小柴胡汤加减治疗急性期亚急性甲状腺炎

Clinical Study on Treatment of Subacute Thyroiditis in Acute Stage with Modified Minor Bupleurum Decoction

目的:观察小柴胡汤加减治疗急性期亚急性甲状腺炎(subactute thyroiditis,SAT)的临床疗效。方法:选择2012年5月至2015年5月在新乡医学院第一附属医院中西医结合科门诊和住院部就诊的SAT患者30例,按数字表法随机分为治疗组和对照组,每组15例。对照组给予泼尼松片治疗,治疗组在对照组治疗的基础上给予小柴胡汤加减(免煎剂)治疗。结果:治疗组丙二醛、总抗氧化能力、超氧化物歧化酶水平优于对照组(P <0. 05),差异有统计学意义;治疗组患者退热、疼痛明显减轻、甲状腺消肿时间均优于对照组(P <0. 05),差异有统计学意义;治疗组治疗后游离三碘甲状腺原氨酸、血清游离甲状腺素、促甲状腺激素、C-反应蛋白水平优于对照组(P <0. 05),差异有统计学意义;对照组有效率为80. 0%,治疗组有效率为93. 3%,两组有效率比较,差异具有统计学意义(P <0. 05);在治疗过程中,两组患者均未出现肝肾功能损害等不良反应。结论:小柴胡汤加减治疗急性期亚急性甲状腺炎有较好疗效,可以明显改善患者临床症状,且安全性较高。

Objective: To observe the clinical curative effect of Modified Minor Bupleurum Decoction on subacute thyroiditis( SAT)in acute stage. Methods: Thirty patients with SAT in the outpatient and inpatient departments of integrated traditional Chinese and Western medicine in the First Affiliated Hospital of Xinxiang Medical College from May 2012 to May 2015 were selected and randomly divided into the treatment group and the control group,with 15 cases in each group. The ones in the control group were treated with prednisone tablets,while the ones in the treatment group were treated with Modified Minor Bupleurum Decoction( decoction-free) on the basis of the control group. Results: The levels of malondialdehyde,total antioxidant capacity and superoxide dismutase in the treatment group were better than those in the control group( P < 0. 05),and the differences were statistically significant. The time of fever,pain relief and goiter detumescence in the treatment group were better than those in the control group( P < 0. 05),and the differences were statistically significant. After the treatment,the levels of free triiodothyronine,serum free thyroxine,thyrotropin and C-reactive protein in the treatment group were higher than those in the control group( P < 0. 05),and the differences were statistically significant. The effective rate of the control group was 80. 0%,and that of the treatment group was93. 3%. There was a significant difference between the two groups( P < 0. 05). During the treatment,there were no adverse reactions such as liver and kidney function damage in the two groups. Conclusion: Modified Minor Bupleurum Decoction has a remarkable clinical curative effect on subacute thyroiditis( SAT) in acute stage,can significantly improve the clinical symptoms of patients with high safety.