中药内服治疗甲状腺功能亢进症的临床研究

Clinical Study on Hyperthyroidism with Chinese Herbs for Oral Administration

目的探讨中药内服治疗甲状腺功能亢进症的临床疗效。方法 2013年1月至2016年12月将收治的初发或复发甲亢患者70例随机分为对照组与治疗组,每组35例。两组患者均给予一般治疗,嘱其适当休息,避免精神紧张和过度劳累,避免高碘食物和药物。在此基础上对照组采用西药甲巯咪唑,治疗组在对照组基础上根据患者不同的症状辨证分为气机郁结型、痰瘀互结型、心肝火旺型、心肝阴虚型4型,分别给予不同的中药方剂治疗。观察两组患者治疗后临床疗效及甲状腺激素[血清总三碘甲腺原氨酸(TT_3)、血清总甲状腺素(TT_4)、血清游离三碘甲腺原氨酸(FT_3)和血清游离甲状腺素(FT_4)、促甲状腺激素(TSH))]、甲状腺TSH受体抗体(TRAb)情况,对血尿常规、肝肾功能等安全性指标进行检测。结果两组患者治疗后,对照组总有效率为71.4%,治疗组为94.3%,治疗组总有效率明显高于对照组(P<0.05)。两组治疗后,血清甲状腺激素各指标TT_3、TT_4、FT_3、FT_4水平及相关抗体TRAb均明显下降,TSH水平明显升高,与本组治疗前比较差异有统计学意义(P<0.05);且治疗组各指标水平下降和升高程度均明显优于对照组(P<0.05)。两组患者治疗期间,对照组不良反应率为25.7%,治疗组为8.6%,治疗组不良反应发生率明显低于对照组(P<0.05)。结论中药辨证分型结合西药治疗甲状腺功能亢进患者临床疗效确切,不良反应少,值得推广。

Objective To investigate the clinical efficacy on hyperthyroidism treated with Chinese herbs for oral administration. Methods 70 patients with primary or recurrent hyperthyroidism were randomly divided into control group and treatment group from January 2013 to December 2016, each with a total of 35 cases. Two groups were given general treatment, proper rest, avoiding mental stress and overwork and high iodine food and medicine. The control group was treated with methimazole. The treatment group was treated with different treatment prescription according to different symptoms differentiated as qi stagnation, phlegm and blood stasis, heart and liver yin deficiency, liver yin deficiency. The clinical efficacy, thyroid hormone （TT3 , TT4 ,TT3, FT4, TSH ）and thyroid TSH receptor antibody （TRAb）were observed before and after treatment. Blood and urine routine, liver and kidney function and other safety indicators were examined. Results After treatment,the total effective rate was 71.4% in the control group, the treatment group was 94.3% , the total effective rate in the treatment group was significantly higher than that in the control group（P 〈0.05）. Compared to before treatment, serum thyroid hormone TT4 , the indexes of TT3 , FT3 , FW4 levels and antibodies of TRAb were significantly decreased and TSH level was significantly increased in two groups after treatment（ P 〈 0.05 ）. The control group adverse reaction rate was 25.7%, treatment group was 8.6%, the difference between the two groups was significant （ P 〈 0.05 ） during treatment （ P 〈 0.05 ）. Conclusion The clinical curative effect of Chinese herbs for oral administration and western medieine in treating of hyperthyroidism is obvious, little adverse reactions, which is worthy of spreading.