本文選題：橋本氏病 + 甲狀腺功能亢進(jìn)癥��； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過觀察清熱養(yǎng)陰湯治療橋本甲亢(心肝火旺證)的臨床療效,分析本方治療橋本甲亢(心肝火旺證)的有效性和安全性,為臨床中治療本病提供更多的思路和方案選擇。方法:選擇隨機(jī)對照試驗(yàn)方法,將符合納入標(biāo)準(zhǔn)的68例橋本甲亢患者分為治療組和對照組,每組34例。治療組予清熱養(yǎng)陰湯,對照組予甲巰咪唑,觀察兩組患者中醫(yī)癥候、體征、甲狀腺功能、肝功能、腎功能、血常規(guī)、尿常規(guī)指標(biāo)的變化,兩組均每2周(14天)為一個(gè)療程,共觀察6個(gè)療程,共三個(gè)月(90土7天)�；颊呙刊煶虖�(fù)診1次,并分別于治療前、每次復(fù)診時(shí)進(jìn)行檢驗(yàn)和檢查并詳細(xì)記錄,進(jìn)行療效判斷及統(tǒng)計(jì)學(xué)數(shù)據(jù)分析。結(jié)果:1.治療組總有效率90.90%,對照組總有效率87.88%,兩組比較無顯著性差異(P0.05);2.治療后兩組中醫(yī)證候積分較治療前明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中,煩躁、心悸癥候積分降低治療組優(yōu)于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);3.治療后兩組甲狀腺腫大積分、甲狀腺質(zhì)地積分、脈率積分和突眼積分較治療前均明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);4.治療后兩組FT3、FT4較治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),TSH較治療前明顯升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療后兩組TGAb和TPOAb較治療前有所降低,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);5.治療后,兩組白細(xì)胞計(jì)數(shù)減少發(fā)生率比較無顯著性差異(P0.05),兩組肝功能損害發(fā)生率比較,治療組低于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療后兩組均未發(fā)生腎功能改變和尿常規(guī)改變。結(jié)論:1.清熱養(yǎng)陰湯能夠顯著改善橋本甲亢(心肝火旺證)的中醫(yī)證候,尤其在改善在煩躁、心悸癥候上療效顯著。2.清熱養(yǎng)陰湯顯著降低橋本甲亢(心肝火旺證)的FT3、FT4水平,升高TSH水平,降低TGAb和TPOAb水平。3.清熱養(yǎng)陰湯治療橋本甲亢(心肝火旺證)過程中未見白細(xì)胞減少及肝功能損害發(fā)生,未見腎功改變,具有可靠的安全性。
[Abstract]:Objective: to observe the efficacy and safety of Qingre Yangyin decoction in treating Hashimoto hyperthyroidism (heart-liver-fire and hyperthyroidism syndrome), and to analyze its efficacy and safety in treating Hashimoto hyperthyroidism. For the clinical treatment of this disease to provide more ideas and options. Methods: 68 patients with Hashimoto hyperthyroidism were divided into treatment group (n = 34) and control group (n = 34). The treatment group was treated with Qingre Yangyin decoction and the control group with methimazole. The changes of TCM symptoms, signs, thyroid function, liver function, kidney function, blood routine and urine routine indexes were observed as a course of treatment in the two groups. A total of 6 courses of treatment were observed for 3 months, 90 days and 7 days. The patients were reviewed once per course of treatment. Before and after each visit, the patients were examined and recorded in detail, and the curative effect was judged and the statistical data were analyzed. The result is 1: 1. The total effective rate was 90.90 in the treatment group and 87.88 in the control group. There was no significant difference between the two groups. After treatment, the scores of TCM syndromes in the two groups were significantly lower than those before treatment, and the difference was statistically significant (P 0.05). The treatment group was better than the control group in reducing the score of fidgety and palpitation symptoms, and the difference was statistically significant (P 0.05). After treatment, the scores of goiter, thyroid texture, pulse rate and exophthalmos in the two groups were significantly lower than those before treatment, and the difference was statistically significant (P 0.05). After treatment, FT3 / FT4 in the two groups was significantly lower than that before treatment, the difference was statistically significant (P 0.05) and the difference was statistically significant (P 0.05). After treatment, the TGAb and TPOAb in the two groups were lower than those before treatment, and the difference was statistically significant (P 0.05). After treatment, there was no significant difference in the incidence of leukopenia between the two groups. The incidence of liver function damage in the treatment group was lower than that in the control group. The difference was statistically significant (P 0.05). There were no changes in renal function and urine routine after treatment. Conclusion 1. Qingre Yangyin decoction can significantly improve the TCM syndromes of Hashimoto hyperthyroidism (heart-liver-fire flourishing syndrome), especially in improving the symptoms of irritability, palpitations. Qingre Yangyin decoction significantly decreased FT3FT-4 level of Hashimoto hyperthyroidism (syndrome of heart-liver-fire flourishing), increased the level of TSH, and decreased the levels of TGAb and TPOAb .3. During the treatment of Hashimoto hyperthyroidism with Qingre Yangyin decoction, leukopenia and liver function damage did not occur.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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