养阴散结法治疗分化型甲状腺癌术后的临床疗效研究  

Clinical Effect of Therapy of Nourishing Yin and Dissipating Mass for the Treatment of Differentiated Thyroid Carcinoma after Operation

作　　者：黎绮颖 王炜[2] LI Qi-Ying;WANG Wei(The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510095 Guangdong China)

机构地区：[1]广州中医药大学第五临床医学院,广东广州510405 [2]广州中医药大学附属广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2021年第8期1571-1577,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨在左甲状腺素钠片常规治疗的基础上结合养阴散结法治疗分化型甲状腺癌术后气阴两虚型患者的临床疗效。【方法】将80例分化型甲状腺癌术后气阴两虚型患者随机分为观察组和对照组,每组各40例。对照组给予左甲状腺素钠片常规治疗,观察组在对照组的基础上给予加服养阴散结颗粒剂治疗,疗程为2个月。观察2组患者治疗前后中医证候评分、Karnofsky功能状态(KPS)评分、甲状腺功能[血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白(thyroglobulin,Tg)]及血常规[白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)]的变化情况,并评价2组的中医证候疗效。【结果】(1)治疗2个月后,观察组的总有效率为87.5%(35/40),对照组为57.5%(23/40),观察组的中医证候疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的KPS评分均较治疗前明显升高(P<0.05),且观察组对KPS评分的升高作用明显优于对照组(P<0.05)。(3)治疗后,2组患者的各项中医证候评分及总分均较治疗前明显降低(P<0.05),且观察组对疲倦乏力、烦热汗出、急躁易怒、失眠多梦、口干咽燥等中医证候评分及总分的降低作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者血清FT3、FT4水平均较治疗前升高,TSH水平均较治疗前下降(P<0.05),而Tg水平也均较治疗前有一定程度下降,但差异均无统计学意义(P>0.05);组间比较,观察组对血清FT3、FT4水平的升高作用及对血清TSH水平的降低作用均优于对照组(P<0.05)。(5)治疗后,2组患者的WBC、Hb、PLT水平均较治疗前升高(P<0.05);治疗后组间比较,观察组的PLT、Hb水平高于对照组,而WBC水平略低于对照组(P<0.05)。【结论】在左甲状腺素钠片常规治疗的基础上结合养阴散结法治疗分化型甲状腺癌术后气阴两虚型患者疗效确切,能有效改善患者临床不适症状,提高患者�Objective To investigate the therapeutic effect of therapy of nourishing yin and dissipating mass combined with Levothyroxine Sodium Tablets for the treatment of postoperative patients with differentiated thyroid cancer differentiated as the syndrome of deficiency of both qi and yin. Methods Eighty postoperative patients with differentiated thyroid carcinoma after operation were randomly divided into control group and observation group,and each group had 40 cases. All of the patients were differentiated as the syndrome of deficiency of both qi and yin.The control group was treated with Levothyroxine Sodium Tablets orally,and the observation group was treated with Levothyroxine Sodium Tablets orally combined with the herbal granules with the actions of nourishing yin and dissipating mass. The course of treatment for the two groups covered 2 months. Before and after treatment, we examined the traditional Chinese medicine(TCM)syndrome scores,Karnofsky Performance Status(KPS)scores,levels of thyroid function indicators of free triiodothyronine(FT3), free thyroxine(FT4), thyroid stimulating hormone(TSH), and thyroglobulin(Tg), and blood routine test indexes of white blood cell(WBC)count,hemoglobin(Hb)level,and platelet(PLT)count. Meanwhile,the efficacy for TCM syndrome was also evaluated in the two groups. Results(1)After treatment for 2 months,the total effective rate in the observation group was87.5%(35/40), and that in the control group was 57.5%(23/40). The intergroup comparison showed that the efficacy for TCM syndrome in the observation group was superior to that in the control group(P<0.01).(2)After treatment, the KPS scores in the two gorups were obviously increased in comparison with those before treatment(P<0.05),and the observation group had stronger efficacy on increasing the KPS scores than the control group(P<0.05).(3)After treatment,the scores of each TCM syndrome manifestations as well as the overall TCM syndrome scores in the two groups were obviously decreased in comparison with those before treatmen

关 键 词：养阴散结法 分化型甲状腺癌 术后 气阴两虚型 甲状腺功能 生活质量 

分 类 号：R273.361[医药卫生—中西医结合]