养阴清热消瘿方治疗甲状腺功能亢进的临床疗效及对激素水平的影响

Clinical Efficacy of Yangyin Qingre Xiaoying Recipe in Treating for Hyperthyroidism and Its Effect on Hormone Level

目的:观察养阴清热消瘿方治疗甲状腺功能亢进的临床疗效及对激素水平的影响。方法:将60例甲状腺功能亢进患者采用随机数字表法分为对照组和治疗组,每组30例。对照组给予甲巯咪唑片治疗,治疗组给予养阴清热消瘿方治疗,方药组成:熟地黄10 g,山萸肉10g,怀山药15 g,麦冬10 g,白芍10 g,五味子6 g,夏枯草15 g,白蒺藜10 g,枸杞子12g,牡丹皮12 g,甘草6 g。辨症加减:若气短者,加太子参10 g;出汗明显者,加浮小麦15 g;腰膝酸软明显者,加续断6 g,杜仲10 g。清水煎至200 m L,早晚温服,每日1剂,4周为1个疗程,共治疗3个疗程。观察两组患者中医证候积分、甲状腺激素水平、临床疗效和不良反应情况。结果:治疗后治疗组患者颈前肿大、腰膝酸软、口咽干燥、手足心热、倦怠乏力、心悸少寐、眼胀多泪、多食消瘦、烦躁易怒等中医证候总积分显著低于对照组,差异均有统计学意义(t=7.093,P<0.05);治疗组患者三碘甲状腺原氨酸(three triiodothyronine,T3)、四碘甲状腺原氨酸(four triiodothyronine,T4)、游离T3(free T3,FT3)、游离T4(free T4,FT4)均显著低于对照组,差异有统计学意义(P<0.05);治疗组患者促甲状腺素(thyroidstimulating hormone,TSH)明显高于对照组,差异有统计学意义(P<0.05);治疗组患者甲状腺肿大程度比较,治疗组显著高于对照组,差异有统计学意义(P<0.05);治疗组患者有效率为93.33%,显著高于对照组的73.33%,差异有统计学意义(P<0.05);治疗组患者不良反应发生率为6.67%,显著低于对照组的16.67%,差异有统计学意义(P<0.05)。结论:养阴清热消瘿方治疗甲状腺功能亢进临床疗效显著,可有效降低甲状腺激素水平,改善甲状腺肿大程度,且不良反应较少。

Objective： To investigate the clinical efficacy of Yangyin Qingre Xiaoying Recipe in treatment of hyperthyroidism and its influence on Hormone level. Methods： 60 patients with hyperthyroidism in our hospital from July 2014 to October 2016 were selected as the research object and were randomly divided into 2 groups. 30 cases in the normal group which were treated with Methimazole and the other 30 cases in the study group which were given Yangyin Qingre Xiaoying Recipe in treatment. Formula composition： Rehmannia glutinosa 10 g,Hawthorn meat 10 g,Dioscorea opposita 15 g,Ophiopogon japonicus 10 g,Angelica 10 g,Schisandra 6 g,Prunella 15 g,Angelica 10 g,Gardenia 12 g,Paeoniae 12 g,and Licorice 6 g. In syndrome differentiation,if there was shortness of breath,plus Taizi Senate 10 g; if sweat was obvious,plus floating 15 g; Yaoxisuanruan obvious,plus Dipsacus 6 g,Eucommia 10 g. The amount of the decoction each time was 200 m L,with1 dose daily and 4 weeks for a course of treatment. There were a total of 3 courses of treatment. Detailed record of preoperative and postoperative TCM syndrome score,heart rate,physique quality,thyroid hormone,postoperative curative effect and adverse reactions was made. Results： After treatment,TCM syndrome scores including anterior cervical swelling,soreness of waist and knees,oropharyngeal dryness,hot hands,feet and heart,fatigue,palpitations,eye swelling with more tears,polyphagia and marasmus,irritability and others of the study group were significantly lower than those of the normal group,the difference of which was statistically significant（ t = 7. 093,P〈0. 05）. T3,T4,FT3 and FT4 of the study group were significantly lower than those of the normal group,with the difference being statistically significant（ t = 7. 228,7. 896,7. 171,5. 610; P〈0. 05）. TSH of the study group was significantly higher than that of the normal group,the difference was statistical significance（ t = 5. 513,P〈0. 05）. The number of patients with no goiter of the study group was significantly higher than that of the normal group,the difference of which was statistically significant（ χ2= 8. 036,P〈0. 05）. The study group＇s total efficiency of 93. 33%,which was significantly higher than that of the normal group of 73. 33%（ χ2= 14. 398,P〈0. 05）. The heart rate of the study group was significantly lower than that of the normal group（ t = 6. 773,P〈0. 05）. The physique quality of the study group was significantly higher than that of the normal group（ t = 8. 123,P〈0. 05）; The incidence of adverse reactions of the study group was 6. 67%,which was significantly lower than that（ 16. 67%） of the normal group（ χ2= 4. 851,P〈0. 05）. Conclusion： Yangyin Qingre Xiaoying Recipe in treatment of hyperthyroidism shows significant clinical efficacy and it can effectively reduce the level of thyroid hormone,improve the degree of goiter,and reduce adverse reactions.