柴夏滋阴方剂治疗Grave’s病的临床研究

Clinical Research on Treatment of Graves' Disease With Chaixia Nourishing Yin Prescription

目的:探讨中药柴夏滋阴方剂治疗Grave’s病的疗效和安全性。方法:选择Grave’s病患者119例,分为柴夏滋阴方剂组89例(观察组),丙基硫氧嘧啶组30例(对照组)。观察组患者煎服中药柴夏滋阴方剂,150ml/次,每日3次;对照组口服丙基硫氧嘧啶片50～100mg/次,3次/d,各组疗程3月。比较两组患者治疗前、后甲状腺功能、面积、重量、24h摄碘率、血常规、肝肾功能和电解质变化。结果:两组患者治疗1个月后血清FT3、FT4浓度均明显降低,3月后部分患者甲状腺功能正常,部分接近正常,与治疗前比较,两组均有极显著性差异(P<0.001),但两组间比较疗效无显著性差异(P>0.05)。治疗3个月后,观察组甲状腺面积、重量、24h摄碘率均较治疗前有明显好转(P<0.05);对照组24h摄碘率也较治疗前有显著差异(P<0.05),但甲状腺面积、重量较治疗前无显著性差异(P>0.05)。观察组中合并白细胞低下、肝功能受损者1个月后均恢复正常。两组患者肾功能、电解质治疗前、后均无显著性差异(P>0.05)。结论:柴夏滋阴方剂可明显改善患者甲状腺功能、缩小甲状腺肿、降低摄碘率,且能提升白细胞,对肝肾功能及电解质无影响。

Objective： To investigate the efficacy and safety of Chinese medicine chaihu nourishing yin prescription in treatment of Graves＇ disease （GD）. Methods： One hundred and ninteen GD patients with hyperthyroidism were divided into two groups： treatment group （89 cases） and control group（30 cases）. Treatment group were oral ly given Chinese medicine（150 ml,t. i. d）, control group were orally given P. T. U（50-100 mg, t. i. d）. All cases had been treated for three months. Thyroid function, thyroid area and weight, 24 hours ^131 I uptake rate, liver and renal function, blood routine and electrolytes were determined before and after treatment and compared between two groups. Results： Concerntration of serum FT3, FT4 reduced significantly one month after treatment in both groups. Thyroid function became normal or nearly normal three months later. There was significant difference in thyroid function compared with that of before treatment in both groups（P〈0. 001 ）, but there was no significant difference in therapeutic effect between two groups（P〉0. 05）. Thyroid area, weight and 24 hours ^131 I uptake rate were significantly improved 3 months after treatment compared with those before treatment（P〈0. 05）. There was significant difference in 24 hours ^131 I uptake rate in control group before and after treatment （P〈0. 05）, but there were no significant differencs in thyroid area and weight（P〈0. 05）. All patients with leukopenia and/or liver disfunction in treatment group recovered obviously after one month（P〈0. 05）. There were no significant differences in renal function and electrolytes in two groups （P〉0. 05）. Conclusion： Chaihu nourishing yin prescription can signifi cantly improve symptoms of hyperthyroidism and thyroid function, reduce thyroid mass and ^131 I uptake rate, increase leucocytic count, and it has no side effect on liver and renal function and neither on electrolyte levels.