消瘿扶正平瘤汤辅助手术治疗甲状腺癌的疗效观察

Observation on Efficacy of Xiaoying Fuzheng Pingliu Decoction(消瘿扶正平瘤汤)Supplemented with Surgery on Thyroid Cancer

目的探讨消瘿扶正平瘤汤辅助手术治疗甲状腺癌的效果和预后,以及对外周血细胞角蛋白19(CK19)、多态性上皮黏蛋白(MUC1)表达水平的影响。方法选取2017年1月—2020年1月该院收治的68例甲状腺癌患者,用计算机随机数字法分为观察组和对照组各34例。两组患者均行全甲状腺切除术+相应淋巴结治疗性清扫,术后予以;I治疗。对照组患者予以左甲状腺素钠片口服,观察组患者在对照组基础上予以消瘿扶正平瘤汤治疗。观察两组患者治疗前后临床症状评分、甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]变化情况,比较外周血微转移表达情况和淋巴结转移、复发情况。结果治疗3个月后,两组患者甲状腺肿大、甲状腺疼痛、畏寒、发热等临床症状评分以及血清FT3、FT4、IL-6、CRP、TNF-α水平均较治疗前降低,且观察组低于对照组(P<0.05),两组患者血清TSH水平较治疗前升高,且观察组高于对照组(P<0.05)。治疗1个月、3个月后,观察组患者外周血CK19、MUC1阳性表达率均低于对照组(P<0.05)。随访1年,两组患者均有1例出现淋巴结转移,复发率分别为5.88%(2/68)、11.76%(4/68),组间比较差异无统计学意义(P>0.05)。结论消瘿扶正平瘤汤辅助手术治疗甲状腺癌具有良好的疗效和预后,可显著改善临床症状和甲状腺功能,降低炎症水平,对外周血微转移有抑制作用。

Objective To explore the effects and prognosis of Xiaoying Fuzheng Pingliu Decoction(消瘿扶正平瘤汤)supplemented with surgery on thyroid cancer,and its influence on expression levels of peripheral blood cytokeratin 19(CK19)and polymorphic epithelial mucin(MUC1).Methods A total of 68 patients with thyroid cancer admitted to our hospital from January 2017 to January 2020 were selected and divided into observation group and control group by computer random number method,with 34 cases in each group.Patients in the two groups underwent total thyroidectomy and therapeutic lymph node dissection,and received 131I treatment after surgery.Patients in control group were given levothyroxine sodium tablets orally,and those in observation group were given Xiaoying Fuzheng Pingliu Decoction on the basis of control group.The clinical symptoms scores,thyroid function[free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH)]and inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]were observed in the two groups before and after treatment,and the expression of peripheral blood micrometastasis and lymph node metastasis and recurrence were compared.Results After 3 months of treatment,the scores of clinical symptoms such as goiter,thyroid pain,intolerance of cold and fever and levels of serum FT3,FT4,IL-6,CRP and TNF-αof the two groups were lower than those before treatment,and the scores and levels in the observation group were lower than those in the control group(P<0.05),the serum TSH level of the two groups was higher than that before treatment,and the level in the observation group was higher than that in the control group(P<0.05).After 1 and 3 months of treatment,the positive expression rates of CK19 and MUC1 in peripheral blood of the observation group were lower than those of the control group(P<0.05).After 1-year follow-up,there was 1 case of lymph node metastasis in each group,and the recurrence rates were 5.88%(2/68)and 11.76%(4/68)respectively(P>0.05).Conclusion Xiaoying Fuzheng Pingliu Decoction has a good efficacy and prognosis in the treatment of thyroid cancer.It can significantly improve clinical symptoms and thyroid function,reduce inflammation level and inhibit peripheral blood micrometastasis.