柴胡疏肝散加减治疗肝郁脾虚型甲亢的研究

Study on the treatment of hyperthyroidism of liver depression and spleen deficiency with addition and reduction of Bupleurum Shugan Powder

目的:探讨柴胡疏肝散加减治疗肝郁脾虚型甲状腺功能亢进症的临床疗效。方法:选取2019年1月至2020年12月医院收治的92例肝郁脾虚型甲亢患者为研究对象。采用随机数表法将患者分为对照组和观察组,每组各46例。对照组给予甲巯咪唑片治疗,观察组采用甲巯咪唑片联合柴胡疏肝散加减治疗。分析对比两组甲状腺功能指标、中医证候评分及不良反应。结果:治疗后,两组促甲状腺激素(Thyroid stimulating hormone,TSH)水平均高于治疗前,三碘甲状腺原氨酸(Triiodothyronine,T3)、游离三碘甲腺原氨酸(Free triiodothyronine,FT3)、甲状腺素(Thyroxine,T4)水平均低于治疗前,且观察组上述指标改善更明显(P<0.05)。治疗后,两组甲状腺肿、心悸、烦躁、消瘦症状评分均降低,且观察组较对照组显著降低(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:柴胡疏肝散加减治疗肝郁脾虚型甲亢可改善患者甲状腺功能及临床症状,且安全性较高。

Objective:To investigate the clinical efficacy of bupleurum Shugan Powder in the treatment of hyperthyroidism with liver-stagnation and spleen-deficiency.Methods:92 cases of hyperthyroidism with liver-stagnation and spleendeficiency treated in hospital from January 2019 to December 2020 were selected as the study objects.The patients were divided into control group and observation group by random number table method,46 cases in each group.The control group was treated with methimazole tablets,and the observation group was treated with methimazole tablets combined with Bupleurum Shugan powder.Thyroid function indexes,TCM syndrome scores and adverse reactions were analyzed and compared between the two groups.Result:After treatment,the levels of Thyroid stimulating hormone(TSH)in both groups were higher than those before treatment,Triiodothyronine(T3),Free triiodothyronine(FT3)and Thyroxine(T4)levels were lower than before treatment,and the above indexes in observation group were improved more obviously(P<0.05).After treatment,the scores of goiter,palpitation,irritability and wasting were decreased in both groups,and the observation group was significantly lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Chaihu Shugan Powder can improve thyroid function and clinical symptoms in patients with liver depression and spleen deficiency type hyperthyroidism,and has high safety.