消瘿汤联用甲硫咪唑治疗高原地区甲状腺功能亢进临床研究

Clinical Study on Xiaoying Tang Combined with Methimazole for Hyperthyroidism in Plateau Area

目的:观察消瘿汤联合甲硫咪唑治疗高原地区甲状腺功能亢进(HPY)的临床疗效及其对患者甲状腺激素水平的影响。方法:将HPY患者80例随机分为照组与治疗组,每组40例。对照组给予甲硫咪唑治疗,治疗组在对照组的基础上加用自拟消瘿汤治疗,共治疗8周。观察比较2组临床疗效,2组治疗前后血清总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)及证候积分变化。结果:总有效率治疗组为97.50%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清TT3、TT4、FT3、FT4均较治疗前降低(P<0.05),TSH水平较治疗前升高(P<0.05);且治疗组上述各项指标改善均较对照组更显著(P<0.05)。治疗后,2组中医证候积分均较治疗前明显下降(P<0.05),且治疗组证候积分明显低于对照组(P<0.05)。结论:消瘿汤联用甲硫咪唑治疗HPY临床疗效确切,可显著缓解了患者临床症状,有效调节甲状腺激素水平。

Objective: To observe the clinical effect of Xiaoying tang combined with methimazole for hyperthyroidism(HPY) in plateau area and its effect on the level of thyroid hormones. Methods:A total of 80 cases of HPY patients were randomly divided into the control group and the treatment group, 40 cases in each group. The control group was given methimazole,and the treatment group was additionally given self-made Xiaoying tang based on the treatment of the control group. Both groups were treated for eight weeks. The clinical effect,and the changes in the levels of total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH) in serum as well as syndrome scores before and after treatment were observed and compared between the two groups. Results:The total effective rate was 97.50% in the treatment group and 80.00% in the control group,the difference being significant(P<0.05). After treatment,when compared with those before treatment,the levels of TT3,TT4,FT3 and FT4 in serum in the two groups were decreased(P<0.05),and the levels of TSH were increased(P<0.05);the improvement of above each index in the treatment group was more significant than that in the control group(P<0.05). After treatment, Chinese medicine syndrome scores in the two groups were significantly decreased when compared with those before treatment(P<0.05),and syndrome scores in the treatment group were significantly lower than those in the control group(P<0.05). Conclusion:The therapy of Xiaoying tang combined with methimazole in treating HPY has definite clinical effect,which can significantly relieve patients’ clinical symptoms,effectively regulate the level of thyroid hormones.