愈瘿散外敷联合双氯芬酸钠治疗亚急性甲状腺炎所致疼痛的临床研究

Clinical Study on Yuying Powder Combined with Diclofenac Sodium on Pain Caused by Subacute Thyroiditis

目的 观察愈瘿散外敷联合双氯芬酸钠治疗亚急性甲状腺炎(SAT)(热毒炽盛证)所致疼痛的临床效果。方法 选取100例SAT(热毒炽盛证)所致疼痛患者,采用随机数字表法分为观察组与对照组各50例。对照组口服双氯芬酸钠缓释片治疗,在此基础上,观察组采用愈瘿散外敷治疗。治疗2周后比较两组中医证候积分、疼痛视觉模拟量表(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分及血清C反应蛋白(CRP)水平。记录两组副作用情况及随访复发情况。结果 观察组镇痛总有效率达96.00%,显著高于对照组的82.00%(P <0.05)。与对照组相比,观察组甲状腺疼痛的止痛起效时间和缓解时间均显著缩短(P <0.05)。两组治疗后瘿肿、瘿痛、咽痛积分和中医证候总积分及疼痛VAS评分、PSQI评分、血清CRP水平较同组治疗前均显著降低(P <0.05),但均以观察组的下降更显著(P <0.05)。观察组不良反应率与对照组相比,差异无统计学意义(P> 0.05)。随访3个月,观察组复发率为2.00%,较对照组的16.00%显著降低(P <0.05)。结论 应用愈瘿散外敷联合双氯芬酸钠治疗SAT(热毒炽盛证)所致疼痛可快速且安全有效地缓解患者疼痛,下调血清CRP水平,降低复发风险。

Objective:To explore the clinical efficacy of Yuying Powder combined with diclofenac sodium in the treatment of pain caused by subacute thyroiditis(SAT)with excessive heat toxicity and its influence on thyroid function and serum C-reactive protein(CRP)level.Methods:A total of 100 patients with pain caused by SAT were selected and divided into observation group(n=50)and control group(n=50)by random number table method.The control group was treated with diclofenac sodium sustained-release tablets,and the observation group was treated with Yuying Powder on the basis of the control group.The analgesic efficacy of the two groups was observed after continuous treatment for 2 weeks.The TCM syndrome scores,visual analog scale(VAS)scores for pain,Pittsburgh Sleep Quality Index(PSQI)scores and serum C-reactive protein(CRP)levels were compared between the two groups before and after treatment.The adverse reactions and recurrence of the two groups were recorded.Results:The total effective rate of the observation group was 96.00%,which was significantly higher than that of the control group 82.00%(P < 0.05).Compared with the control group,the time of fever reduction and disappearance of thyroid pain in the observation group was significantly shortened(P < 0.05).After treatment,the swollen gall,gall pain,sore throat score,total score of TCM syndrome,pain VAS score,PSQI score,and serum CRP level in the two groups were significantly lower than those before treatment(P < 0.05),and the observation group decreased more significantly than the control group(P < 0.05).The adverse reaction rate had no significant difference compared with the control group(P > 0.05).After 3 months of follow-up,the recurrence rate of the observation group was 2.00%,which was significantly lower than that of the control group 16.00%(P < 0.05).Conclusion:The application of Yuying Powder combined with diclofenac sodium in the treatment of pain caused by SAT with excessive heat toxicity is effective,which can quickly,safely and effectively eliminate patients′ pain,reduce the expression level of serum CRP and reduce the risk of recurrence.