疏肝活血法治療肝郁血瘀型甲狀腺功能亢進(jìn)癥臨床研究
發(fā)布時間：2018-11-11 17:45
【摘要】：目的:通過觀察運(yùn)用疏肝活血法治療原發(fā)性甲狀腺功能亢進(jìn)癥中醫(yī)辨證為肝郁血瘀型患者的臨床癥狀、體征、理化檢查指標(biāo),評價其治療效果及臨床意義。方法:病例來源為2016年1月-2016年12月北京中醫(yī)藥大學(xué)東直門醫(yī)院內(nèi)分泌科門診及住院患者符合納入標(biāo)準(zhǔn)者50例。采用隨機(jī)對照方法分為治療組25例,對照組25例,治療組采用基礎(chǔ)治療加疏肝活血中藥加減治療,對照組只用基礎(chǔ)治療。療程為8周,觀察患者臨床癥狀、體征、及相關(guān)理化檢查,記錄病例報告表。將資料建立數(shù)據(jù)庫,使用SPSS21.0軟件進(jìn)行統(tǒng)計分析,比較兩組治療前后癥狀、體征、甲狀腺功能及中醫(yī)證候量化評分以評估臨床療效。結(jié)果:(1)中醫(yī)證候療效比較:治療組總療效92%,25例患者中痊愈2例、顯效14例、有效7例、無效2例,對照組總療效80%,25例患者中痊愈0例、顯效4例、有效16例、無效5例,兩組相比差異有統(tǒng)計學(xué)意義(P0.05)。(2)主要癥狀改善程度比較:兩組治療后癥狀均有明顯改善,其中煩躁易怒、胸脅脹滿、心悸、神疲乏力、多汗改善程度組間比較差異有統(tǒng)計學(xué)意義(P0.05)。(3)對甲狀腺功能改善情況比較:兩組FT3、FT4均有降低,TSH均有升高,治療后組間比較差異無統(tǒng)計學(xué)意義(P0.05)。(4)對甲狀腺腫大改善比較:治療組治療前后甲狀腺腫大程度比較差異有統(tǒng)計學(xué)意義(P0.05),對照組治療前后甲狀腺腫大程度比較差異無統(tǒng)計學(xué)意義(P0.05)。(5)兩組安全性比較:治療組25例中出現(xiàn)肝功能異常者1例、白細(xì)胞減少者1例,對照組25例中出現(xiàn)肝功能異常者2例、白細(xì)胞減少者3例,組間比較差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:(1)疏肝活血法聯(lián)合西藥治療甲狀腺功能亢進(jìn)癥療效優(yōu)于單純西藥治療。(2)疏肝活血法在改善甲狀腺腫大及煩躁易怒、胸脅脹滿、心悸、神疲乏力、多汗等癥狀方面更具優(yōu)勢。(3)疏肝活血法聯(lián)合西藥治療甲狀腺功能亢進(jìn)癥在改善甲功及副作用方面與單純西藥治療相比療效相當(dāng)。
[Abstract]:Objective: to observe the clinical symptoms, signs, physical and chemical indexes of patients with primary hyperthyroidism treated with the method of soothing liver and activating blood circulation, and to evaluate its therapeutic effect and clinical significance. Methods: from January 2016 to December 2016, 50 patients in the Department of Endocrinology and Endocrinology of Dongzhimen Hospital, Beijing University of traditional Chinese Medicine, met the inclusion criteria. 25 cases were divided into treatment group (n = 25) and control group (n = 25). The treatment group was treated with basic treatment plus traditional Chinese medicine for dispersing liver and activating blood circulation, while the control group was treated only with basic therapy. The course of treatment was 8 weeks. The clinical symptoms, signs, physical and chemical examinations were observed, and case report forms were recorded. The data base was set up and SPSS21.0 software was used for statistical analysis. The symptoms, signs, thyroid function and TCM syndromes were compared between the two groups before and after treatment to evaluate the clinical efficacy. Results: (1) comparison of TCM syndromes efficacy: in the treatment group, 2 cases were cured, 14 cases were effective, 7 cases were effective and 2 cases were ineffective. In the control group, the total curative effect was 80%. There were significant differences between the two groups (P0.05). (2). The main symptoms of the two groups were improved after treatment, including irritability, fullness of chest and flank, palpitation, fatigue, and so on. There was significant difference in the degree of hyperhidrosis between the two groups (P0.05). (3). The results showed that FT3,FT4 was decreased and TSH was increased in both groups. There was no significant difference between the groups after treatment (P0.05). (4) on the improvement of goiter: there was significant difference in the degree of thyroid enlargement before and after treatment in the treatment group (P0.05). There was no significant difference in the degree of thyroid enlargement between the two groups before and after treatment (P0.05). (5). In the treatment group, there were 1 case of abnormal liver function, 1 case of leukopenia, 1 case of abnormal liver function and 1 case of leukopenia. There were 2 cases of abnormal liver function and 3 cases of leukopenia in the control group. There was no significant difference between the two groups (P0.05). Conclusion: (1) the curative effect of soothing liver and activating blood circulation method combined with western medicine in treating hyperthyroidism is better than that of western medicine alone. (2) soothing liver and activating blood circulation method can improve goiter and irritability, chest distention, palpitation and fatigue. Hyperhidrosis and other symptoms have more advantages. (3) the treatment of hyperthyroidism with the method of soothing liver and activating blood circulation combined with western medicine is the same as that of western medicine alone in improving thyroid function and side effects.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
[Abstract]:Objective: to observe the clinical symptoms, signs, physical and chemical indexes of patients with primary hyperthyroidism treated with the method of soothing liver and activating blood circulation, and to evaluate its therapeutic effect and clinical significance. Methods: from January 2016 to December 2016, 50 patients in the Department of Endocrinology and Endocrinology of Dongzhimen Hospital, Beijing University of traditional Chinese Medicine, met the inclusion criteria. 25 cases were divided into treatment group (n = 25) and control group (n = 25). The treatment group was treated with basic treatment plus traditional Chinese medicine for dispersing liver and activating blood circulation, while the control group was treated only with basic therapy. The course of treatment was 8 weeks. The clinical symptoms, signs, physical and chemical examinations were observed, and case report forms were recorded. The data base was set up and SPSS21.0 software was used for statistical analysis. The symptoms, signs, thyroid function and TCM syndromes were compared between the two groups before and after treatment to evaluate the clinical efficacy. Results: (1) comparison of TCM syndromes efficacy: in the treatment group, 2 cases were cured, 14 cases were effective, 7 cases were effective and 2 cases were ineffective. In the control group, the total curative effect was 80%. There were significant differences between the two groups (P0.05). (2). The main symptoms of the two groups were improved after treatment, including irritability, fullness of chest and flank, palpitation, fatigue, and so on. There was significant difference in the degree of hyperhidrosis between the two groups (P0.05). (3). The results showed that FT3,FT4 was decreased and TSH was increased in both groups. There was no significant difference between the groups after treatment (P0.05). (4) on the improvement of goiter: there was significant difference in the degree of thyroid enlargement before and after treatment in the treatment group (P0.05). There was no significant difference in the degree of thyroid enlargement between the two groups before and after treatment (P0.05). (5). In the treatment group, there were 1 case of abnormal liver function, 1 case of leukopenia, 1 case of abnormal liver function and 1 case of leukopenia. There were 2 cases of abnormal liver function and 3 cases of leukopenia in the control group. There was no significant difference between the two groups (P0.05). Conclusion: (1) the curative effect of soothing liver and activating blood circulation method combined with western medicine in treating hyperthyroidism is better than that of western medicine alone. (2) soothing liver and activating blood circulation method can improve goiter and irritability, chest distention, palpitation and fatigue. Hyperhidrosis and other symptoms have more advantages. (3) the treatment of hyperthyroidism with the method of soothing liver and activating blood circulation combined with western medicine is the same as that of western medicine alone in improving thyroid function and side effects.
【學(xué)位授予單位】：北京中醫(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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