本文選題：瀉火化痰消癭方 + 甲狀腺功能亢進癥　； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：探討中西醫(yī)學(xué)對甲狀腺功能亢進癥的認識,觀察導(dǎo)師經(jīng)驗方——瀉火化痰消癭方治療甲狀腺功能亢進癥痰火內(nèi)擾證的療效,探討該方防治本病的作用機理。方法：采用隨機平行對照的研究方法,將符合甲亢痰火內(nèi)擾證的患者,隨機分為治療組和對照組。在對照組西藥常規(guī)治療的基礎(chǔ)上,治療組給予中藥水煎劑每日1劑,分早晚兩次服用,療程12周。觀察兩組治療前后甲狀腺激素(TT3、TT4、FT3、FT4、TSH)及相關(guān)抗體(TRAb)、甲狀腺B超、中醫(yī)證候積分等指標變化,以及其安全性。全部數(shù)據(jù)以SPSS20.0統(tǒng)計軟件進行統(tǒng)計學(xué)分析。結(jié)果：甲狀腺功能亢進癥患者60例,隨機分為2組。治療組與對照組各30例,治療前兩組的性別、年齡、病程、主要癥狀和體征等基線數(shù)據(jù)經(jīng)統(tǒng)計學(xué)分析均無顯著性差異,具有可比性。治療后：①疾病總療效比較：治療組總有效率達96.67%,對照組為73.33%,經(jīng)卡方檢驗P0.05,說明治療組優(yōu)于對照組；②證候療效及癥狀積分比較：在證候療效方面治療組總有效率為96.67%,對照組為70.00%,治療組優(yōu)于對照組(P0.05),在癥狀積分方面兩組治療前后比較均見明顯改善,差異有統(tǒng)計學(xué)意義(P0.01),且治療組效果明顯優(yōu)于對照組(組間比較P0.05)；③心率比較：組內(nèi)比較,兩組患者心率均有所降低,統(tǒng)計分析有顯著性差異(P0.01),組間比較P0.05,提示兩組在改善患者心率方面療效相近；④甲狀腺激素比較：兩組患者治療后TT3、TT4、FT3、FT4均見顯著下降,TSH顯著升高(P0.01),且治療組下降和上升的幅度優(yōu)于對照組,有統(tǒng)計學(xué)意義(P0.05)；⑤TRAb比較：兩組患者TRAb均較治療前見顯著下降(P0.01),組間比較P0.05,提示兩組降低TRAb療效相近；⑥甲狀腺腫比較：組間比較,兩組患者治療后的甲狀腺體積均比治療前縮小,統(tǒng)計分析P0.01,有顯著差異,組間比較提示治療組甲狀腺縮小程度高于對照組(P0.05,有統(tǒng)計學(xué)意義)；⑦安全性比較：對照組出現(xiàn)了2例白細胞減少和2例肝功能輕度異常的患者,經(jīng)常規(guī)治療后均恢復(fù)正常,治療組未見不良反應(yīng)。結(jié)論：從初步臨床研究看來,瀉火化痰消癭方合用西藥治療甲狀腺功能亢進癥痰火內(nèi)擾證,可明顯改善患者的臨床癥狀和證候積分；在西醫(yī)學(xué)檢測指標方面,其可以調(diào)節(jié)甲狀腺激素水平和甲狀腺相關(guān)抗體滴度、減慢心率、降低癥狀積分及甲狀腺腫大,并且安全有效,應(yīng)用前景廣泛,值得進一步深入研究。但由于條件限制,本病例研究數(shù)相對較少,觀察指標比較簡單,研究周期較短,確切療效仍需進一步大樣本、長周期、多中心觀察。
[Abstract]:Objective: to explore the understanding of hyperthyroidism in Chinese and western medicine, to observe the curative effect of Xiehuhuatanxiaoying prescription on hyperthyroidism with phlegm and fire disturbance, and to explore the mechanism of prevention and treatment of hyperthyroidism. Methods: the patients with hyperthyroidism were randomly divided into treatment group and control group. On the basis of the routine treatment of western medicine in the control group, the treatment group was given 1 dose of Chinese medicine decoction daily, divided into two times in the morning and evening, the course of treatment was 12 weeks. Before and after treatment, the changes of thyroid hormone TT _ 3T _ 3T _ 4T _ 4T _ 4T _ 4T _ (4) T _ (4) T _ (4) T _ (4) T _ (TSHH), thyroid B ultrasound, TCM syndromes score, and its safety were observed. All the data were analyzed by SPSS20.0 statistical software. Results: 60 patients with hyperthyroidism were randomly divided into two groups. There were 30 cases in the treatment group and 30 cases in the control group. There was no significant difference in baseline data such as sex, age, course of disease, main symptoms and signs between the two groups before treatment. The total effective rate of the treatment group was 96.677.The total effective rate of the control group was 73.33. The chi-square test showed that the treatment group was superior to the control group. 2 comparison of syndromes curative effect and symptom score: the total effective rate of the treatment group was 96.677.The control group was 70.00. the treatment group was superior to the control group (P0.05A), and the two groups were obviously improved before and after treatment. The difference was statistically significant (P 0.01), and the effect of the treatment group was significantly better than that of the control group (compared with the control group). The statistical analysis showed that there was significant difference between the two groups (P 0.01) and the difference between the two groups (P 0.05), which indicated that the curative effect of the two groups in improving the heart rate of the patients was similar. 4 comparison of thyroid hormone: after treatment, there was a significant decrease in TSH in both groups, and the decrease and increase of TSH in the treatment group was better than that in the control group. There were significant differences in TRAb between two groups compared with before treatment (P 0.01) and between groups (P 0.05), suggesting that the two groups had similar effect in reducing TRAb and the comparison of goiter: comparison between two groups, there was no significant difference between the two groups. The volume of thyroid gland in the two groups after treatment was smaller than that before treatment, and there was a significant difference between the two groups in the statistical analysis (P0.01). The comparison between groups indicated that the degree of thyroid contraction in the treatment group was higher than that in the control group (P 0.05), and there was a significant difference in the safety of the treatment group. There were 2 cases of leukopenia and 2 cases of mild abnormal liver function in the control group, all of them returned to normal after routine treatment. There was no adverse reaction in the treatment group. Conclusion: from the preliminary clinical study, the treatment of hyperthyroidism with Xiehuo Huatan Xiaoying decoction combined with western medicine can obviously improve the clinical symptoms and syndromes of patients with hyperthyroidism. It can regulate thyroid hormone level and thyroid-associated antibody titer, slow down heart rate, reduce symptom score and goiter, and is safe and effective. However, due to the limitation of conditions, the number of cases is relatively small, the observation index is relatively simple, the research period is relatively short, the exact curative effect still needs to be further large sample, long period, multi-center observation.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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本文編號：1939431