尿毒症血液透析患者继发性甲状旁腺亢进的超声表现与中医证型的相关性探讨

Discussion on the Correlation between Ultrasonic Manifestations of Hyperparathyroidism and TCM Syndrome Types in Hemodialysis Patients

目的:探讨尿毒症血液透析患者继发性甲状旁腺亢进的超声表现与中医证型的相关性;研究SHPT患者甲状旁腺体积、甲状旁腺激素的影响因素,以达到对症施治、提高SHPT患者中医治疗的临床疗效。方法:本研究将140例SHPT患者按其不同的中医证型主证分为四组,分别命名为肝肾阴虚组、脾肾两虚组、气虚组和阴阳俱虚组,各组人数分别为33人、37人、34人、36人。分别为每组患者行超声检查,观察并测量其甲状旁腺体积,并记录同一时期患者血液甲状旁腺激素水平,探究甲状旁腺体积和血液甲状旁腺激素水平的数值与患者性别、年龄、BMI指数的相关性。研究结论:SHPT患者超声影像下测得的甲状旁腺体积的大小和血液检测得出的甲状旁腺激素水平与SHPT患者的中医证型主证和兼证有明显相关性,其中主证为脾肾两虚证、兼证为浊毒 + 血瘀的患者的甲状旁腺体积最大,主证为阴阳俱虚证、兼证为浊毒 + 血瘀证的患者甲状旁腺激素水平最高。SHPT患者的甲状旁腺体积大小与甲状旁腺激素水平具有明显相关性,而患者的甲状旁腺体积和甲状旁腺激素水平与患者性别、年龄、BMI指数等其他因素无明显相关性。

Objective: To investigate the correlation between ultrasonic manifestations of hyperparathyroidism and TCM syndrome types in hemodialysis patients;to study the influence factors of parathyroid volume and parathyroid hormone in hyperthyroidism patients in order to achieve symptomatic treatment and improve the clinical curative effect of hyperthyroidism patients. Methods: In this study, 140 patients with hyperparathyroidism were divided into four groups according to different TCM syndrome types, which were named as liver and kidney Yin deficiency group, spleen and kid-ney deficiency group, qi deficiency group and yin-yang deficiency group, with 33, 37, 34 and 36 pa-tients in each group. Ultrasound examination was performed for each group of patients, and para-thyroid volume and parathyroid hormone levels were observed and measured. At the same time, the correlation between the value of parathyroid volume and parathyroid hormone level and the gender, age, BMI index of patients was explored. Conclusion: The volume of thyroid gland in hyper-thyroidism patients was significantly correlated with the main and concurrent syndromes of tradi-tional Chinese medicine syndromes. The volume of parathyroid gland was the largest in patients with spleen-kidney deficiency syndrome and turbidity toxin + blood stasis syndrome, and the vol-ume of thyroid gland in hyperthyroidism patients was significantly correlated with the level of thy-roid hormone. The level of parathyroid hormone was the highest in patients with deficiency of both Yin and Yang and turbidity-poison plus blood stasis. There was no significant correlation between parathyroid volume and parathyroid hormone level and age, sex and other factors.