【摘要】：目的：通過(guò)觀察三甲復(fù)脈湯化裁方治療肝腎陰虛型甲亢患者中醫(yī)證候以及FT3、FT4、TSH、TNF-α各項(xiàng)指標(biāo)變化情況,從而探討三甲復(fù)脈湯化裁方治療甲亢的作用機(jī)制以及對(duì)TNF-α的影響。方法：選取病例皆來(lái)自于2014年03月至2014年12月黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院門(mén)診并經(jīng)診斷確定為甲亢(肝腎陰虛型)的患者64例,并將其隨機(jī)分為治療組與對(duì)照組,兩組病例數(shù)均為32例。治療組應(yīng)用三甲復(fù)脈湯化裁和甲巰咪嘩進(jìn)行治療。對(duì)照組應(yīng)用甲巰咪嘩治療。本試驗(yàn)以4周為一個(gè)療程,定期檢測(cè)安全性指標(biāo)和療效性觀察指標(biāo)結(jié)果(1)兩組中醫(yī)證候療效比較P0.05,差異有統(tǒng)計(jì)學(xué)意義,其中治療組總有效率為97%,而對(duì)照組則為83%,治療組優(yōu)于對(duì)照組。單個(gè)癥狀積分比較,治療組在頭暈眼花、頸前腫大癥狀改善情況均優(yōu)于對(duì)照組(P0.05)。(2)兩組西醫(yī)療效比較P0.05,差異有統(tǒng)計(jì)學(xué)意義,其中治療組總有效率為96%,而對(duì)照組則為76%,治療組明顯優(yōu)于對(duì)照組(3)兩組治療前FT3、FT4、TSH比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,具有可比性；兩組治療后,二者FT3、FT4、TSH的組內(nèi)比較,P0.05,說(shuō)明兩組甲狀腺功能均有改善,兩組治療后FT3、FT4、TSH組間比較,P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義。(4)治療組治療前后和對(duì)照組治療前后TNF-α比較P0.05,差異有統(tǒng)計(jì)學(xué)意義。兩組治療后TNF-α比較P0.05,差異有統(tǒng)計(jì)學(xué)意義,且治療組優(yōu)于對(duì)照組。結(jié)論(1)三甲復(fù)脈湯化裁方在改善中醫(yī)證候方面療效明顯,尤其是在改善頭暈眼花、頸前腫大方面療效更為突出。(2)三甲復(fù)脈湯化裁方可以降低FT3、FT4、升高TSH。(3)三甲復(fù)脈湯化裁方有效的降低了TNF-α水平。
[Abstract]:Objective: to observe the changes of TCM syndromes and FT3,FT4,TSH,TNF- 偽 indexes in the treatment of hyperthyroidism of liver and kidney yin deficiency type by Sanjiafumai decoction, so as to explore the mechanism of Sanjiafumai decoction in treating hyperthyroidism and its effect on TNF- 偽. Methods: from March 2014 to December 2014, 64 patients with hyperthyroidism (liver and kidney yin deficiency) were selected from outpatient clinic of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine, and were randomly divided into treatment group and control group. There were 32 cases in both groups. The treatment group was treated with Sanjia Fumai decoction and cimercaptopril. The control group was treated with cimetidine. The results of this study were as follows: (1) the curative effect of TCM syndrome in the two groups was compared with that of P0.05, and the difference was statistically significant. The total effective rate in the treatment group was 97 and 833 in the control group, which was superior to that in the control group. Single symptom score comparison, the treatment group in dizziness, cervical swelling symptoms were better than the control group (P0.05). (2) two groups of Western medicine efficacy comparison P0.05, the difference was statistically significant, The total effective rate of the treatment group was 96g and that of the control group was 76.The treatment group was obviously superior to the control group (3) the FT3,FT4,TSH of the two groups was significantly higher than that of the control group (P 0.05), the difference was not statistically significant and comparable. The results showed that the thyroid function of the two groups was improved, and there was no significant difference between the two groups after FT3,FT4,TSH treatment. (4) the TNF- 偽 in the treatment group was significantly higher than that in the control group before and after treatment (P 0.05). There was significant difference in TNF- 偽 between the two groups after treatment (P 0.05), and the treatment group was superior to the control group. Conclusion (1) Sanjia Fumai decoction is effective in improving TCM syndromes, especially in improving dizziness. (2) Sanjia Fumai decoction can reduce FT3,FT4, and increase TSH. (3) Sanjia Fumai decoction can effectively reduce the level of TNF- 偽.
【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)】：R581.1

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