平目汤配合针灸治疗阳气亏虚、痰瘀阻滞型非活动期甲状腺相关眼病的疗效观察

Observation on the clinical effect of Pingmu Decoction combined with acupuncture on non-active thyroid Graves’orbitopathy with yang qi deficiency and phlegm and blood stasis syndrome

目的:观察平目汤配合针灸治疗非活动期甲状腺相关眼病(GO)阳气亏虚、痰瘀阻滞证患者的临床疗效及安全性。方法:将108例非活动期GO阳气亏虚、痰瘀阻滞证患者随机分为针药组、中药组与针灸组,每组36例。针药组予平目汤配合针灸治疗,中药组予平目汤口服,针灸组单纯针灸治疗,3组均维持基础治疗,疗程12周。比较3组治疗后突眼度、临床疗效、中医证候疗效改善情况及甲状腺功能(FT3、FT4、TSH)水平。结果:治疗12周后,突眼度:针药组[(18.86±2.19)mm]显著低于针灸组[(20.75±2.48)mm]和中药组[(20.19±2.38)mm](P<0.01,P<0.05);突眼临床疗效:针药组总有效率[91.67%(33/36)]优于中药组[69.44%(25/36)]和针灸组[44.44%(16/36)](P<0.05,P<0.01),中药组优于针灸组(P<0.05);中医证候疗效:针药组总有效率[94.44%(34/36)]优于中药组[72.22%(25/36)]及针灸组[50.00%(18/36)](P<0.05,P<0.01),且中药组优于针灸组(P<0.05)。治疗前后FT3、FT4、TSH差异无统计学意义,针药组不良反应少。结论:平目汤配合针灸可有效降低非活动期GO阳气亏虚、痰瘀阻滞证的突眼度,改善其临床症状,具有良好的临床疗效和安全性。

Objective:To observe the clinical effect and safty of Pingmu Decoction combined with acupuncture on patients with yang qi deficiency and phlegm and blood stasis syndrome in the non-active thyroid Graves’orbitopathy(GO).Methods:A total of 108 patients of non-active thyroid GO with yang-qi deficiency and phlegm-blood stasis syndrome were randomly divided into acupuncture combined with Pingmu Decoction group,traditional Chinese medicine group and acupuncture group,with 36 cases in each group,three groups maintained basic treatment and they were all treated for 12 weeks.Acupuncture combined with Pingmu Decoction group received acupuncture therapy and Pingmu Decoction,the traditional Chinese medicine group gave Pingmu Decoction orally.Acupuncture group received acupuncture alone.Compared the degree of protrusion,clinical effect,improvement of TCM syndrome effect and thyroid function(FT3,FT4 and TSH)of the three groups after treatment.Results:After 12 weeks of treatment,the degree of exophthalmia:acupuncture combined with Pingmu Decoction group[(18.86±2.19)mm]was significantly lower than acupuncture group[(20.75±2.48)mm]and the traditional Chinese medicine group[(20.19±2.38)mm](P<0.01,P<0.05).Clinical efficacy of protrusion:the total effective rate of acupuncture group[91.67%(33/36)]was better than that of traditional Chinese medicine group[69.44%(25/36)]and the acupuncture group[44.44%(16/36)](P<0.05,P<0.01),the traditional Chinese medicine group was superior to the acupuncture group(P<0.05).Clinical effect comparison of TCM syndrome integral:the total effective rate of acupuncture combined with Pingmu Decoction group[94.44%(34/36)]was better than that of traditional Chinese medicine group[72.22%(25/36)]and acupuncture group[50.00%(18/36)](P<0.05,P<0.01),and traditional Chinese medicine group was better than acupuncture group(P<0.05).There were no significant difference in FT3,FT4 and TSH before and after treatment between three groups.There were fewer side effects in the acupuncture combined with Pingmu Decoction group.Conclusion:Pingmu Decoction combined with acupuncture can effectively reduce the degree of protrusion in patients with yang-qi deficiency and phlegm-blood stasis syndrome in the non-actived thyroid of GO,improve the clinical traditional Chinese medicine syndromes,and have good clinical efficacy and safety.