桥本氏甲状腺炎350例中医证素分布规律的临床研究  

Clinical study on the distribution rules of traditional Chinese medicine syndrome in 350 cases of Hashimoto’s thyroiditis

作　　者：丁婉丽 林燕[2] 杜宗毓 赵彩虹 DING Wan-li;LIN Yan;DU Zong-yu;ZHAO Cai-hong(Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院甲状腺病科,北京100700

出　　处：《中华中医药杂志》2023年第2期915-920,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京中医药新奥奖励基金课题(No.2018-XAJLJJ-025)。

摘　　要：目的:探讨桥本氏甲状腺炎中医证素的分布规律。方法:于2019年10月—2020年12月收集350例桥本氏甲状腺炎患者临床资料,进行中医证素判定,基于统计分析探讨桥本氏甲状腺炎中医证素分布以及和年龄、病程、甲状腺功能、甲状腺彩超的相关性。结果:桥本氏甲状腺炎病位证素以肝、脾为主,病性证素以气虚、气滞、阴虚、痰湿为主。随年龄增长,脾、痰湿、血瘀、气虚、阴虚、阳虚证素的分布均呈增加趋势(P<0.01,P<0.05)。随病程发展,脾、肾、心、气虚、阳虚证素的分布均呈增加趋势(P<0.01,P<0.05)。火热证素表现为甲状腺功能正常>甲状腺功能亢进>甲状腺功能减退(P<0.05),气虚证素表现为甲状腺功能正常>甲状腺功能减退>甲状腺功能亢进(P<0.05)。各病位证素和病性证素对甲状腺体积无明显影响。肺证素甲状腺腺体血流主要表现为正常>减弱>增多(P<0.01)。其余各病位证素和病性证素对甲状腺腺体血流无明显影响。结论:桥本氏甲状腺炎主要证素为肝、脾、气虚、气滞、阴虚、痰湿,证素与年龄、病程、甲状腺功能、甲状腺彩超具有一定相关性。Objective: To study the distribution of traditional Chinese medicine(TCM) syndrome elements in Hashimoto’s thyroiditis. Methods: Clinical data of Hashimoto’s thyroiditis patients from October 2019 to December 2020were collected,TCM syndrome elements were determined,and the correlation between TCM syndrome elements distribution and age,disease course,thyroid function and thyroid color doppler ultrasound were discussed based on statistical analysis.Results: Liver and spleen were the main disease position symptom elements of Hashimoto’s thyroiditis,while qi deficiency,qi stagnation,yin deficiency and phlegm dampness were the main pathogenic syndrome elements. With the increase of age,the distribution of syndrome elements of spleen,phlegm-dampness,blood stasis,qi deficiency,yin deficiency and yang deficiency showed an increasing trend(P<0.01,P<0.05). With the development of the disease course,the distribution of spleen,kidney,heart,qi deficiency and yang deficiency syndrome elements all showed an increasing trend(P<0.01,P<0.05).The fire syndrome elements were characterized by normal thyroid function>hypothyroidism>hyperthyroidism(P<0.05),while the qi deficiency syndrome elements were characterized by normal thyroid function>hyperthyroidism>hypothyroidism(P<0.05). Syndrome factors of different disease locations and syndrome factors of different diseases have no obvious influence on thyroid volume. The blood flow of thyroid gland in lung syndrome elements were mainly normal>weakened>increased(P<0.01). Other syndrome factors of disease location and syndrome factors of disease had no obvious effect on blood flow of thyroid gland. Conclusion: The main syndromes of Hashimoto’s thyroiditis are liver,spleen,qi deficiency,qi stagnation,yin deficiency and phlegm-dampness. The syndromes are related to age,course of disease,thyroid function and thyroid color doppler ultrasound.

关 键 词：桥本氏甲状腺炎 证素 病位 病性 年龄 病程 甲状腺功能 甲状腺彩超 

分 类 号：R259[医药卫生—中西医结合]