养阴清火消甲汤治疗甲状腺功能亢进症临床疗效

Analysis of Clinical Effect of Yangyin Qinghuo Xiaojia Decoction on Hyperthyroidism

目的观察养阴清火消甲汤联合甲巯咪唑治疗阴虚阳亢、肝火上炎型甲状腺功能亢进症急性期的临床疗效。方法将东莞市中医院内分泌科2018年1月-2018年12月门诊及住院部收治82例甲亢患者,采用随机双盲对照方法,分为治疗组42例和对照组40例,治疗组使用养阴清火消甲汤联合甲巯咪唑治疗,对照组单用甲巯咪唑治疗。8周为一疗程,比较用药前及用药后两组的临床疗效、中医症状体征积分、甲状腺激素水平、SF-36生活质量量表变化,以及不良反应。结果8周后对比,治疗组总有效率明显高于对照组(P<0.05)。治疗后两组中医症状体征积分、FT3及FT4水平、SF-36生活质量量表积分均低于治疗前,且治疗组降低更显著(P<0.05);治疗后两组TSH水平均有所升高,但差异不显著(P>0.05),提示两组调节TSH的作用相近。安全性比较中,治疗组不良反应率为11.9%(5/42),与对照组的17.5%(7/40),无显著性差异(P>0.05)。结论养阴清火消甲汤联合甲巯咪唑治疗阴虚阳亢、肝火上炎型甲状腺功能亢进症急性期,能显著改善中医症状体征,有效降低FT3、FT4水平,提高生活质量,药物安全性良好。

Objective To observe the clinical effect of Yangyin Qinghuo Xiaojia decoction combined with methimazole in the treatment of the acute stage of hyperthyroidism with Yin deficiency and Yang hyperactivity and liver fire.Methods Eighty-two patients with hyperthyroidism were admitted to the Department of Endocrinology of Dongguan Hospital of Traditional Chinese Medicine from January 2018 to December 2018.They were divided into treatment group(42 cases)and control group(40 cases).The treatment group was treated with Yangyin Qinghuo Xiaojia decoction combined with methimazole,and the control group was treated with methimazole alone.Eight weeks was a course of treatment.The clinical efficacy,TCM symptom and sign scores,thyroid hormone level,SF-36 quality of life scale changes,and adverse reactions were compared before and after the treatment.Results After 8 weeks,the total effective rate of the treatment group was higher than that of the control group(P<0.05).After treatment,the scores of symptoms and signs,levels of FT3 and FT4,SF-36 quality of life scale in the two groups were lower than those before treatment,and the scores in the treatment group were significantly lower(P<0.05).After treatment,the level of TSH in both groups increased,but the difference was not significant(P>0.05).In the safety comparison,there was no significant difference of the adverse reaction rate between the treatment group(11.9%,5/42)and the control group(17.5%,7/40)(P>0.05).Conclusion Yangyin Qinghuo Xiaojia decoction combined with methimazole can significantly improve the symptoms and signs of traditional Chinese medicine,effectively reduce the levels of FT3 and FT4,improve the quality of life,and has good safety.