中西医结合治疗甲状腺功能亢进症近期疗效及远期复发率观察

Term Effect and Long-Term Recurrence Rate of Hyperthyroidism Treated by Traditional Chinese Combined with Western Medicine

目的:探讨中药对甲状腺功能亢进症的临床疗效。方法:将符合标准的102例患者随机分为两组,对照组50例采用甲巯咪唑治疗,观察组52例在对照组基础上加用中药辨证论治,肝郁气滞化火者用柴胡疏肝散加减,阴虚火旺、痰淤凝结者用知柏地黄丸合消瘰丸加减,气阴两虚兼痰瘀互结者予以生脉散、二至丸合消瘰丸加减。结果:观察组和对照组临床痊愈率分别为42.31%、24.00%,总有效率分别为84.62%、76.00%,不良反应总发生率分别为7.69%、16.00%,组间比较,差异均有统计学意义(P<0.05)。治疗后第1个月,观察组症状总积分低于对照组,但差异无统计学意义(P>0.05);自治疗后第3个月起,组间比较,差异均有统计学意义(P<0.05)。治疗后两组TT3、TT4、FT3、FT4和TRAb均降低,TSH升高,组间比较,差异均有统计学意义(P<0.05)。观察组复发率45.45%,对照组复发率66.67%。结论:甲巯咪唑联合中药辨证论治用于甲状腺功能亢进症,可有效改善患者临床症状和甲状腺功能,降低药物不良反应发生率,减少复发。

Objective： To study the clinical curative effect of traditional Chinese medicine （TCM） on treating hyper- thyroidism. Methods： 102 patients were conformed to the standard and were randomly divided into two groups. The con- trol group had 50 cases and used the sulfhydryl imidazole therapy. The observation group had 52 cases and added TCM treatment on the basis of control group＇s treatment based on syndrome differentiation. Liver depression and qi stagnation syndrome was treated with modified Chaihu Shugan powder. Yin fire excess and phlegm and stasis accumulation syndrome was treated with Zhibai Dihuang Pill and Xiaoluo Pill. Results： The clinical cure rates of observation group and control group were 42.31% and 24.00% , respectively. The total effective rates were 84.62% and 76.00% , respectively. The total incidence of adverse reactions rates were 7.69% and 16.00%, respectively. Comparison between groups had statis- tical significance （P 〈 0.05）. After 1 month treatment, the total score of observation group was lower than that of the control group, but there was no statistically significant difference （ P 〉 0.05 ）. After 3 months treatment, comparsion be- tween groups had statistical significance （ P 〈 0.05 ）. Two groups after treatment, 333, TF4, FT3, FT4 and TRAb were lower, TSH was higher, comparison between two groups had statistical significance （P 〈0.05 ）. The recurrence rate of observation group was 45.45%, and that of control group was 66.67%. Conclusion ：Sulfhydryl imidazole combined with traditional Chinese medicine can effectively treat hyperthyroidism and improve the clinical symptoms and thyroid function, reduce the incidence of adverse drug reactions, and reduce recurrence.