甲状腺结节手术切除后中医用药规律分析

Analysis on Rule of Traditional Chinese Medicine in the Treatment of Thyroid Nodules by Surgical Resection

目的:采用回顾性研究方法分析甲状腺结节手术切除后中药用药特点。方法:收集广东省中医院2015年1—8月244例因甲状腺结节行手术切除患者的资料,包括人口学信息、结节的病理诊断、首剂中药等。结果:244例患者男女比例1∶3.9;良性结节170例,良性组平均年龄(48.7±13.8)岁;恶性结节74例,恶性组平均年龄(42.0±12.7)岁;累计使用中药频次2697次,使用较多为清热药、解表药、补虚药、化痰药、理气药、活血化瘀药。聚类分析结果表明:生姜、大枣、升麻、黄芪、当归为一类,党参、白术、柴胡为一类,法半夏、茯苓、枳壳为一类,芦根、淡竹叶、淡豆豉、金银花、薄荷、连翘、牛蒡子、桔梗、荆芥为一类。结论:青年及中年人的甲状腺结节更倾向于恶变,需要手术治疗,行手术切除的甲状腺结节患者术后常见风热痰瘀之邪犯于头颈部,清热解表化痰利咽为其主要治则。

Objective： To study the characteristics of traditional Chinese medicine of surgical removal of thyroid nodules. Methods： The data of patients with thyroid nodules underwent surgical resection from January to August, 2015 in Guangdong Province Traditional Chinese Medical Hospital were collected, including demo- graphic information, pathological diagnosis, first dose of traditional Chinese medicine and so on. Results： The ratio of male to female ratio was 1：3.9 in 244 cases. There were 170 cases of benign nodules, with mean age （48.7＋13.8） years old, 74 cases of malignant nodules in malignant group, with mean age （42.0-＋12.7） years old. Cumulative use of Chinese medicine frequency 2697, widely used for heat clearing drugs, medicine, virtual medicine, drugs for resolving phlegm, regulating Qi, promoting blood circulation to remove blood stasis. Cluster analysis results show that Shengj＇iang （ginger）, Dazao （jujube）, Shengma （Cimicifuga）, Huangqi （Astragalus） and Dangui （angelica） for a class, Dangshen （Codonopsis）, Baizhu （Atractylodes, Chaihu （bupleurum root） for a class, Fabanxia （pinellia）, Fuling （Poria）, Zhiqiao （Fructus aurantii） for a class, Lugen （reed root）, Danzhuye （lophatherum gracile）, Dandouchi （light Douchi）, Jinyinhua （honeysuckle）, Bohe （mint）, Lianqiao （forsythia）, Ni- ubanzi （buff）, Jiegeng （Balloonflower root）, Jingjie （Schizonepeta） for a class. Conclusion： The young and middle- aged thyroid nodules are more prone to malignant transformation, need operation treatment, surgical resection of thyroid nodule patients after common wind heat and stagnation of phlegm evil invading in the head and neck, and clearing heat and relieving exterior phlegm throat is the main treatment.