自拟消肿散结汤联合左甲状腺素钠片治疗甲状腺结节的临床观察

Self-made xiaozhongsanjie decoction combined with levothyroxine sodium tablets in treatment of thyroid nodule

目的探讨自拟消肿散结汤联合左甲状腺素钠片治疗甲状腺结节的临床疗效。方法选取2013年7月~2014年7月来杭州市余杭区第一人民医院就诊的甲状腺结节患者52例,按照随机数字表法分为对照组(n=25)和研究组(n=27)。其中对照组给予左甲状腺素钠片,研究组在对照组的基础上加用自拟消肿散结汤。疗程均为24周。分别于治疗前后记录2组的促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、血清游离四碘甲状腺原氨酸(free tetraiodothyronine,FT4)水平及甲状腺结节大小变化。结果治疗24周后,2组甲状腺结节均明显缩小,且研究组的缩小幅度大于对照组(P<0.05);2组TSH水平与治疗前相比均明显下降,且研究组的下降幅度大于对照组(P<0.05);2组FT4水平与治疗前相比均明显升高,且研究组的升高幅度大于对照组(P<0.05);FT3研究组治疗的总有效率为(77.78%)明显优于对照组(48.00%,P<0.05)。结论自拟消肿散结汤联合左甲状腺素钠片治疗甲状腺结节效果显著,能有效控制或缩小甲状腺结节。

Objective To observe clinical effect of self-made xiaozhongsanjie decoction combined with levothyroxine sodium tablets in treatment of thyroid nodule.Methods From July 2013 to July 2014, 52 cases of thyroid nodule patients were randomly divided into two groups: control group( n=25)and study group(n=27).The control group were received levothyroxine sodium tablets, while the study group were given self-made xiaozhongsanjie decoction on the basis of control group.Both groups were treated for 24 weeks.The changes of thyroid stimulating hormone ( TSH ) , serum free triiodothyronine (FT3), serum free tetraiodothyronine (FT4) levels, and the thyroid nodule size of two groups before and after treatment were recorded and compared.ResuIts After 24 weeks’ treatment, the thyroid nodule size of both groups reduced, and the descending range of study group was much larger than that of control group (P<0.05).The TSH levels of both groups descended, and the descending range of study group was much larger than control group (P<0.05).While the FT4 levels all increased in both groups, and the ascending range of study group was much larger than control group (P<0.05).And the total effective rate of study group was 77.78%, which was significantly higher than control group (48.00%, P<0.05). ConcIusion The therapy of self-made xiaozhongsanjie decoction combined with levothyroxine sodium tablets in treatment of thyroid nodule could control or reduce the thyroid nodule size effectively.