清热消瘿汤治疗火郁痰阻型亚急性甲状腺炎临床研究  

Clinical study of Qingre Xiaoying decoction in the treatment of subacute thyroiditis with fire-stagnati on and phlegm-obstruction type

作　　者：陈晨[1] 李莉 CHEN Chen;LI Li(Department of Endocrinology,Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi,Xinjiang 830000)

机构地区：[1]新疆医科大学附属中医医院内分泌科,新疆乌鲁木齐830000 [2]江苏省无锡市第二中医医院内分泌科,江苏无锡214000

出　　处：《河北中医》2020年第3期360-364,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2017D01C177)。

摘　　要：目的观察清热消瘿汤治疗火郁痰阻型亚急性甲状腺炎的临床疗效。方法将70例火郁痰阻型亚急性甲状腺炎患者按照随机数字表法分为2组。对照组34例予醋酸泼尼松片治疗,治疗组36例在对照组治疗基础上加清热消瘿汤治疗。2组均治疗3个月。比较2组疗效;观察2组治疗前后血清游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)、促甲状腺激素(TSH)变化,血清甲状腺球蛋白抗体(TGAb)、抗甲状腺微粒体抗体(TMAb)及红细胞沉降率(ESR)变化;观察2组治疗前后甲状腺体积及甲状腺峡部厚度变化;比较2组治疗前后中医症状评分变化及退热时间、甲状腺肿消退时间、甲状腺区疼痛消退时间;记录2组不良反应发生情况。结果治疗组总有效率94.44%(34/36),对照组总有效率73.53%(25/34),治疗组疗效优于对照组(P<0.05)。2组治疗后血清FT 3、FT 4水平均较本组治疗前降低(P<0.05),血清TSH较本组治疗前升高(P<0.05),且治疗组FT 3、FT 4水平均降低更明显(P<0.05),TSH升高更明显(P<0.05)。2组治疗后血清TGAb、TMAb及ESR水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后甲状腺体积及甲状腺峡部厚度均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后颈前肿大、颈前疼痛、发热多汗、咽痛烦躁、心悸不宁、震颤多食及便频消瘦评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组退热时间、甲状腺肿消退时间、甲状腺区疼痛消退时间均早于对照组(P<0.05)。治疗组不良反应发生率2.78%,对照组不良反应发生率11.76%,治疗组低于对照组(P<0.05)。结论清热消瘿汤治疗火郁痰阻型亚急性甲状腺炎,可明显改善患者临床症状及甲状腺激素水平,且不良反应较少。Objective To observe the effect of Qingre Xiaoying decoction in the treatment of subacute thyroiditis with fire-stagnati on and phlegm-obstruction type.Methods 70 patients with subacute thyroiditis were randomly divided into two groups according to the random number table method.34 cases in control group were treated by prednisone acetate tablets.36 cases in treatment group were treated by Qingre Xiaoying decoction on the basis of the control group.Both groups were treated for three month.The efficacy of two groups were compared.The changes of free triiodothyronine(FT 3),free thyroxine(FT 4),thyrotropin(TSH),erythrocyte sedimentation rate(ESR),thyroglobulin antibody(TGAb)and thyroid microsomal antibody(TMAb)were observed before and after treatment in the two groups.The changes of thyroid volume and thickness of isthmus were observed before and after treatment in the two groups.The changes of TCM symptom scores before and after treatment in the two groups were compared.The adverse reactions in the two groups were recorded.Results the total effective rate was 94.44%(34/36)in the treatment group and 73.53%(25/34)in the control group.The effect of the treatment group was better than that of the control group(P<0.05).After treatment,FT 3 and FT 4 in the two groups were lower than those in the group before treatment(P<0.05),TSH was higher than that in the group before treatment(P<0.05),and FT 3 and FT 4 were decreased more significantly in treatment group(P<0.05),TSH was increased more significantly in treatment group(P<0.05).The levels of ESR,TGAb and TMAb in the two groups were lower than thosein the group before treatment(P<0.05),and the treatment group was significantly lower(P<0.05).The thyroid volume and isthmus thickness of the two groups after treatment were lower than those in the group before treatment(P<0.05),and the treatment group was significantly lower(P<0.05).The scores of anterior cervical enlargement,anterior cervical pain,fever,sweating,pharyngalgia,fidgety,palpitation,tremor,hyperphagia and stool fr

关 键 词：甲状腺炎 亚急性 辨证分型 中药疗法 

分 类 号：R581.405.31[医药卫生—内分泌] R241[医药卫生—内科学]