桥本甲状腺炎疲劳患者213例的中医证素规律研究及相关因素分析  

A study on the pattern of TCM syndrome elements in 213 patients with Hashimoto’s thyroiditis fatigue and related factors

作　　者：卜赵君 林燕 赵程博文 赵彩虹 彭新宇 魏子楠 黄河 BU Zhaojun;LIN Yan;ZHAO Chengbowen;ZHAO Caihong;PENG Xinyu;WEI Zinan;HUANG He(College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院,100029 [2]北京中医药大学东直门医院

出　　处：《环球中医药》2024年第12期2503-2509,共7页Global Traditional Chinese Medicine

基　　金：中华中医药学会青年求实项目(2022-QNQSDEP-06);北京市东城区优秀人才培养资助项目(2022-dchrcpyzz-15);北京中医药大学基本科研业务费揭榜挂帅项目(2023-JYB-JBZD-005)。

摘　　要：目的探讨桥本甲状腺炎疲劳患者的中医证素规律研究及相关因素分析。方法采用横断面研究,收集有疲劳症状的桥本甲状腺炎患者的临床信息,观察其中医证素分布规律,分析各证素与性别、年龄、病程、甲状腺功能以及甲状腺相关抗体的相关性。结果本研究共收集72项症状及体征,发现桥本甲状腺炎疲劳患者的病位证素有肝、脾、肾、心、肺,病性证素既有实性证素(气滞、痰湿、血瘀),又有虚性证素(气虚、血虚、阳虚、阴虚)。各病位证素与各病性证素在不同性别组、年龄组、病程组、甲状腺功能组以及甲状腺抗体阳性组均有一定的体现,其中最常见的病位证素为肝(95.8%)、脾(82.6%),常见实性证素有气滞(95.8%)、痰湿(87.3%),常见虚性证素有气虚(91.1%)、血虚(76.1%)。中老年桥本甲状腺炎疲劳患者心证素、肺证素的出现率均比青年桥本甲状腺炎疲劳患者显著升高(P<0.05),随着病程的发展,痰湿证素分布呈增长趋势(P<0.05)。结论桥本甲状腺炎患者疲劳症状的发生与肝脾功能失调关系密切,其病机总属虚实夹杂,虚以气虚、血虚为主,实以气滞、痰湿为主。Objective To explore the study of the pattern of Traditional Chinese Medicine syndrome elements in patients with fatigue of Hashimoto’s thyroiditis and the analysis of related factors.Methods A cross-sectional study was used to collect clinical information on Hashimoto’s thyroiditis patients with fatigue symptoms,observe the distribution pattern of TCM evidence elements,and analyse the correlation between each evidence element and gender,age,duration of disease,thyroid function,and thyroid antibodies.Results In this study,a total of 72 symptoms and signs were collected,and it was found that the pathognomonic elements of Hashimoto’s thyroiditis fatigue patients were liver,spleen,kidney,heart,and lungs.The pathognomonic elements were both solid(qi stagnation,phlegm-dampness,and blood stasis)and deficient(deficiency of qi,blood,yang,and yin).The disease locus and disease elements were reflected in different gender groups,age groups,disease duration groups,thyroid function groups and thyroid antibody positive groups.The most common pathological elements were liver(95.8%)and spleen(82.6%),common solid elements were qi stagnation(95.8%)and phlegm-dampness(87.3%),and common deficiency elements were qi deficiency(91.1%)and blood deficiency(76.1%).Middle-aged and elderly patients with Hashimoto’s thyroiditis fatigue had significantly higher rates of cardiac evidence elements and pulmonary evidence elements than young patients with Hashimoto’s thyroiditis fatigue(P<0.05).The distribution of phlegm-dampness evidence elements tended to increase as the disease progressed(P<0.05).Conclusion The occurrence of fatigue symptoms in patients with Hashimoto’s thyroiditis is closely related to the dysfunction of the liver and spleen,and its pathology is always a mixture of deficiency and solidity,with deficiency being dominated by qi deficiency and blood deficiency,and solidity being dominated by qi stagnation and phlegm-dampness.

关 键 词：桥本氏甲状腺炎 甲亢 甲减 疲劳 肝脾失调 中医证素 

分 类 号：R269[医药卫生—中西医结合]