甲亢平消方联合西药治疗Graves病合并甲状腺毒症性心脏病的疗效及对心肌酶、心电图及心脏结构与功能的影响  

Effect of Jiakang Pingxiaofang decoction combined with western medicine on Graves' disease complicated with thyrotoxic heart disease and its effect on myocardial enzyme, electrocardiogram and cardiac structure and function

作　　者：鲁江艳 舒仪琼[2] LU Jiangyan;SHU Yiqiong(Anhui University of Traditional Chinese Medicine,Hefei 230061,Anhui,China;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China)

机构地区：[1]安徽中医药大学,安徽合肥230061 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《现代中西医结合杂志》2019年第13期1391-1396,1449,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察甲亢平消方联合西药治疗Graves病合并甲状腺毒症性心脏病(HHD)的疗效及对心肌酶、心电图及心功能的影响。方法将110例Graves病合并HHD患者按照随机数字表法分为观察组和对照组,每组55例,对照组给予西药治疗,观察组在对照组基础上加用甲亢平消方治疗,疗程均为3个月。统计2组临床疗效,记录2组治疗前后中医症状积分、甲状腺激素、心肌酶、心电图及心功能指标的变化。结果观察组中医证候治疗疗效、临床疾病治疗疗效均显著优于对照组(P均<0.05);2组治疗后心悸、胸闷多痰、胸胁窜痛、急躁易怒、喜叹息、不寐多梦、颜面青黯积分和总积分均显著降低(P均<0.05),观察组治疗后以上中医症状积分均显著低于对照组(P均<0.05);2组治疗后血清游离T3(FT_3)、游离T4(FT_4)、TSH受体抗体(TRAb)水平均较治疗前显著降低(P均<0.05),血清促甲状腺激素(TSH)水平均较治疗前显著升高(P均<0.05),观察组治疗后以上指标改善情况均显著优于对照组(P均<0.05);2组治疗后肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、α-羟丁酸脱氢酶(α-HBD)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)水平均较治疗前显著降低(P均<0.05),观察组治疗后以上指标水平均显著低于对照组(P均<0.05);观察组治疗后窦性心动过速、期前收缩、ST—T段改变、Q-T间期延长、甲亢P波、阵发性室上速发生率均较治疗前显著降低(P均<0.05),且观察组前五项发生率均显著低于对照组(P均<0.05)。2组治疗后左室舒张末期内径(LVEDD)、右心室内径(RV)、左心房内径(LA)、肺动脉收缩压(PASP)、N端脑钠肽前体(NT-proBNP)水平均较治疗前显著降低(P均<0.05),左心室射血分数(LVEF)、E/A较治疗前显著升高(P均<0.05),观察组以上指标均显著优于对照组(P均<0.05)。结论在西药治疗Graves病合并HHD的基础上,加用甲亢平消方可显著缓解患者临床症状,提高临床疗效,不仅可Objective It is to observe the therapeutic effect of Jiakang Pingxiaofang decoction combined with western medicine on Graves’ disease with thyrotoxic heart disease(HHD) and its effect on myocardial enzymes, electrocardiogram and cardiac function. Methods 110 patients with Graves disease and HHD were divided into observation group and control group according to the random number table method. There were 55 cases in each group. The control group was treated with western medicine. The observation group was treated with Jiakang Pingxiaofang decoction on the basis of the control group. The course of treatment was 3 months. The clinical efficacy of the two groups was statistically analyzed. The changes of TCM symptom scores, thyroid hormone, myocardial enzymes, electrocardiogram and cardiac function indexes before and after treatment were recorded. Results The curative effect of TCM symptom treatment and the therapeutic effect of clinical disease were significantly better in the observation group than those in the control group(P<0.05). After treatment, the scores of palpitations, chest tightness and abundant phlegm, sternal rib pain, irritability, sigh, and insomnia and dreamful sleep and total scores were significantly decreased(P<0.05), the scores of the above TCM symptoms in the observation group were significantly lower than those in the control group(P<0.05). The levels of serum free T3(FT3) and free T4(FT4) and TSH receptor antibodies(TRAb) after treatment were significantly lower while that of serum thyroid stimulating hormone(TSH) were significantly higher that those before treatment in the two group(P<0.05), and the improvements of the above indicators after treatment in the observation group were significantly better than those in the control group(P<0.05). After treatment, the levels of creatine kinase isoenzyme(CK-MB), creatine kinase(CK),α-hydroxybutyrate dehydrogenase(α-HBD), lactic acid dehydrogenase(LDH) and aspartate aminotransferase(AST) were significantly lower than those before treatment in the

关 键 词：甲亢平消方 GRAVES病 甲状腺毒症性心脏病 心肌酶 心功能 

分 类 号：R581.04[医药卫生—内分泌]