本文選題：姜桂益癭湯 + 脾腎陽(yáng)虛��； 參考：《黑龍江中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：觀察姜桂益癭湯聯(lián)合小劑量左甲狀腺素鈉治療脾腎陽(yáng)虛型橋本氏田狀腺炎合并甲狀腺機(jī)能減退患者的臨床療效及對(duì)SOD、MDA的影響。方法：將66例符合納入標(biāo)準(zhǔn)的脾腎陽(yáng)虛型橋本氏甲狀腺炎合并甲狀腺機(jī)能減退患者按照隨機(jī)表隨機(jī)分為兩組：治療組,33例,對(duì)照組,33例。對(duì)照組：服用左甲狀腺素鈉片每日25 μ g,每日1次,每2周增加12.5μg劑量,觀察4周共一療程。治療組：在對(duì)照組的用藥基礎(chǔ)上加服姜桂益癭湯。藥物組成：干姜20g,肉桂20g,熟地黃15g,山藥15g,茯苓15g,澤瀉10g,夏枯草15 g,玄參15g,黃芪20g,白術(shù)20g,當(dāng)歸15g,川芎15g,青皮10g,陳皮15g。用法：早晚各1次,飯后30分鐘溫服。觀察4周共1療程。結(jié)果：試驗(yàn)過(guò)程中,治療組1例因主動(dòng)要求退出,實(shí)際完成32例,其中男2例,女30例；對(duì)照組1例因外出而退出,2例因未及時(shí)復(fù)查,實(shí)際完成30例,其中男1例,女29例。治療組中醫(yī)證候療效總有效率優(yōu)于對(duì)照組,P0.05,差異具有統(tǒng)計(jì)學(xué)意義。兩組在中醫(yī)單項(xiàng)癥狀積分方面比較,治療后主要癥狀方面均有改善,P0.05,但治療組面浮肢腫、腰膝酸軟、畏寒肢冷、頸部腫大方面明顯優(yōu)于對(duì)照組,P0.01,差異具有統(tǒng)計(jì)學(xué)意義。在甲狀腺功能方面比較,兩組組內(nèi)比較FT3、FT4、TSH指標(biāo)均顯著改善,P0.01,差異有統(tǒng)計(jì)學(xué)意義,組間比較FT3、FT4有改善,P0.05,表明治療組在升高FT3、FT4的作用方面優(yōu)于對(duì)照組。在氧化指標(biāo)SOD、MDA方面,組內(nèi)治療前后,P0.01,治療組治療前后比較有顯著差異性,說(shuō)明效果顯著；治療后組間比較,P0.05,說(shuō)明治療組與對(duì)照組比較具有差異性,治療組效果優(yōu)于對(duì)照組。結(jié)論：1.姜桂益癭湯聯(lián)合左甲狀腺素鈉片治療脾腎陽(yáng)虛型HT在中醫(yī)證候療效方面有明顯改善作用。2.可以明顯改善脾腎陽(yáng)虛型HT的中醫(yī)單項(xiàng)癥狀尤其是面浮肢腫、腰膝酸軟、畏寒肢冷、頸部腫大方面。3.可以明顯改善脾腎陽(yáng)虛型HT的甲功指標(biāo)：FT3、FT4、TSH。4.可能通過(guò)本作用機(jī)制來(lái)升高SOD水平,降低MDA水平,提高患者整體狀態(tài),安全無(wú)副作用。
[Abstract]:Objective: to observe the clinical effect of Jianggui Yiying decoction combined with low dose left thyroxine sodium in treating patients with Hashimoto's farmland adenositis complicated with hypothyroidism with deficiency of spleen and kidney yang. Methods: 66 patients with Hashimoto's thyroiditis complicated with hypothyroidism were randomly divided into two groups: treatment group (n = 33) and control group (n = 33). In the control group, 25 渭 g levothyroxine sodium tablets were taken daily, once a day, and 12.5 渭 g / d was added every 2 weeks. The course of treatment was observed for 4 weeks. Treatment group: in the control group on the basis of medication plus Jiang Gui Yi Ying Tang. Drug composition: ginger 20g, cinnamon 20g, cooked Rehmannia 15g, yam 15g, Poria cocos 15g, alisma 10g, Prunella subtilis 15g, Radix Xuanshen 15g, Astragalus Astragali 20g, Atractylodes macrocephala 20g, Angelica sinensis 15g, Chuanxiong 15g, Qingpi 10g, Chen Pei 15g. Usage: 1 time each morning and evening, 30 minutes after meal warm clothes. A course of treatment was observed for 4 weeks. Results: in the course of the experiment, 32 cases were actually completed in the treatment group (2 males and 30 females) due to active withdrawal, while in the control group (1 case), 2 cases were withdrawn because of going out, 30 cases were actually completed, including 1 male and 29 female. The total effective rate of TCM syndrome in the treatment group was better than that in the control group (P 0.05), the difference was statistically significant. The main symptoms of the two groups were improved after treatment (P0.05), but the treatment group was significantly better than the control group in the aspects of surface floating limb swelling, weak waist and knee, cold chilled limbs and swelling of neck. The difference was statistically significant. In terms of thyroid function, the indexes of TSH of FT3 and FT4 in the two groups were significantly improved (P 0.01), the difference was statistically significant, and the comparison of FT3 FT 4 between the two groups improved P0.05, which indicated that the treatment group was superior to the control group in increasing the effect of FT3 FT 4. In the oxidation index of SOD MDA, there were significant differences before and after treatment in the treatment group (P 0.01), which indicated that the effect was significant, and the comparison between the treatment group and the control group showed that there were differences between the treatment group and the control group, and the effect of the treatment group was better than that of the control group. Conclusion 1. Jiang Gui Yi Ling Tang combined with left thyroxine sodium tablets in the treatment of spleen and kidney yang deficiency type HT has a significant improvement in TCM syndromes. Can obviously improve the spleen and kidney yang deficiency type HT single symptoms, especially the face floating limb swelling, waist and knee sore soft, cold, neck swelling. 3. It can obviously improve the index of thyroid function of HT of spleen and kidney yang deficiency type: t FT 3 + FT 4 and TS H. 4. This mechanism may increase the level of SOD, reduce the level of MDA, improve the overall state of patients, safety and no side effects.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R581

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