瘿病心肝火旺证病证结合减毒增效的研究

Effect of the Combination of Disease and Syndrome on Toxicity-reducing and Action-enhancing in Gall Patients with Hyperactivity Heart-liver Fire Syndrome

目的探讨瘿病(Graves病,毒性弥漫性甲状腺肿甲状腺机能亢进症)心肝火旺证中医辨证和西医辨病相结合在减毒增效方面的疗效。方法将瘿病初诊患者随机分为对照组(30例)、病证结合1组(治疗1组,30例)和病证结合2组(治疗2组,30例)。对照组仅予甲巯咪唑10 mg,每日3次起始治疗;病证结合1组予甲巯咪唑10 mg,每日3次起始,联合泻火消瘿方治疗;病证结合2组予甲巯咪唑10 mg,每日1次起始,联合泻火消瘿方治疗;比较3个月后三组的临床疗效。结果在改善中医症候积分方面,治疗1组、治疗2组均优于对照组(P<0.01),但治疗1组与治疗2组间无显著性差异(P>0.05);甲功改善方面,组内各自治疗前后相比均有显著性差异(P<0.01),但治疗后三组组间相比均无显著性差异(P>0.05);毒副作用方面,对照组明显高于治疗1组(P<0.05),治疗1组明显高于治疗2组(P<0.05)。结论病证结合方案能明显改善临床症状,在保证同等疗效的前提下减少西药的用量,从而减少毒副作用。

Objective To investigate the effect of the combination of disease and syndrome on toxicity-reducing and action-enhancing in gall patients（ Graves disease,toxic diffuse goiter） with hyperactivity heart-liver fire syndrome. Methods A randomized controlled clinical trial was carried out. 90 patients were randomly divided into three groups. The patients in the combination of disease and syndrome group（ the treatment group one） received thiamazole tablets（ 10 mg tid） and Xiehuo Xiaoying decoction,the patients in the combination of disease and syndrome group（ the treatment group 2） received thiamazole tablets（ 10 mg qd） and Xiehuo Xiaoying decoction,while the patients in the control group only received thiamazole tablets（ 10 mg tid）. Three groups regard 6 months as a course of treatment. The clinical indexes were observed before and after treatment. Results The TCM syndrome scores in the treatment groups were better than these in the control group,and there were no differences between the treatment group one and the treatment group two（ P〉0. 05）. After the therapy,thyroid function in three groups showed significantly difference comparing with before treatment（ P〈0. 01）,but there were no differences between the three groups. The toxic effects in the control group were more serious than that in the treatment group one and two（ P〈0. 05）,but the toxic effects in the treatment group one were more serious than that in the treatment group two（ P〈0. 05）. Conclusion The combination of disease and syndrome can improve the clinical effects,reduce the dose of the drugs,and decrease the rates of adverse reactions.