消补兼施汤加减联合塞来昔布治疗亚急性甲状腺炎气虚痰阻证临床研究

Clinical Study on Modified Xiaobu Jianshi Tang Combined with Celecoxib for Sub actue Thyroiditis with Qi Deficiency and Phlegm Obstruction Syndrome

目的:观察消补兼施汤加减联合塞来昔布治疗亚急性甲状腺炎气虚痰阻证的临床疗效。方法:将80例亚急性甲状腺炎气虚痰阻证患者按随机数字表法分为治疗组和对照组各40例。治疗组给予消补兼施汤加减联合塞来昔布胶囊治疗,对照组单纯给予塞来昔布胶囊治疗,治疗4周。比较2组临床疗效,观察甲状腺激素、红细胞沉降率(ESR)、生活质量的改善情况,对比2组随访8周的复发率,记录不良反应发生情况。结果:治疗组总有效率90.00%,对照组总有效率77.50%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)及ESR水平均较治疗前降低(P<0.05),促甲状腺素(TSH)水平均较治疗前升高(P<0.05);治疗组FT4、FT3及ESR水平均低于对照组(P<0.05);治疗后2组TSH水平比较,差异无统计学意义(P>0.05)。治疗后,2组健康调查简表(SF-36)评分均较治疗前升高(P<0.05);治疗组SF-36评分高于对照组(P<0.05)。停药后进行8周随访,治疗组无复发,对照组复发2例,复发率为6.45%,2组复发率比较,差异无统计学意义(P>0.05)。治疗组未发现明显不良反应,对照组2例患者出现胃痛症状,1例患者出现转氨酶增高。结论:消补兼施汤加减联合塞来昔布治疗亚急性甲状腺炎气虚痰阻证具有良好的临床疗效,能提高患者的生活质量,无不良反应。

Objective:To observe the clinical effect of modified Xiaobu Jianshi tang combined with celecoxib for subactue thyroiditis with qi deficiency and phlegm obstruction syndrome.Methods:A total of 80 cases of patients with subactue thyroiditis with qi deficiency and phlegm obstruction syndrome were divided into the treatment group and the control group according the random number table method,40 cases in each group.The treatment group was treated with modified Xiaobu Jianshi tang combined with celecoxib capsules,and the control group was given celecoxib capsules only.Both groups were treated for four weeks.The clinical effect in the two groups was compared.The improvement of thyroid hormone,erythrocyte sedimentation rate(ESR)and quality of life was observed.The recurrence rates during the eight-week follow-up in the two groups were compared.The incidence of adverse reactions was recorded.Results:The total effective rate was 77.50%in the control group,and 90.00%in the treatment group,the difference being significant(P<0.05).After treatment,the levels of free thyroxine(FT4),free triiodothyronine(FT3)and ESR in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of thyroid-stimulating hormone(TSH)were increased when compared with those before treatment(P<0.05);the levels of FT4,FT3 and ESR in the treatment group were lower than those in the control group(P<0.05);there was no significant difference being found in the comparison of the level of TSH between the two groups(P>0.05).After treatment,the scores of Short Form 36 Health Survey(SF-36)in the two groups were increased when compared with those before treatment(P<0.05);the above score in the treatment group was higher than that in the control group(P<0.05).During the eight-week follow-up after administration,there was no recurrence in the treatment group and two cases in the control group,the recurrence rate was 6.45%in the control group,there being no significance in the difference(P>0.05).There was no significant adverse reaction in the treatment group;in the control group,there were two cases of stomachache and one case of transaminase elevation.Conclusion:The therapy of modified Xiaobu Jianshi tang combined with celecoxib has good clinical effect in treating subactue thyroiditis with qi deficiency and phlegm obstruction syndrome,which can improve the quality of life without any adverse reactions.