瘿痛方治疗亚急性甲状腺炎的临床观察

Clinical Observation on Yingtong Formula for the Treatment of Subacute Thyroiditis

【目的】观察瘿痛方治疗气郁痰阻型亚急性甲状腺炎的临床疗效。【方法】将60例气郁痰阻型亚急性甲状腺炎患者随机分为治疗组和对照组,每组各30例。对照组给予双氯芬酸钠双释放肠溶胶囊口服治疗,治疗组在对照组的基础上配合中药瘿痛方口服治疗,疗程为4周。观察2组患者治疗前后中医证候积分、甲状腺功能及红细胞沉降率(ESR)的变化情况,评价2组患者的临床疗效及安全性。【结果】(1)治疗4周后,治疗组的总有效率为90.0%(27/30),对照组为73.3%(22/30),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.01),且治疗组对中医证候积分的下降作用明显优于对照组(P<0.05)。(3)治疗后,2组患者血清促甲状腺激素(TSH)水平均较治疗前明显升高(P<0.01),血清游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)水平均较治疗前明显降低(P<0.01),且治疗组对血清TSH水平的升高作用及对血清FT3、FT4水平的降低作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的ESR均较治疗前明显下降(P<0.01),且治疗组对ESR的下降作用明显优于对照组(P<0.01)。(5)治疗过程中,2组患者均未出现恶心呕吐、皮疹等不良反应,且患者的血、尿、大便常规、肝肾功能及心电图等安全性指标也均未发现有明显的异常改变。【结论】瘿痛方治疗气郁痰阻型亚急性甲状腺炎,可有效改善患者的临床症状、体征及理化检测指标,缩短治疗周期,具有较好的临床疗效。

Objective To observe the clinical efficacy of Yingtong Formula in treating subacute thyroiditis(ST)with qi depression and phlegm obstruction syndrome.Methods Sixty patients with qi depression and phlegm obstruction type of ST were randomly divided into the treatment group and the control group,with 30 cases in each group.The control group was given oral use of Diclofenac Sodium Dual Release Enteric-coated Capsules,and the treatment group was treated with Chinese medicine Yingtong Formula on the basis of treatment for the control group.The treatment for both groups lasted for 4 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,thyroid function and erythrocyte sedimentation rate(ESR)level in the two groups were observed before and after treatment.And after treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 4 weeks of treatment,the overall effective rate of the treatment group was 90.0%(27/30)and that of the control group was 73.3%(22/30).The intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores of patients in both groups were decreased significantly compared with those before treatment(P<0.01),and the effect on decreasing TCM syndrome scores in the treatment group was significantly superior to that in the control group(P<0.05).(3)After treatment,the thyroid stimulating hormone(TSH)level in both groups was significantly increased(P<0.01),and the free triiodothyronine(FT3)and free thyroxine(FT4)levels were significantly decreased compared with those before treatment(P<0.01),and the effect on increasing TSH level and on decreasing FT3 and FT4 levels in the treatment group was significantly superior to that in the control group(P<0.01).(4)After treatment,the ESR of both groups was significantly decreased compared with that before treatment(P<0.01),and the effect on decreasing ESR in the treatment group was significantly superior to that in the control group(P<0.01).(5)During the treatment,there were no adverse reactions such as nausea and vomiting,and skin rash occurring in the two groups of patients,and there were no significant abnormal changes were found in the safety indexes of routine blood,urine and stool test,liver and kidney function,and electrocardiogram of the patients.Conclusion Yingtong Formula is effective on improving the clinical symptoms and signs,and physiochemical indexes of patients,and on shortening the course of treatment,and the formula has better clinical efficacy for the treatment of qi depression and phlegm obstruction type of ST.