疏肝化痰消瘿汤联合优甲乐治疗良性甲状腺结节患者的临床疗效及对其超声指标、搏动指数、阻力指数的影响  

Clinical Efficacy of Shugan Huatan Xiaoying Decoction Combined with Euthyrox on Benign Thyroid Nodule and the Treatment′s Influence on Ultrasound Index,Pulsatility Index,and Resistance Index

作　　者：马婷 涂瑞沙 黄良玖 王芳芳 秦盛梅 MA Ting;TU Rui-sha;HUANG Liang-jiu;WANG Fang-fang;QIN Sheng-mei(Hainan Cancer Hospital,Haikou Hainan 570100)

机构地区：[1]海南省肿瘤医院,海南海口570100

出　　处：《世界中西医结合杂志》2025年第3期539-545,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：2020年海南省重大科技计划项目(ZDKJ202005)。

摘　　要：目的探讨疏肝化痰消瘿汤联合优甲乐治疗良性甲状腺结节(Thyroid nodule,TNS)患者的临床疗效及对其超声指标、血流搏动指数(Pulsatility index,PI)、阻力指数(Resistance index,RI)的影响。方法选取2021年5月—2023年5月期间海南省肿瘤医院收治的116例良性TNS患者作为研究对象,按随机数字表法分为对照组和观察组,每组各58例。对照组给予优甲乐治疗,观察组在对照组基础上加用中药疏肝化痰消瘿汤,两组患者均治疗8周。观察比较两组患者临床疗效、安全性,治疗前后中医证候评分、甲状腺超声指标(结节数量、结节最长直径、甲状腺峡部厚度、两叶前后径、超声弹性评分)、血流参数[搏动指数(Pulsatility index,PI)、阻力指数(Resistance index,RI)]、甲状腺功能[促甲状腺激素(Thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)、促甲状腺素受体抗体(Thyrotropin receptor antibody,TRAb)]、相关血清细胞因子[胰岛素样生长因子-1(Insulin-like growth factor,IFG-1)、转化生长因子-β1(Transforming growth factor-β1,TGF-β1)]变化情况。结果治疗后两组患者中医证候积分颈前瘿肿、颈前觉胀、咽有阻塞感、胸胁窜痛、善太息、胸闷不适、不思饮食、倦怠乏力评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分颈前瘿肿、颈前觉胀、咽有阻塞感、胸胁窜痛、善太息、胸闷不适、不思饮食、倦怠乏力评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗8周后两组患者超声指标均较治疗前降低,差异有统计学意义(P<0.05);且观察组各指标低于对照组,差异有统计学意义(P<0.01)。治疗后两组患者PI、RI水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组PI、RI水平低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TSH、TRAb水平较治疗前Objective To explore the clinical efficacy of Shugan Huatan Xiaoying Decoction combined with Euthyrox in the treatment of benign thyroid nodule(TNS),and to analyze the treatment′s influence on ultrasound index,pulsatility index(PI),and resistance index(RI)of patients.Methods 116 patients with benign TNS admitted to Hainan Cancer Hospital from May 2021 to May 2023 were selected as the research subjects and randomly divided into a control group and an observation group using a random number table method,with 58 patients in each group.For 8 weeks of treatment,the control group received Euthyrox while the observation group was additionally given Traditional Chinese Medicine(TCM)Shugan Huatan Xiaoying Decoction.The clinical efficacy and safety of two groups of patients were observed and compared before and after treatment according to the aspects below:the TCM syndrome scores,thyroid ultrasound indexes[number of nodules,longest diameter of nodules,isthmus thickness,anterior-posterior diameter of two lobes and ultrasound elasticity score],blood flow parameters[Pulsatility Index(PI)and Resistance Index(RI)],thyroid function[Thyroid Stimulating Hormone(TSH),Free Triiodothyronine(FT3),Free Thyroxine(FT4)and Thyrotropin Receptor Antibody(TRAb)],and related serum cytokines[Insulin-like Growth Factor(IFG-1),and Transforming Growth Factor-β1(TGF-β1)].Results After 8 weeks of treatment,the TCM syndrome scores of enlargement of the thyroid gland,neck swelling sensation,blocked sensation of the Pharynx,scurrying pain in chest and hypochondrium,frequent sighing,chest tightness and discomfort,lack of appetite,as well as fatigue and weakness were decreased in both groups of patients,and the difference was statistically significant(P<0.05),with the above changes being more pronounced in the observation group(P<0.05).The ultrasound indexes were significantly reduced in both groups of patients(P<0.05),with the indexes lower in the observation group(P<0.01).PI and RI levels in both groups were significantly reduced and were lower i

关 键 词：疏肝化痰消瘿汤 优甲乐 甲状腺结节 超声检查 

分 类 号：R581[医药卫生—内分泌]