本文選題：平亢消癭湯 + Graves病��； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察平亢消癭湯治療心肝火旺型Graves病患者FT3、FT4、TSH、sFas的變化和臨床癥狀改善情況,并探討平亢消癭湯治療Graves病的作用機理可能是通過調(diào)節(jié)外周血sFas,減輕了甲狀腺細胞凋亡的抑制。方法:將符合本試驗病例納入標準的68例患者采用隨機分組法分成治療和對照兩組,兩組各34例�；A(chǔ)治療,即甲巰咪唑10mg,Qdpo,鹽酸普萘洛爾片10mg,Tidpo。對照組給予基礎(chǔ)治療;治療組在基礎(chǔ)治療的同時給予平亢消癭湯,每天1劑,水煎取300ml,每次150ml,Bidpo。臨床觀察周期為4周,FT3、FT4、TSH、外周血sFas、腎功能、心電圖治療前后各檢測一次,TPOAb、TGAb、TRAb在治療前檢測一次,肝功能每兩周檢查一次,血常規(guī)每周檢查一次,中醫(yī)臨床癥狀積分試驗前后各記錄一次,并用統(tǒng)計學(xué)進行分析處理。結(jié)果:1.中醫(yī)療效比較,P0.05。2.中醫(yī)總證候積分比較,兩組治療前進行組間對比P0.05;兩組治療前與治療后分別進行組內(nèi)對比,均為P0.05;兩組證候積分的差值進行對比,P0.05。3.中醫(yī)單項癥狀積分比較,各項癥狀積分治療前進行組間對比,均為P0.05。對于甲狀腺腫、目漲突眼、消瘦,兩組分別進行治療前后組內(nèi)對比,均為P0.05。對于頭暈?zāi)垦！⑸嗤�、少寐多夢、倦怠乏力、口渴多�?兩組分別進行治療前后組內(nèi)對比,均為P0.05;兩組治療前后積分差值進行對比P0.05。對于心悸、煩躁易怒、手指震顫、口苦、胸脅脹痛、多食、惡熱,兩組分別進行治療前后組內(nèi)對比,均為P0.05;兩組治療前后積分差值進行對比P0.05。4.西醫(yī)臨床療效比較,P0.05。5.血清甲狀腺激素變化比較,兩組治療前FT3、FT4、TSH的值進行組間對比P0.05。兩組FT3、FT4治療前后進行組內(nèi)對比,均為P0.05;兩組治療前后差值進行組間對比P0.05。兩組TSH治療前后進行組間對比,均為P0.05;兩組治療前后差值進行組間對比P0.05。6.外周血sFas變化比較,兩組治療前sFas的值進行組間對比P0.05;兩組治療前后分別進行組內(nèi)對比,均為P0.05;兩組前后差值進行組間對比 P0.05。7.不良反應(yīng)觀察,出現(xiàn)不良反應(yīng)的例數(shù),分別經(jīng)χ 2檢驗,均為P0.05。結(jié)論:1.平亢消癭湯可明顯降低中醫(yī)證候積分,改善臨床癥狀及相應(yīng)體征,且在心悸不寧、煩躁易怒、手指震顫、口苦、胸脅脹痛、多食、惡熱的癥狀改善方面效果更明顯。2.平亢消癭湯治療Graves病,可明顯降低FT3、FT4,升高TSH。3.平亢消癭湯可降低外周血sFas含量,其作用機制之一可能是通過降低外周血sFas含量,從而調(diào)節(jié)甲狀腺細胞凋亡,使Graves病得到治療。
[Abstract]:Objective: to observe the changes and clinical symptoms of FT _ (3) T _ (3) T _ (4) T _ (SHH) SFAS in patients with heart-liver-fire flourishing Graves disease treated with Pingkangxiaoying decoction, and to explore the mechanism of Pingkangxiaoying decoction in the treatment of Graves disease, which may be through regulating the peripheral blood sFasS, and lighten the inhibition of thyroid cell apoptosis. Methods: 68 patients who met the criteria were randomly divided into two groups: treatment group and control group with 34 cases in each group. Basic treatment, namely methimazole 10 mg / g Qdpob, propranolol hydrochloride 10 mg / L Tidpo. The control group was given basic treatment, the treatment group was treated with Pingkangxiaoying decoction at the same time, 1 dose per day, decoction 300 ml, 150ml Bidpo. The clinical observation period was 4 weeks after treatment, the blood sFasA, renal function, electrocardiogram (ECG) were detected once before and after treatment, the liver function was examined once every two weeks, and the blood routine examination was performed once a week before and after the treatment. The clinical symptom integral test of traditional Chinese medicine (TCM) was recorded once before and after the test, and was analyzed by statistics. The result is 1: 1. Comparison of curative effects of traditional Chinese Medicine (P0.05.2). The comparison of TCM total syndrome score before treatment between the two groups compared P0.05; the two groups before and after treatment were compared within the group, both P0.05; the difference between the two groups of syndromes score was compared with P0.05.3. Chinese medicine single symptom integral comparison, each symptom integral carries on the comparison before the treatment, all is P0.05. For goiter, bulge eye, thin, the two groups were treated before and after treatment, the comparison was P0.05. For dizziness, tongue pain, less sleep and more dreams, fatigue, thirst and drink, the two groups were compared before and after treatment, both P0.05; the difference between the two groups before and after treatment was compared P0.05. For palpitations, irritability, finger tremor, bitter mouth, chest and flank pain, more food, evil fever, the two groups were compared before and after treatment, both P0.05. the difference between the two groups before and after treatment was compared (P0.05.4). The clinical curative effect of western medicine was compared with that of P0.05.5. The changes of serum thyroid hormone were compared between the two groups before treatment, and the values of FT3, FT4 and TSH were compared between the two groups (P 0.05). The difference between the two groups before and after treatment was P0.05. the difference between the two groups before and after treatment was P0.05. The difference between the two groups before and after TSH treatment was P0.05.The difference between the two groups before and after treatment was P0.05.6. The changes of sFas in peripheral blood of the two groups were compared before and after treatment (P0.05), the difference between the two groups before and after treatment was P0.05.The difference between the two groups before and after treatment was P0.05.7. The number of adverse reactions were all P 0.05 by 蠂 2 test. Conclusion 1. Pingkangxiaoying decoction can obviously reduce the syndromes integral of traditional Chinese medicine, improve clinical symptoms and corresponding signs, and in the palpitation restlessness, irritability, finger tremor, bitter mouth, chest and flank distended pain, more food, evil fever symptom improvement effect is more obvious. 2. The treatment of Graves's disease with Pingkangxiaoying decoction can obviously reduce FT _ 3 FT _ 4 and increase TSH _ 3. Pingganxiaoying decoction can reduce the content of sFas in peripheral blood, and one of its mechanisms may be to regulate the apoptosis of thyroid cells by reducing the content of sFas in peripheral blood, so that Graves disease can be treated.
【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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