黄芪桂枝五物汤加减方对甲状腺全切术后甲状旁腺功能减退的疗效

Effect of Huangqi Guizhi Wuwu Decoction Modified Recipe on Hypoparathyroidism After Total Thyroidectomy

目的探讨黄芪桂枝五物汤加减方治疗甲状腺全切术后甲状旁腺功能减退患者的效果。方法选取2018年10月至2019年10月于河南省中医院接受甲状腺全切术的78例患者为研究对象,其术后均出现甲状旁腺功能减退。根据随机数表法分为对照组和观察组,每组39例。对照组术后常规补液和口服钙片治疗,观察组在此基础上增加黄芪桂枝五物汤加减方治疗,共治疗2周。比较两组患者血清甲状旁腺激素(PTH)、血钙水平,比较两组血清PTH、血钙水平恢复时间和低钙血症消失时间,观察两组患者低钙血症发生率。结果观察组治疗总有效率高于对照组(P<0.05)。观察组术后1、3、5 d血清PTH水平高于对照组(P<0.05),两组术前及术后血钙水平差异无统计学意义(P>0.05)。观察组血钙水平恢复时间、低钙血症消失时间短于对照组(P<0.05),两组血清PTH水平恢复时间差异无统计学意义(P>0.05)。观察组甲状腺全切术后6例(15.38%)患者出现低钙血症,对照组10例(25.64%)患者出现低钙血症,两组低钙血症发生率差异无统计学意义(P>0.05)。结论黄芪桂枝五物汤加减方有利于甲状腺全切术后甲状旁腺功能减退患者病情恢复,可降低术后低钙血症发生风险,疗效较好。

Objective To investigate the effect of Huangqi Guizhi Wuwu decoction in the treatment of patients with hypoparathyroidism after total thyroidectomy.Methods A total of 78 patients who underwent total thyroidectomy in Henan Provincial Hospital of TCM from October 2018 to October 2019 were selected as the research subjects,and all of them developed hypoparathyroidism after surgery.According to the random number table method,they were divided into control group and observation group,with 39 cases in each group.The control group was treated with routine fluid infusion and oral calcium tablets after operation,and the observation group was additionally treated with Huangqi Guizhi Wuwu decoction on this basis.Both groups were treated for two weeks.The serum parathyroid hormone(PTH)and blood calcium levels,the recovery time of serum PTH and blood calcium levels,and the disappearance time of hypocalcemia were compared between the two groups.The incidence of hypocalcemia was observed in the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).The serum PTH levels in the observation group were higher than those in the control group on the 1st,3rd and 5th days after operation(P<0.05).There was no statistical difference in serum calcium levels between the two groups before and after surgery(P>0.05).The recovery time of blood calcium level and the disappearance time of hypocalcemia in the observation group were shorter than those in the control group(P<0.05).There was no statistical difference in the recovery time of serum PTH level between the two groups(P>0.05).Hypocalcemia occurred in 6 patients(15.38%)in the observation group after total thyroidectomy,and in 10 patients(25.64%)in the control group.There was no statistical difference in the incidence of hypocalcemia between the two groups(P>0.05).Conclusion Huangqi Guizhi Wuwu decoction is beneficial to the recovery of patients with hypoparathyroidism after total thyroidectomy,and could reduce the risk of postoperative hypocalcemia,with good curative effect.