20例老年淡漠型甲亢中医诊治

TCM diagnosis and treatment of 20 cases of elderly apathetic hyperthyroidism

目的结合有关文献及临床病例分析探讨老年淡漠型甲亢的主要病机及与地理环境、体质因素、情志失调的相关性。方法采用SPSS 17.0统计学软件包进行聚类分析和频数分析,对20例老年淡漠型甲亢患者进行病因分析及证型分类。结果中医证型分为:气阴两虚、血瘀痰阻,肾阳亏虚、脾虚湿盛,肾虚不固、冲任失调,心肝阴虚,气滞痰瘀5个证型,因症状多不典型,故常易漏诊和误诊,经特异性治疗后,症状多能控制。结论临证应辨明虚实,以补其不足为治疗第一要务,着重益气养阴,密切结合病位的不同而选方用药,加强治疗的针对性。同时结合实验室检查,做到及早诊断、及早预防。

Objective By combining literature research and analysis of clinical cases, we summed up the main pathogenesis of senile apathetic hyperthyroidism. It is closely related with geographical environment, imbalance of physical factors and emotional disorders.Methods SPSS 17.0 statistical software package was used to have analysis of cluster, frequency, the cause of disease and syndrome-classification. Results The TCM syndrome types are divided into these five types： deficiency Qi and Yin, blood stasis phlegm obstruction;kidney Yang deficiency, damp abundance due to spleen asthenia; deficiency of kidney; disharmony of the thoroughfare and controlling vessels; deficiency of Yin of both the heart and liver; stagnation of Qi and phlegm and blood stasis. Because the symptoms are not typical, they are often missed and misdiagnosed. With specific treatment, the symptoms can be controlled. Conclusion Doctors should identify the actual situation. Tonifying deficiency should be given priority. We should also attach importance to supplementing Qi, nourishing Yin and selecting different prescriptions on different locations of diseases. Strengthening targeted therapy combined with laboratory examination was used to have early diagnosis and prevention.