不同中医证型甲状腺结节的超声特征浅析

Analysis of ultrasonic characteristics of thyroid nodules with different Chinese medicine syndrome

目的:探讨甲状腺结节2种常见中医证型的超声形态学特征,为中医辨证分型及早期干预治疗提供诊断依据。方法:选择甲状腺结节患者119例,分析不同证型之间甲状腺结节超声形态学参数的差异。结果:119例中气郁痰阻型60例,单发结节15例(25.0%),多发结节45例(75.0%);血流分类0、1类25例(41.7%),2、3类35例(58.3%)。痰结瘀血型59例,单发结节33例(55.9%),多发结节26例(44.1%);血流分类0、1类41例(69.5%),2、3类18例(30.5%)。2种证型甲状腺结节的数量与血流信号差异均有统计学意义(均P<0.05)。2种证型的TI-RADS分类比较,差异有统计学意义(P<0.05),大小、形态、内部回声差异均无统计学意义(均P>0.05)。结论:不同证型甲状腺结节的超声测量指标存在差异,其中痰结瘀血型甲状腺结节单发多见,血流少或无,TI-RADS分类较低;气郁痰阻型甲状腺结节患者多发常见,血流信号丰富,TI-RADS分类较高。甲状腺结节的超声特征可为中医辨证分型及早期干预治疗提供客观依据。

Objective:To explore the ultrasonic morphological characteristics of thyroid nodules of 2 TCM syndromes,so as to provide diagnostic basis for syndrome differentiation of TCM and early intervention.Methods:A total of 119 patients with thyroid nodules were selected,and the differences of ultrasonic morphological parameters between different syndromes were analyzed.Results:A total of 119 cases were included,60 cases were qi stagnation and phlegm stagnation type,15 cases of single nodule(25.0%),45 cases of multiple nodules(75.0%),25 cases of blood flow grade 0 and 1(41.7%)and 35 cases of grade 2 and 3(58.3%).The other 59 cases were phlegm stasis type,33 cases of single nodule(55.9%),26 cases of multiple nodules(44.1%),41 cases of blood flow grade 0 and 1(69.5%)and 18 cases of grade 2 and 3(30.5%).There were significant differences in the number of thyroid nodules and blood flow signals between the two syndrome types(P<0.05).There was a significant difference in TI-RADS category between the two types(P<0.05),while there were no significant differences in size,shape and internal echo between the two groups(all P>0.05).Conclusions:There are differences in ultrasonic measurement indexes in patients with different syndrome types of thyroid nodules.Among them,most of the patients with phlegm stagnation and blood stasis type of thyroid nodules are solitary nodules,with little or no blood flow,and the TI-RADS category score is lower.Most of the patients with thyroid nodules of qi stagnation and phlegm obstruction type are multiple nodules,with rich blood flow signals and higher TI-RADS category score,which can provide objective basis for TCM syndrome differentiation and early intervention in the treatment of thyroid nodules.