扶正化浊汤联合甲状腺片治疗对甲状腺结节大小及疗效的影响  

Impact of Fuzheng Huazhuo decoction combined with thyroid tablets on the size of thyroid nodules and therapeutic effect

作　　者：韩娟[1] 张立文 宋金岭[2] 董进[3] 李海华[2] 赵辉[2] 左艳敏[2] HAN Juan;ZHANG Liwen;SONG Jinling;DONG Jin;LI Haihua;ZHAO Hui;ZUO Yanmin(Department of Ultrasound,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061001,Hebei,China;Department of Preventive Medicine,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061001,Hebei,China;Department of Cerebrology,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061001,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院超声科,河北沧州061001 [2]河北省沧州中西医结合医院治未病科,河北沧州061001 [3]河北省沧州中西医结合医院脑病科,河北沧州061001

出　　处：《贵州医科大学学报》2024年第3期463-468,共6页Journal of Guizhou Medical University

基　　金：河北省中医药管理局科研计划项目(2018478)。

摘　　要：目的探讨扶正化浊汤治疗甲状腺结节(TN)对结节大小的影响。方法TN患者106例,随机均分为观察组和对照组,对照组给予左甲状腺素钠片常规治疗,观察组在对照组基础上同时增加扶正化浊汤治疗;于治疗前、治疗3个月时,对2组患者进行中医主症评分,采用彩色多普勒超声仪记录2组患者结节数目、最大直径、结节体积、血流阻力指数(RI)及搏动指数(PI),同时采集患者外周静脉血4 mL,检测促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)及血管内皮生长因子(VEGF)水平,治疗3个月后评估2组患者的西医疗效,记录2组治疗期间恶心、呕吐、皮疹及口干等不良反应发生情况。结果治疗后3个月,2组中医主症评分均较治疗前下降,且观察组低于对照组(P<0.05);与对照组比较,2组TN患者治疗3个月后结节数目减少、结节最大直径和结节体积均降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后3个月,观察组TSH低于对照组,FT 3、FT 4高于对照组(P<0.05);治疗3个月后,观察组VEGF、RI、PI低于对照组(P<0.05);观察组西医疗效和中医证候疗效中的临床痊愈和总有效率均高于对照组,差异有统计学意义(P<0.05);比较观察组与对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论扶正化浊汤治疗TN疗效显著,可有效减轻患者症状,减小结节数目及大小,调节甲状腺功能,改善血流状况,降低VEGF表达,且安全性高。Objective To explore the impact of Fuzheng Huazhuo decoction in treating thyroid nodules on thyroid nodule(TN)size.Methods A total of 106 patients with TN were randomly and evenly divided into observation and control groups.Control group was given levothyroxine sodium tablets(conventional treatment),and observation group was given Fuzheng Huazhuo decoction in addition to levothyroxine sodium tablets.Before treatment and 3 months of treatment,two groups of patients were evaluated for traditional Chinese medicine main symptom scores.Color Doppler ultrasound was used to record the nodule number,the nodule maximum diameter,nodule volume,blood flow resistance index(RI)and pulsatility index(PI)of the nodules in the patients in two groups.At the same time,4 mL of peripheral venous blood was collected from the patients to detect the levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4)and vascular endothelial growth factor(VEGF).After 3 months of treatment,Western medicine efficacy was evaluated for the patients in two groups.Adverse reactions were recorded,including nausea,vomiting,rash and dry mouth during the treatment.Results After 3 months of treatment,the main symptom scores of traditional Chinese medicine in both groups were decreased when compared to before treatment,and lower in observation group than in control group(P<0.05).When compared with control group,the nodule numbers,the nodule maximum diameter and the nodule volumes were decreased in the patients with TN in two groups after 3 months of treatment,and which were lower in observation group than those in control group(P<0.05).After 3 months of treatment,TSH was lower in observation group than that in control group,while FT3 and FT4 were higher than those in control group(P<0.05).After 3 months of treatment,VEGF,RI and PI were lower in observation group than those in control group(P<0.05).Clinical cure rate and total effective rate were higher in observation group than those in control group in terms of Western

关 键 词：甲状腺结节 扶正化浊汤 疗效 结节大小 甲状腺功能 血管内皮生长因子水平 

分 类 号：R445.1[医药卫生—影像医学与核医学]