夏枯草汤合海藻玉壶汤加减治疗良性甲状腺结节临床研究  

Clinical Study on Modified Xiakucao Decoction Combined with Haizao Yuhu Decoc⁃ tion for Benign Thyroid Nodules Complicated with Thyroid Hormone Abnormalities

作　　者：王麒又 王国华 阮丽丽 李四华 WANG Qiyou;WANG Guohua;RUAN Lili;LI Sihua(Department of Endocrinology,Zhecheng Traditional Chinese Medicine Hospital,Shangqiu He'nan 476200,China)

机构地区：[1]商丘市柘城中医院内分泌科,河南商丘476200

出　　处：《新中医》2023年第16期47-51,共5页New Chinese Medicine

摘　　要：目的:观察夏枯草汤合海藻玉壶汤加减治疗良性甲状腺结节伴甲状腺激素异常的临床疗效。方法:将80例良性甲状腺结节患者按随机数字表法分为观察组与对照组各40例。对照组对甲状腺功能减退者给予左甲状腺素片治疗,对甲状腺功能亢进者给予甲巯咪唑片治疗;观察组在对照组基础上给予夏枯草汤合海藻玉壶汤加减治疗。观察比较2组临床疗效、中医证候评分、甲状腺激素[游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)]水平及复发率。结果:观察组总有效率为92.50%,对照组为70.00%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组颈部肿胀、胸胁窜痛、善太息、咽部阻塞感、咽喉生痰、胸闷等中医证候评分比较,差异均无统计学意义(P>0.05);治疗后,2组上述各项中医证候评分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗前,2组血清TSH、FT_(3)、FT_(4)水平比较,差异均无统计学意义(P>0.05)。治疗后,2组TSH水平均较治疗前升高(P<0.05),FT_(3)、FT_(4)水平均较治疗前降低(P<0.05);且观察组TSH水平高于对照组(P<0.05),FT_(3)、FT_(4)水平均低于对照组(P<0.05)。随访3个月,观察组复发率为5.41%,对照组为28.57%,2组比较,差异有统计学意义(P<0.05)。结论:夏枯草汤合海藻玉壶汤加减治疗良性甲状腺结节疗效显著,可显著减轻患者的临床症状,改善甲状腺功能,降低复发率。Objective:To observe the clinical effect of modified Xiakucao Decoction combined with Haizao Yuhu Decoction for patients with benign thyroid nodules complicated with thyroid hormone abnormalities.Methods:A total of 80 cases of patients with benign thyroid nodules were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The control group was treated with Levothyroxine Tablets for hypothyroidism,and Thiamazole Tablets for hyperthyroidism;the observation group was additionally treated with modified Xiakucao Decoction combined with Haizao Yuhu Decoction based on the treatment of the control group.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,thyroid hormone[free thyroxine(FT_(4)),free triiodothyronine(FT_(3))and thyroid stimulating hormone(TSH)],and recurrence rates were observed and compared between the two groups.Results:The total effective rate was 92.50%in the observation group and 70.00%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of TCM syndrome scores including neck swelling,chest rib pain,preference for sighing,pharyngeal obstruction feeling,pharyngeal phlegm,and chest distress between the two groups(P>0.05).After treatment,the above TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of TSH,FT_(3) and FT_(4) in serum between the two groups(P>0.05).After treatment,the TSH levels in the two groups were increased when compared with those before treatment(P<0.05),and levels of FT_(3) and FT_(4) were decreased when compared with those before treatment(P<0.05);the TSH level in the observation group was higher than that in the control group(P<0.05),and the levels of FT_(3) and FT_(4) wer

关 键 词：良性甲状腺结节 夏枯草汤 海藻玉壶汤 甲状腺激素 

分 类 号：R581.3[医药卫生—内分泌]