扶正消瘿汤联合微波消融术治疗巨大甲状腺囊肿的临床疗效及安全性研究  

Clinical effect and safety of Fuzheng Xiaoying Decoction combined with microwave ablation in the treatment of huge thyroid cyst

作　　者：王涛 刘永刚 韩永彬 WANG Tao;LIU Yong-gang;HAN Yong-bin(Department of Traditional Chinese Medicine,the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,CHINA;Department of Clinical Surgery,Yulin Third Hospital,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]陕西中医药大学附属医院中医内科,陕西咸阳712000 [2]榆林市第三医院临床外科,陕西榆林719000

出　　处：《海南医学》2024年第9期1248-1252,共5页Hainan Medical Journal

基　　金：陕西省中医药管理局计划项目(编号:SZY-KJCYC-2023-087)。

摘　　要：目的研究扶正消瘿汤联合微波消融术(MWA)治疗巨大甲状腺囊肿的临床疗效及安全性。方法选取2019年12月至2023年2月期间陕西中医药大学附属医院收治的130例巨大甲状腺囊肿患者纳入研究,采用随机数表法将患者分为观察组和对照组,每组65例。两组患者经MWA治疗后,对照组采用常规的术后药物治疗,观察组在对照组治疗的基础上服用扶正消瘿汤,均连续治疗1个月。治疗后,比较两组患者的治疗效果,以及治疗前后的囊腔体积、囊肿缩小率、甲状腺功能[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)]及炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平;同时比较两组患者治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为98.46%,明显高于对照组的89.23%,差异具有统计学意义(P<0.05);观察组患者治疗后的囊腔体积为(3.14±0.37)mL,明显小于对照组的(3.88±0.33)mL,囊肿缩小率为(88.64±4.79)%,明显高于对照组的(83.64±4.88)%,差异均具有统计学意义(P<0.05);治疗后,观察组患者的FT3,FT4分别为(4.76±0.38)pmol/L、(13.94±3.35)pmol/L,明显高于对照组的(4.33±0.21)pmol/L、(11.12±3.23)pmol/L,差异均具有统计学意义(P<0.05);治疗后,观察组患者的血清TSH、IL-6、CRP、TNF-α水平分别为(2.35±0.22)μIU/mL、(5.29±1.06)ng/L、(6.25±0.81)mg/L、(25.42±3.57)ng/L,明显低于对照组的(2.64±0.34)μIU/mL、(8.66±1.94)ng/L、(10.73±1.19)mg/L、(32.24±4.19)ng/L,差异均有统计学意义(P<0.05);观察组和对照组患者治疗期间的不良反应发生率分别为7.69%和6.15%,比较差异无统计学意义(P>0.05)。结论扶正消瘿汤联合MWA治疗巨大甲状腺囊肿可有效调节患者的甲状腺功能,改善炎症反应,临床应用具有良好的疗效,且安全性较高。Objective To explore the clinical effect and safety of Fuzheng Xiaoying Decoction combined with microwave ablation(MWA)in the treatment of huge thyroid cyst.Methods A total of 130 patients with huge thyroid cysts admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2019 and February 2023 were included in the study.They were divided into an observation group and a control group by random number table method,with 65 patients in each group.After MWA treatment,the control group was treated with conventional postoperative drug therapy,and the observation group was treated with Fuzheng Xiaoying Decoction on the basis of the control group,continuously for 1 month.After treatment,the effective rate,and the changes of cystic volume,cyst reduction rate,thyroid function[free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)]and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels before and after treatment were compared between the two groups.The occurrence of adverse reactions between the two groups during treatment was compared.Results After treatment,the total effective rate in the observation group was 98.46%,which was significantly higher than 89.23%in the control group(P<0.05).The volume of cystic cavity in the observation group was(3.14±0.37)mL,which was significantly smaller than(3.88±0.33)mL in the control group(P<0.05),and the reduction rate of cyst was(88.64±4.79)%,significantly higher than(83.64±4.88)%in the control group(P<0.05).After treatment,FT3 and FT4 in the observation group were(4.76±0.38)pmol/L and(13.94±3.35)pmol/L,which were significantly higher than(4.33±0.21)pmol/L,(11.12±3.23)pmol/L in the control group(P<0.05).After treatment,the levels of serum TSH,IL-6,CRP,and TNF-αin the observation group were(2.35±0.22)μIU/mL,(5.29±1.06)ng/L,(6.25±0.81)mg/L,and(25.42±3.57)ng/L,which were significantly lower than(2.64±0.34)μIU/mL,(8.66±1.94)ng/L,(10.73±1.19)mg/L,and(3

关 键 词：巨大甲状腺囊肿 扶正消瘿汤 微波消融术 临床疗效 安全性 

分 类 号：R581[医药卫生—内分泌]