疏肝消瘿方联合穴位敷贴治疗甲状腺结节的临床观察  

Clinical Observation on Treating Thyroid Nodules by Shugan Xiaoying Recipe Combined with Acupuncture Application

作　　者：袁加文[1] 彭文波[1] 李馨蕊 闫丹丹 单静怡 何婧[3] YUAN Jiawen;PENG Wenbo;LI Xinrui;YAN Dandan;SHAN Jingyi;HE Jing(Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China;Shanghai TMC-Integrated Hospital,Shanghai 200082,China)

机构地区：[1]上海交通大学医学院附属第六人民医院,上海200233 [2]上海中医药大学附属龙华医院,上海200030 [3]上海市中西医结合医院,上海200082

出　　处：《世界中医药》2024年第5期691-695,共5页World Chinese Medicine

基　　金：上海市卫生和计划生育委员会科研项目(20184Y0355)。

摘　　要：目的:探讨疏肝消瘿方联合穴位敷贴治疗甲状腺结节的效果及对甲状腺激素、血流阻力指数(RI)、搏动指数(PI)、微血管密度(MVD)影响。方法:选取2022年1月至2023年6月上海交通大学医学院附属第六人民医院收治的甲状腺结节患者80例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组40例。对照组患者给予西医治疗,观察组在对照组基础上,采用疏肝消瘿方联合穴位敷贴治疗。比较2组治疗效果,包括游离三碘甲状腺素(FT3)、游离甲状腺素(FT4)及促甲状腺激素水平(TSH),以及超声指标(RI、PI、MVD)的变化情况。结果:观察组患者治疗有效率为92.50%,显著高于对照组的75.00%(P<0.05),其中医证候积分也明显低于对照组(P<0.05);2组患者治疗前后,FT3和FT4水平差异无统计学意义(P>0.05),TSH水平比治疗前下降,且观察组治疗后TSH水平降低更多(P<0.05);治疗后2组患者RI、PI、MVD值明显低于治疗前(P<0.05),且观察组RI、PI、MVD明显低于对照组(P<0.05)。结论:疏肝消瘿方联合穴位敷贴可以改善甲状腺结节患者中医证候积分,降低TSH表达水平,减少RI、PI、MVD值,效果明显。Objective:To explore the therapeutic effect of Shugan Xiaoying Recipe combined with acupuncture application on thyroid nodules and the effects of this therapy on thyroid hormones,resistance index(RI),pulsatility index(PI),and microvascular density(MVD).Methods:Eighty patients with thyroid nodules treated at the Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University from January 2022 to June 2023 were selected and randomly allocated by the random number table method into a control group and an observation group,each comprising 40 patients.The control group received Western medical treatment,and the observation group was treated with Shugan Xiaoying Recipe combined with acupoint application on the basis of the therapy in the control group.The therapeutic effects were compared between the two groups in terms of thyroid hormones[free triiodothyronine(FT 3),free thyroxine(FT 4),and thyroid-stimulating hormone(TSH)]and ultrasound indicators(RI,PI,and MVD).Results:The response rate in the observation group was 92.50%,which was higher than that(75.00%)in the control group(P<0.05).The TCM symptom scores in the observation group were lower than those in the control group(P<0.05).The levels of FT 4 and FT 3 showed no significant differences between the two groups(P>0.05),and the TSH level declined compared with that before treatment.Moreover,the observation group had more reduction in the TSH level than the control group after treatment(P<0.05).The treatment in both groups decreased the RI,PI,and MVD(P<0.05),and the observation group exhibited lower RI,PI,and MVD than the control group after treatment(P<0.05).Conclusion:The combination of Shugan Xiaoying Recipe with acupoint application can alleviate TCM symptoms,lower the TSH level,and decrease RI,PI,and MVD in the patients with thyroid nodules,demonstrating definite therapeutic effects.

关 键 词：甲状腺结节 疏肝消瘿方 穴位敷贴 甲状腺激素 促甲状腺激素 游离甲状腺素 游离三碘甲状腺素 超声指标 

分 类 号：R265[医药卫生—中医外科学]