亚甲方治疗重症亚急性甲状腺炎的中西医疗效观察  

Chinese and Western Medicine Clinical Curative Effect of Yajiafang Treating Severe Subacute Thyroiditis

作　　者：黄洋[1] 李红[1] 高龙 张霞[1] HUANG Yang;LI Hong;GAO Long;ZHANG Xia(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Henan Hospital of TCM, Zhengzhou 450000, Henan, China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]河南省中医院,河南郑州450000

出　　处：《辽宁中医杂志》2018年第2期334-338,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81373617);上海市科委课题项目(15401930400);上海市浦发新区名中医工作室建设项目(PDZYXK-3-2014005)

摘　　要：目的：探讨亚甲方治疗重症亚急性甲状腺炎的中西医临床疗效及其安全性。方法：将66例热毒壅盛、血热夹瘀型的重症亚急性甲状腺炎患者随机分为中药亚甲方治疗组33例,西药醋酸泼尼松片对照组33例。两组疗程均为1个月,观察1个月,停药后随访3个月,比较两组症状体征改善时间、疗效、中医证候、疗程、不良反应和复发率。结果：（1）疗程结束时,最终完成试验者共62例,试验组31例,对照组31例。（2）用药4周时中药试验组临床疗效显著,总有效率93.55%,优于西药对照组总有效率87.10%;组间临床疗效比较有显著性差异（P〈0.01）。（3）试验组可明显改善热毒壅盛、血热夹瘀型的重症亚急性甲状腺炎患者总中医证候,并且随着治疗时间的增加,治疗的效果也是更加显著,疗效优于对照组,P〈0.05。（4）试验组可有效改善热毒壅盛、血热夹瘀证的各项中医证候,两组治疗后中医各项证候疗效比较,其中试验组甲状腺肿、乏力、多汗、震颤、肢体酸痛、食欲不振均优于对照组,P〈0.05;发热、甲状腺痛、咽痛治疗后两组无明显差异。（5）虽然试验组对SAT患者发热、疼痛缓解所需的时间和完全热退、疼痛消除所需的时间比对照组长,两组差别有统计学意义P〈0.05,但是试验组完全停药所用的时间（疗程）较短,两组差别有统计学意义P〈0.05。（6）试验组不良反应发生率低（0.00%）优于对照组（19.35%）,P〈0.05。（7）试验组复发率低（0.00%）优于对照组（35.48%）,P〈0.01。结论：亚甲方可有效降低热毒壅盛、血热夹瘀型的重症亚急性甲状腺炎的中医证候总积分,改善各项中医证候,痊愈时间短,停药迅速,无不良反应,复发率低。Objective： To do an evaluation of curative effects of Yajiafang treating the severe subacute thyroiditis with the syndrome of＂toxin and heat excess,blood-heat and stagnation＂and its security. Methods： A total of 66 cases who have severe subacute thyroiditis with the syndrome of ＂toxin and heat excess,blood-heat and stagnation＂were randomly divided into treatment group using Yajiafang or controlled group using prednisone on average for 1 and 3 months follow-up after drug discontinuance.Then we observed the improving time of the clinic symptom,the course of clinical effects,the changing of syndrome differentiation in TCM,the time required for drug discontinuance and treatment adverse reactions and relapse rate. Results：（1） 62 cases complicated the treatment,including 31 cases in both treatment group and controlled group on equal.（2） After 4 weeks＇ treatment,the treatment group＇s curative effect was distinct and the total effective rate was 93. 55%,better than the control group＇ s 87. 10%.There was a significant difference between the two groups（P〈 0. 01）.（3） It had more effection of treatment group than controlled group in reducing the general symptom integral of＂toxin and heat excess,blood-heat and stagnation＂of the severe subacute thyroiditis and the effect of the treatment was even more significant changing with the time（P〈 0. 05）.（4） The treatment group can effectively ameliorate the symptomatology of TCM,and there was apparent difference in the ameliorating points of thyroid enlargement,weakness,hyperidrosis,sore limbs and inappetence after therapy for the treatment group（P〈 0. 05）. But there was no obvious difference in ameliorating points of radiation,thyroid pain and pharyngalgia.（5） Though it took more time to relieve or completely heal the fever and thyroid pain of the treatment group than controlled group,the time required for complete withdrawal of the treatment group was shorter than that of the controlled group. The differences were statist

关 键 词：重症亚急性甲状腺炎 亚甲方 热毒壅盛 血热夹瘀 中医治疗 

分 类 号：R581.4[医药卫生—内分泌]