愈瘿散外敷联合黄连上清丸治疗以颈前疼痛为主诉的亚急性甲状腺炎的疗效及对血清致痛因子、氧化应激水平的影响  

The efficacy of external application of the Yuying powder combined with the Huanglian Shangqing pill in the treatment of subacute thyroiditis with cervical anterior pain as the main complaint and its impact on serum pain factors and oxidative stress levels

作　　者：于向慧 任筱雅 张庚良 马凤梅 Yu Xianghui;Ren Xiaoya;Zhang Gengliang;Ma Fengmei(Department of Endocrinology,Hebei Provincial Hospital of Traditional Chinese Medicine(Affiliated Hospital of Hebei University of Traditional Chinese Medicine),Shijiazhuang 050013,China;Department of Otolaryngology,Hebei Provincial Hospital of Traditional Chinese Medicine(Affiliated Hospital of Hebei University of Traditional Chinese Medicine),Shijiazhuang 050013,China)

机构地区：[1]河北省中医院(河北中医学院附属医院)内分泌科,石家庄050013 [2]河北省中医院(河北中医学院附属医院)耳鼻喉科,石家庄050013

出　　处：《中国医师杂志》2023年第10期1490-1495,共6页Journal of Chinese Physician

基　　金：河北省中医药类科研计划项目(2021061)

摘　　要：目的分析愈瘿散外敷联合黄连上清丸内服治疗以颈前疼痛为主诉的亚急性甲状腺炎(SAT)的临床疗效以及其对患者血清致痛因子、氧化应激水平的影响。方法前瞻性选取2020年1月至2022年5月河北省中医院收治的100例以颈前疼痛为主诉的SAT患者,按随机数字表法均分为两组,每组各50例。对照组给予双氯芬酸钠缓释片治疗,观察组给予愈瘿散外敷联合黄连上清丸内服治疗。连续治疗2周后观察两组镇痛疗效以及药物不良反应情况。比较两组颈前疼痛的镇痛起效时间。并比较治疗前后两组简化McGill疼痛问卷[SF-MPQ,包含疼痛分级指数(PRI)、视觉模拟量表(VAS)、现时疼痛强度(PPI)]评分,中医证候积分,血清致痛因子[肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、前列腺素E_(2)(PGE_(2))、一氧化氮(NO)]水平和氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]水平。结果观察组镇痛总有效率[98.00%(49/50)]显著高于对照组[82.00%(41/50)](P<0.05)。观察组镇痛起效时间显著短于对照组(P<0.05)。治疗后,两组SF-MPQ中各部分(PRI、VAS、PPI)评分和中医证候积分均较治疗前显著降低(均P<0.05);且均以观察组下降更显著(均P<0.05)。治疗后,两组血清TNF-α、IL-1β、PGE_(2)和NO水平均较治疗前显著下降(均P<0.05),且观察组以上血清致痛因子水平均显著低于对照组(均P<0.05)。治疗后,两组治疗后血清MDA含量均显著下降(均P<0.05),血清SOD、GSH-Px水平均显著升高(均P<0.05);且均以观察组改善更显著(均P<0.05)。观察组不良反应发生率[4.00%(2/50)]低于对照组[16.00%(8/50)](P<0.05)。结论愈瘿散外敷联合黄连上清丸内服治疗以颈前疼痛为主诉的SAT的总体疗效确切,其作用可能与其显著下调患者血清相关致痛因子表达水平以及降低体内氧化应激水平有关。Objective To analyze the clinical efficacy of the Yuying powder combined with the Huanglian Shangqing pill for the treatment of subacute thyroiditis(SAT)with cervical anterior pain as the main complaint,as well as its impact on serum pain factors and oxidative stress levels in patients.Methods A prospective selection of 100 SAT patients with anterior cervical pain as the main complaint admitted to the Hebei Provincial Hospital of Traditional Chinese Medicine from January 2020 to May 2022 was conducted.They were randomly divided into two groups,with 50 patients in each group.The control group was treated with sustained-release diclofenac sodium tablets,while the observation group was treated with external application of the Yuying powder and internal administration of the Huanglian Shangqing pill.After 2 weeks of continuous treatment,the analgesic efficacy and adverse drug reactions of both groups were observed.The analgesic onset time of two groups of anterior cervical pain was compared.Two simplified McGill pain questionnaires before and after treatment[the SF-MPQ scores,including Pain Rating Index(PRI),Visual Analog Scale(VAS),and Current Pain Intensity(PPI)],were compared;the traditional Chinese Medicine Syndrome Score,Serum Pain Factors levels[tumor necrosis factor(TNF)-α,interleukin-1β(IL-1β),prostaglandin E_(2)(PGE_(2)),and nitric oxide(NO)]and oxidative stress indicators[the levels of malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)]were also compared.Results The total effective rate of analgesia in the observation group[98.00%(49/50)]was significantly higher than that in the control group[82.00%(41/50)](P<0.05).The analgesic onset time in the observation group was significantly shorter than that in the control group(P<0.05).After treatment,the scores of various components(PRI,VAS,PPI)and traditional Chinese medicine syndrome scores in the two groups of SF-MPQ were significantly reduced compared to before treatment(all P<0.05);and the decrease was more significant in the

关 键 词：甲状腺炎 亚急性 颈痛 愈瘿散 黄连上清丸 

分 类 号：R259[医药卫生—中西医结合]