甲状腺机能亢进症患者消化道功能异常的探讨

Study on gastroentestinal function disorders of patients with hyperthyroidism

目的探讨甲状腺机能亢进症患者胃肠道功能的改变。方法观察104例甲亢患者的胃肠道症状,其中23例检测胃、结肠电,并进行分析。结果发现甲亢患者存在胃肠功能紊乱的症状,如多食易饥58.7%,食后腹胀38.5%。恶心、呕吐19.2%,便溏、便频45.2%,便硬、便难22.1%。甲亢不同证型的胃肠道症状出现频率有一定差异:多食、易饥以肝胃火旺型为多,同胃热程度较重有关;食后腹胀、恶心呕吐、大便改变则气阴两虚型较多,同肝脾不和有关;多食、易饥出现的频率,便溏、便频的程度同甲状腺激素的含量呈正相关,与甲状腺激素加速人体的新陈代谢、刺激肠蠕动加快有关;甲亢患者的体表胃肠电活动异常,能解释甲亢患者有关胃肠道症状的某些发生机制。结论甲亢患者存在胃肠道功能紊乱。

AIMS To study the relation of hyperthyroidism and gastroentestinal functions. METHODS Gastroentestinal symptoms of 104 patients with hyperthyroidism were observed and eletrogastrocolonogram (EGCOG) of 23 cases were examined. RESULTS The incidence of polyorexia was 59%, postprandial distension 38%, nausea and/or vomiting 19%, loose stool or diarrhea 45%, and constipation or dyschesia 22%; indicating that the patients with hyperthyroidism had obvious symptoms of gastroentestinal function disorder. Polyorexia was more frequent in patients with the syndrome of Gan wei huo wang, which was close correlated with the Weire. But the postprandeal distension nausea and vomiting changes of stool were more in patients with the syndrome of both Qi and Yin deficiency, which was related to Ganpibuhe. The frequency of polyorexia and the degree of loose stool or diarrhea was postitively corretated with the serum contents of thyroid hormones. Hyperth yroidism patients had abnormalities of EGCOG, which could explain some mechanism of gastroenestinal symptoms occured in hyperthyroidism. CONCLUSIONS The relation of hyperthyroidism and gastroentestinal function is revealed preliminaryly.