透热消瘿方内服联合加味金黄散外敷治疗热毒炽盛型亚急性甲状腺炎临床观察  

Clinical Observation on Toure Xiaoying Decoction(透热消瘿方)for Internal Application Combined with Modified Jinhuang Powder(加味金黄散)for External Application in Treatment of Heat Toxicity Incandescence Syndrome Subacute Thyroiditis

作　　者：田妍 陈新[1] 张丹[1] 吴萍[1] 黄炜伦 TIAN Yan;CHEN Xin;ZHANG Dan;WU Ping;HUANG Weilun(Zigong First People’s Hospital,Zigong 643099,China)

机构地区：[1]自贡市第一人民医院,四川自贡643099

出　　处：《山东中医杂志》2023年第5期473-478,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：自贡市市级重点科技计划项目专项(编号:2018SHFZ18)。

摘　　要：目的:观察透热消瘿方内服联合加味金黄散外敷对热毒炽盛型亚急性甲状腺炎(SAT)患者实验室指标和超声剪切波弹性成像(SWE)的影响及相关性研究。方法:选取136例热毒炽盛型SAT患者为研究对象,按照随机数字表法分为对照组、观察组各68例,对照组采用透热消瘿方中药内服,观察组在对照组基础上加用加味金黄散外敷,两组均干预2周。观察两组治疗前后的临床症状积分(包括颈部肿大、颈部疼痛、发热、乏力症状),实验室指标[促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、红细胞沉降率(ESR)、甲状腺球蛋白抗体(TgAb)、甲状腺微粒体抗体(TMAb)],超声指标(甲状腺肿块大小、甲状腺动脉峰值流速、SWE弹性模量)。并分析SWE与实验室指标的相关性。结果:治疗后两组颈部肿大、颈部疼痛、发热、乏力症状积分均较治疗前降低,且观察组颈部肿大、颈部疼痛、发热症状积分均低于对照组(P<0.05);两组乏力症状积分比较,差异无统计学意义(P>0.05)。治疗后两组TSH均较治疗前升高,两组比较差异无统计学意义(P>0.05)。治疗后两组T3、T4、CRP、IL-6、ESR、TgAb、TMAb水平均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后两组甲状腺肿块大小、甲状腺动脉峰值流速、弹性模量均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后观察组T3、T4、CRP、IL-6、TgAb、TMAb与SWE弹性模量呈正相关(P<0.05),ESR与SWE弹性模量无相关性(P>0.05)。结论:透热消瘿方内服联合加味金黄散外敷治疗热毒炽盛型SAT能够改善甲状腺功能,减少炎症反应,降低血清TgAb、TMAb的表达,改善甲状腺的大小、硬度和血流速度,临床症状积分-实验室指标-影像学指标的多维度评价体系能够更加客观地评估患者病情。Objective:To observe the effect of Toure Xiaoying Decoction(透热消瘿方)for internal appli-cation combined with Modified Jinhuang Powder(加味金黄散)for external application on laboratory indexes and ultrasonic shear wave elastography(SWE)in patients with heat toxicity incandescence syndrome subacute thyroiditis(SAT)and its correlation.Methods:A total of 136 SAT patients with heat toxicity incandescent type were selected as the study subjects,and divided into the control group and the observation group by using random number table method,with 68 cases in each group.The control group was given Toure Xiaoying Decoction internally.The observation group was additionally given Modified Jinhuang Powder for external application on the basis of the treatment of the control group,and both groups were intervened for 2 weeks.The scores of traditional Chinese medicine(TCM)clinical symptoms(including neck enlargement,neck pain,fever and fatigue)of the two groups before and after intervention,laboratory indicators[thyroid hormone(TSH),triiodothyronine(T3),thyroxine(T4),C-reactive protein(CRP),interleukin-6(IL-6),erythrocyte sedimentation rate(ESR),thyroglobulin antibody(TgAb),thyroid microsomal antibody(TMAb)],Ultrasound indicators(thyroid mass size,peak thyroid artery flow rate,elastic modulus of SWE)were observed.The correlation between SWE and laboratory indexes was analyzed.Results:After treatment,the symptoms scores of neck swelling,neck pain,fever and fatigue in both groups were lower than those before treatment,and the symptoms scores of neck swelling,neck pain,fever in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the score of fatigue between the two groups(P>0.05).After treatment,the levels of TSH in both groups were higher than those before treatment,and there was no significant difference between the two groups(P>0.05).After treatment,the levels of T3,T4,CRP,IL-6,ESR,TgAb and TMAb in both groups were lower than those before treatment,and those

关 键 词：加味金黄散 透热消瘿方 外敷 亚急性甲状腺炎 热毒炽盛型 剪切波弹性成像 

分 类 号：R259[医药卫生—中西医结合]