中西医结合治疗毒性结节性甲状腺肿临床观察

Therapeutic Effect of Integrated Chinese and Western Medicine on Toxic Nodular Goiter

目的:观察甲巯咪唑片联合活血消瘿片治疗毒性结节性甲状腺肿的临床疗效。方法:将68例患者按就诊序号随机分为2组,完成试验者60例,治疗组30例,采用甲巯咪唑片联合活血消瘿片治疗;对照组30例,采用单纯甲巯咪唑片治疗。疗程3月。观察甲状腺功能游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPoAb)、甲状腺球蛋白抗体(TgAb)的变化,甲状腺彩超的变化,及安全性(血常规、肝肾功能)。结果:总有效率治疗组为80.0%,对照组为53.3%,2组比较,差异有显著性意义(P<0.05)。2组治疗前后FT4、FT3、TSH、TPoAb、TgAb组内比较,差异均有显著性意义(P<0.05);2组治疗后组间比较,差异均有显著性意义(P<0.05)。2组治疗前后最大结节直径组内比较,差异有显著性意义(P<0.05);2组治疗后组间比较,差异也有显著性意义(P<0.05)。治疗期间,治疗组有1例发生药物性皮疹,1例月经量过多、经期延长;对照组1例白细胞减少。肝功能、肾功能均未发生显著改变。结论:甲巯咪唑片联合活血消瘿片治疗毒性结节性甲状腺有较好疗效。

Objective. To observe the therapeutic effect of Thiamazole Tablets combined with Huoxue Xiaoying Tablets for toxic nodular goiter（TNG）. Methods： Sixty-eight TNG patients were randomly assigned to treatment group and control group according to the visit sequence. At the end of the study, 60 patients finished the trial. The treatment group had 30 patients and was given Thiamazole Tablets combined with Huoxue Xiaoying Tablets, and the control group also had 30 patients and was given Thiamazole Tablets alone. The treatment lasted for 3 months. Before and after treatment, we observed the serum levels of free thyroxine（FT4）, free 3, 5, 3＇-triiodothyronine（FT3）, thyroid-stimulating hormone（TSH）, thyroid peroxidase antibody（TPoAb） and thyroglobulin antibody（TgAb）, performed color ultrasonography of thyroid gland, and monitored the safety. Results. The total effective rate was 80.0% in the treatment group and was 53.3% in the control group, the differences being significant（P〈 0.05）. FT4, FT3, TSH, TPoAb and TgAb were improved in both groups after treatment（P 〈 0.05 compared with those before treatment）, and the improvement was obvious in the treatment group（P 〈 0.05 compared with the control group）. The size of the biggest thyroid nodule was reduced in both groups after treatment （P 〈 0.05 compared with that before treatment）, and the improvement was obvious in the treatment group（P 〈 0.05 compared with the control group）. During the treatment, drug-induced skin rash occurred in one patient of the treatment group, menorrhagia and bradymenorrhea occurred in one patient of the treatment group, and leucopenia occurred in one patient of the control group. No renal or hepatic damage was found in both groups.Conclusion： Thiamazole Tablets combined with Huoxue Xiaoying Tablets has better effect for the treatment of toxic nodular goiter.