理气散结中药汤对甲状腺结节合并乳腺增生气滞痰阻证患者乳腺肿块疼痛及甲状腺功能的影响

Effect of Liqi Sanjie decoction on the pain of breast mass and thyroid function in patients with thyroid nodules and breast of breast mass of type of Qi and phlegm stagnation

目的观察理气散结中药汤对甲状腺结节合并乳腺增生气滞痰阻证患者乳腺肿块疼痛及甲状腺功能的影响。方法将2018年1月—2019年2月北京市和平里医院诊治的76例甲状腺结节合并乳腺增生患者随机分为2组,对照组给予枸橼酸他莫昔芬片+左甲状腺素钠片治疗,观察组在对照组治疗基础上给予理气散结中药汤治疗,连续治疗3个月,对比2组甲状腺结节疗效、乳腺症状积分(乳房疼痛、肿块大小、肿块质地)、甲状腺结节大小(结节最大直径、结节体积)、甲状腺功能指标(TSH、TT3、TT4、FT3、FT4)变化,并评价药物安全性。结果观察组治疗后甲状腺结节总有效率为92.1%(35/38),对照组为73.7%(28/38),观察组明显高于对照组(χ^2=4.547,P<0.05);与治疗前比较,2组治疗后乳房疼痛积分、肿块大小积分、肿块质地积分、结节最大直径及结节体积均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组治疗前后及治疗后组间TSH、TT3、TT4、FT3、FT4水平比较差异均无统计学意义(P均>0.05);2组治疗过程中均未出现明显不良反应,血、尿常规及肝肾功能也未发生明显异常变化。结论在西医常规基础上辅助理气散结中药汤治疗甲状腺结节合并乳腺增生,能够促进甲状腺结节缩小,缓解乳腺肿块疼痛,且对甲状腺功能无明显影响,治疗安全。

Objective It is to observe the effect of Liqi Sanjie decoction on the pain of breast mass and thyroid function in patients with thyroid nodules and breast hyperplasia of type of Qi and phlegm stagnation.Methods Seventy-six patients with thyroid nodules and hyperplasia of mammary glands diagnosed and treated in Beijing Hepingli Hospital from January 2018 to February 2019 were randomly divided into 2 groups,the control group was treated with tamoxifen citrate tablets+levothyroxine sodium tablets,the observation group was treated with Liqi Sanjie decoction based on the treatment of the control group,both groups were continuously treated for 3 months.The efficacy of thyroid nodules,and the changes of breast symptom scores(breast pain,tumor size,tumor texture),and thyroid nodule size(maximum nodule diameter,nodule volume),thyroid function indexes(TSH,TT3,TT4,FT3,FT4)were compared between the two groups,and the drug safety was evaluated.Results The total effective rate of thyroid nodules in the observation group after treatment was 92.1%(35/38),and that in the control group was 73.7%(28/38),the observation group was significantly higher than the control group(χ^2=4.547,P<0.05).Compared with before treatment,the breast pain scores,mass size scores,mass texture scores,nodule maximum diameter and nodule volume of the two groups were significantly reduced(P<0.05),and the observation group was significantly lower than the control group(P<0.05).There was no statistically significant differences in the levels of TSH,TT3,TT4,FT3,and FT4 between the two groups before and after treatment and in each group before and after treatment(all P>0.05);there was no obvious adverse reaction during the treatment in the two groups,no significant abnormal change of blood and urine routine and liver and kidney function was found.Conclusion The assistant therapy with Liqi Sanjie decoction on the basis of western medicine can promote the reduction of thyroid nodules,relieve the pain of breast masses,and have no obvious effect on thyroid function with good safety in the treatment of thyroid nodules with hyperplasia of mammary glands.