柴胡疏肝汤加减治疗对肝郁气滞型甲状腺功能亢进患者甲状腺上动脉血流动力学及甲状腺功能的影响

Effect of Modified Chaihu Shugan Decoction on Hemodynamics of Superior Thyroid Artery and Thyroid Function in Patients Liver Stagnation and Qi Stagnation with Hyperthyroidism

目的观察柴胡疏肝汤加减治疗对肝郁气滞型甲状腺功能亢进(HT)患者甲状腺上动脉血流动力学及甲状腺功能的影响.方法选取2020年11月—2021年10月于本院接受治疗的肝郁气滞型HT患者84例为研究对象,依据随机数字表法分为两组,每组42例.对照组口服甲巯咪唑片治疗,观察组在此基础上服用柴胡疏肝汤加减治疗,均连续治疗12周.比较两组的甲状腺上动脉血流动力学、甲状腺功能、临床疗效及不良反应.结果治疗后,观察组的血流舒张末期血流速度、收缩期峰值分别为(0.18±0.08)m/s、(0.35±0.17)m/s,均低于对照组,组间差异有统计学意义(P<0.05).治疗后,观察组的促甲状腺激素水平为(1.79±0.54)μIU/mL,高于对照组,三碘甲状腺原氨酸、四碘甲状腺原氨酸、游离甲状腺素、游离三碘甲状腺原氨酸水平分别为(2.34±0.34)nmol/L、(84.25±12.43)nmol/L、(18.64±6.34)pg/mL、(5.64±3.45)pg/mL,均低于对照组,组间差异有统计学意义(P<0.05).观察组的治疗总有效率为95.24%,高于对照组的80.95%,差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论肝郁气滞型HT患者采用柴胡疏肝汤加减治疗可提高临床疗效,改善甲状腺上动脉血流动力学及甲状腺功能,安全可靠.

Objective To observe the effect of modified Chaihu Shugan Decoction on hemodynamics and thyroid function of superior thyroid artery in patients with liver stagnation and Qi stagnation hyperthyroidism(HT).Methods A total of 84 patients with liver stagnation and Qi stagnation HT who received treatment in the hospital from November 2020 to October 2021 were selected as the research subjects.They were divided into two groups according to random number table method,with 42 patients in each group.The control group was treated with methimazole tablets orally,and the observation group was treated with modified Chaihu Shugan Decoction on this basis.Both groups were treated for 12 weeks.The hemodynamics of superior thyroid artery,thyroid function,clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the end diastolic velocity and systolic peak value in the observation group were(0.18±0.08)m/s and(0.35±0.17)m/s,respectively,lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the thyroid stimulating hormone level in the observation group was(1.79±0.54)μIU/mL,which was higher than that in the control group,the levels of triiodothyronine,tetraiodothyronine,free thyroxine and free triiodothyronine were(2.34±0.34)nmol/L,(84.25±12.43)nmol/L,(18.64±6.34)pg/mL and(5.64±3.45)pg/mL,respectively,lower than those of the control group,the differences between groups were statistically significant(P<0.05).The total effective rate of observation group was 95.24%,higher than 80.95%of control group,the difference was statistically significant(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion Modified Chaihu Shugan Decoction can improve clinical efficacy,blood flow dynamics of superior thyroid artery and thyroid function in HT patients with liver stagnation and Qi stagnation,and it is safe and reliable.