四君子汤合肾气丸治疗原发性甲状腺功能减退症疗效观察

Observation of the clinical effects of modified treatment with sijunzi decoction and shenqi pills for primary hypothyroidism

目的：观察四君子汤合肾气丸治疗脾肾阳虚型原发性甲状腺功能减退症（甲减）的临床疗效。方法将62例脾肾阳虚型甲减患者按数字表法随机分为对照组30例、治疗组32例。对照组予以左旋甲状腺素片口服，每天1次；治疗组在对照组治疗的基础上加四君子汤合肾气丸煎服，每天1剂，分3次口服；两组治疗周期为4个月，观察两组临床疗效。结果治疗组总有效率为96．9％，高于对照组的80．0％（χ2＝4.402，P＜0．05）；两组治疗前后中医症候积分均明显降低（t＝21．40、25．40，均P＜0．01），且治疗组降低幅度更明显（t＝4．30，P＜0．01）；两组治疗前后TSH、FT3、FT4均明显改善（对照组：t＝5．31、1．14、4．13，治疗组：t＝6．27、1．85、6．08，均P＜0．01），且治疗组较对照组改善程度更明显（t＝1．33、0．67、2．78，均P＜0．05）。结论四君子汤合肾气丸能明显改善脾肾阳虚型甲减的中医症候，对甲状腺功能也有明显的改善，该方法治疗脾肾阳虚型甲减有明显的临床疗效。

Objective To observe the clinical curative effect of sijunzi decoction composite with shenqi pills in the treatment of spleen and kidney yang deficiency syndrome in patients with primary hypothyroidism（hypothyroid-ism）.Methods 62 spleen kidney yang deficiency patients with hypothyroidism were randomly divided into 30 cases in the control group and 32 cases in the treatment group.Patients in the control group were given L-thyroxine tablets orally,once a day;patients in the treatment group were given sijunzi decoction combined with shenqi pills for decoc-tion,daily 1 agent,3 times a day orally,on the basis of the control treatment group.Two groups treatment cycle were 4 months,and the clinical efficacy of the two groups were observed.Results The treatment group total effective rate was 96.9%,which was higher than that in the control group 80.0%（χ2 =4.402,P〈0.05）;before and after treat-ment,TCMsyndrome scores were significantly decreased in the two groups （t=21.40,25.40,all P〈0.01）and treatment group decreased more significantly（t=4.30,P〈0.01 ）.Before and after treatment,TSH,FT3,FT4 in the two groups were significantly improved （control group：t=5.31,1.14,4.13,treatment group：t=6.27,1.85,6.08,all P〈0.01）,and the degree of improvement in treatment group was more obvious compared with the control group （t=1.33,0.67,278,all P〈0.05）.Conclusion Sijunzi decoction and shenqi pills can significantly improve the clinical symptoms of primary hypothyroidism of spleen-kidney yang deficiency type in addition to thyroid function and blood lipid,indicating that this method is capable of achieving satisfactory clinical effects in treating primary hypothyroidism of spleen-kidney yang deficiency type.