黄芪桂枝五物汤加减治疗甲状腺全切术后甲状旁腺功能减退症临床研究

Clinical Study on Modified Huangqi Guizhi Wuwu Tang for Hypoparathyroidism After Total Thyroidectomy

目的:观察黄芪桂枝五物汤加减治疗甲状腺全切术后甲状旁腺功能减退症的临床疗效。方法:选取60例甲状腺全切术后并发甲状旁腺功能减退症患者,按随机数字表法分为观察组和对照组各30例。2组术后均给予预防性补钙治疗,对照组术后第3天给予口服药物补钙,观察组在对照组基础上给予黄芪桂枝五物汤加减口服。比较2组临床疗效,检测术后不同时间点血清甲状旁腺激素(PTH)及钙值。结果:观察组总有效率为93.3%,高于对照组70.0%,差异有统计学意义(P<0.05)。观察组和对照组术前、术后第1、3、5天血清PTH、钙水平比较,差异无统计学意义(P>0.05)。观察组术后第9、15、21天血清PTH、钙水平明显高于对照组,差异均有统计学意义(P<0.05)。结论:黄芪桂枝五物汤加减能够减轻甲状腺全切术后甲状旁腺的缺血再灌注损伤,缩短患者术后甲状旁腺功能的恢复时间,改善低钙血症状,疗效显著。

Objective:To observe the curative effect of modified Huangqi Guizhi Wuwu tang on patients with hypoparathyroidism after total thyroidectomy.Methods:A total of 60 cases of patients complicated with hypoparathyroidism after total thyroidectomy were selected and divided into the observation group and the control group according to the random number table method,30 cases in each group.Both groups were treated with preventive calcium supplement after surgery.On the 3rdday after surgery,the control group was given the oral administration of medicine for calcium supplement,and the observation group was additionally given the oral administration of modified Huangqi Guizhi Wuwu tang based on the treatment of the control group.The clinical effect was compared between the two groups.The values of parathyroid hormone(PTH)and calcium in serum at different time points after surgery were detected.Results:The total effective rate was 93.3%in the observation group,higher than that of 70.0%in the control group,the difference being significant(P<0.05).When compared levels of PTH and calcium in serum between the two groups before treatment as well as on the 1st,3rd,and 5th days after surgery,there was no significance in the difference(P>0.05).On the 9th,15th,and 21st days after surgery,levels of PTH and calcium in serum in the observation group were significantly higher than those in the control group,differences being significant(P<0.05).Conclusion:Modified Huangqi Guizhi Wuwu tang can relieve ischemia-reperfusion injury of parathyroid gland after total thyroidectomy,shorten recovery time of parathyroid gland time after surgery,and improve hypocalcemia symptoms,with significant curative effect.