不耐受的胃肠道并发症少于对照组。结论：①四逆汤能够有效改善肾阳虚危重症患者甲状腺功能,特别是合并有心力衰竭患者效果更优；②低蛋白血症对于NTIS发病机制密切相关；③甲状腺激素动态变化能够作为患者病情、预后分析的危险因素之一,特别是与其他预后因素相结合,能提高对患者病情危险性的判断。
[Abstract]:Objective: to study the effect of Sini decoction on thyroid function in severe patients with deficiency of kidney-yang. By studying the changes of thyroid hormone and serum albumin in peripheral blood of patients, the effect of Sini decoction on thyroid function in patients with severe deficiency of kidney yang was evaluated, and the possible mechanism was discussed. It can provide new ideas and references for micro-treatment of critical patients with deficiency of kidney yang. Methods: a prospective, randomized, single-blind, controlled study was conducted on 46 ICU,CCU patients admitted to the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine from March 2015 to March 2016. The exclusion criteria were randomly divided into control group and treatment group at 1:1. All patients in the study started nasogastric enteral nutrition (24-48 hours) at an early stage with stable hemodynamics, homeostasis, and no contraindications for enteral nutrition. The treatment group was treated with 50ml bid, for 7 days. The data of four diagnoses were collected, and the scores of five items (TSH,FT3,FT4, TT3,TT4), albumin, acute physiology and chronic health status 鈪，
本文编号：2414453
[Abstract]:Objective: to study the effect of Sini decoction on thyroid function in severe patients with deficiency of kidney-yang. By studying the changes of thyroid hormone and serum albumin in peripheral blood of patients, the effect of Sini decoction on thyroid function in patients with severe deficiency of kidney yang was evaluated, and the possible mechanism was discussed. It can provide new ideas and references for micro-treatment of critical patients with deficiency of kidney yang. Methods: a prospective, randomized, single-blind, controlled study was conducted on 46 ICU,CCU patients admitted to the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine from March 2015 to March 2016. The exclusion criteria were randomly divided into control group and treatment group at 1:1. All patients in the study started nasogastric enteral nutrition (24-48 hours) at an early stage with stable hemodynamics, homeostasis, and no contraindications for enteral nutrition. The treatment group was treated with 50ml bid, for 7 days. The data of four diagnoses were collected, and the scores of five items (TSH,FT3,FT4, TT3,TT4), albumin, acute physiology and chronic health status 鈪，
本文编号：2414453
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