甲状腺功能亢进患者的中医症型分布特点及与甲功、血脂相关性分析  

The distribution characteristics of TCM syndromes in hyperthyroidism and the correlation analysis with thyroid function and blood lipid

作　　者：何逸俊 魏华[1] HE Yijun;WEI Hua(The Second Clinical Medical College,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405

出　　处：《陕西中医》2024年第9期1190-1194,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：广东省科技厅重大项目(2014B010118005);广东省部共建中医湿证国家重点实验室项目(SZ2021ZZ3203)。

摘　　要：目的:分析甲状腺功能亢进的中医症候分布特点及与甲功、血脂指标的相关性。方法:选取178例甲状腺功能亢进患者(设为甲亢组)进行研究。同时选取80例健康体检者(设为对照组)进行对比。比较两组的临床资料、实验室检查结果。分析甲亢患者中医证型中常见的分型、临床症状、体征。进一步探讨中医常见证型与血脂、甲功指标的相关性。结果:经分析,两组年龄、性别、饮酒、吸烟史、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平相比无统计学差异(P>0.05);甲亢组的甲功游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)、总三碘甲状腺原氨酸(TT 3)、总甲状腺素(TT 4)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、总胆固醇(TC)、TG、高密度脂蛋白胆固醇(HDL-C)、体重指数(BMI)水平均高于对照组(P<0.05);甲亢组的促甲状腺激素(TSH)水平低于对照组(P<0.05)。178例患者中,证型出现频率从高到低前三位分别为三阴阳虚寒证、少阳失枢、胆火内郁证、少阳寒热错杂证。甲亢患者出现频次较高的三个临床症状分别为疲乏无力、烦躁易怒、多汗。甲亢患者常见体征前三位分别为甲状腺肿大、突眼征、甲状腺结节。将血脂、甲功指标作为变量因素代入二分类模型中进行分析,经变量筛选后得到主要影响因素,得出FT 3、FT 4、TGAb水平与三阴阳虚寒证呈正相关,FT 3、TPOAb水平与少阳失枢、胆火内郁证呈正相关,TSH水平与之呈负相关。FT 3、FT 4、TGAb、TC与少阳寒热错杂证呈正相关,TSH水平与之呈负相关。其余各项指标未得出与中医常见证型具有相关性。结论:甲状腺功能亢进患者常见的中医证型为三阴阳虚寒证、少阳失枢、胆火内郁证、少阳寒热错杂证,常见临床症状为疲乏无力、烦躁易怒、多汗,常见的体征为甲状腺肿大、突眼征、甲状腺结节,且进一步得出FT 3�Objective:To analyze the distribution characteristics of TCM symptoms of hyperthyroidism and its correlation with thyroid function and lipid index.Methods:A total of 178 hyperthyroidism patients(hyperthyroidism group)were selected for the study.At the same time,80 healthy subjects(set as control group)were selected for comparison.The clinical data and laboratory results of the two groups were compared.To analyze the common types,clinical symptoms and signs of Chinese medicine syndrome of hyperthyroidism patients.To further explore the correlation between TCM common witness type and blood lipid and thyroid function index.Results:After analysis,there were no significant differences in age,sex,drinking and smoking history,triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels between the two groups(P>0.05).In the hyperthyroidism group,thyroxine(FT 3),thyroxine(FT 4),total triiodothyronine(TT 3),total thyroxine(TT 4),anti-thyroid peroxidase antibody(TPOAb),anti-thyroglobulin antibody(TGAb),total cholesterol(TC),TG and high-density lipoprotein cholesterol(HDL-C)were detected,body mass index(BMI)levels were higher than those of control group(P<0.05);The level of thyroid stimulating hormone(TSH)in hyperthyroidism group was lower than that in control group(P<0.05).Among 178 patients,the top three syndrome-type frequency from high to low were sanyin-yang deficiency cold syndrome,Shaoyang loss of hub syndrome,gallbladder fire internal depression syndrome,Shaoyang cold heat mixed syndrome.The three clinical symptoms with high frequency in patients with hyperthyroidism are fatigue,irritability and hyperhidrosis.The top three common signs of hyperthyroidism were goiter,exophthalmic sign and thyroid nodule.After variable screening,the main influencing factors were obtained.It was concluded that FT 3,FT 4 and TGAb levels were positively correlated with sanyang deficiency cold syndrome,FT 3 and TPOAb levels were positively correlated with Shaoyang loss of Shu and bile fire internal depression syndrome,and TSH level

关 键 词：甲状腺功能亢进 中医证型 临床症状 相关性 辨证 瘿病 

分 类 号：R581.1[医药卫生—内分泌]