摘要
目的观察解毒消瘿汤治疗亚急性甲状腺炎疗效及对血清炎性因子水平的影响并探讨其作用机制。方法80例患者随机分为对照组和治疗组各40例。对照组予醋酸泼尼松片口服,治疗组在对照组治疗基础上内服解毒消瘿汤,共治疗4周,于治疗前后记录两组患者主要症状体征积分、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)]、C反应蛋白(CRP)、红细胞沉降率(ESR)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等指标的变化情况,计算统计分析总有效率、甲减发生率、复发率,记录不良反应情况。结果对照组有1例因患者原因中断治疗退出观察,其余患者均接受完整的治疗观察。两组治疗前甲状腺功能比较,差异无统计学意义(P>0.05);两组治疗后FT3、FT4与治疗前比较均明显降低,TSH明显升高(均P<0.05),且治疗组在降低FT3、FT4和升高TSH方面均优于对照组(P<0.05)。两组治疗前ESR、CRP、TNF-α、IL-6水平比较,差异均无统计学意义(均P>0.05)。治疗组治疗后1周、2周时ESR、CRP、TNF-α、IL-6水平与治疗前比较,均降低(P<0.05),治疗后4周时明显降低(P<0.01),对照组在治疗后2周、4周时降低(P<0.05);治疗组在治疗后2周、4周时ESR、CRP、TNF-α、IL-6水平与对照组比较,降低更明显(P<0.05)。两组治疗前主要症状体征积分比较,差异无统计学意义(P>0.05);治疗组在治疗后1周、2周时主要症状体征积分均降低(P<0.05),治疗后4周时明显降低(P<0.01),且治疗组在治疗后1周、2周、4周时积分降低较对照组更明显(均P<0.05)。治疗组总有效率95.00%高于对照组的84.62%(P<0.05)。两组患者治疗后均随访6个月,均无失访。治疗组复发率2.63%低于对照组的15.15%,甲减发生率2.63%亦低于对照组的15.15%(P<0.05)。两组治疗期间均无不良反应发生,复查肝肾功能均未见异常。结论解毒消瘿汤能显著改善亚急性甲状腺
Objective:To investigate the clinical effect of Jiedu Xiaoying Decoction on subacute thyroiditis with toxic heat flourishing type and its effect on serum inflammatory factors.Methods:80 patients were randomly divided into the control group and the treatment group,40 cases in each.The control group was given prednisone acetate tablets orally;on that basis,the treatment group was given Jiedu Xiaoying Decoction.Both groups were treated for 4 weeks.The changes of main symptoms and signs,thyroid function(FT3,FT4,TSH),CRP,ESR,TNF-αand IL-6 were recorded before and after treatment.The total effective rate,incidence of hypothyroidism and recurrence rate were calculated;adverse reactions were recorded,and statistical analysis was made.Results:The treatment group was superior to the control group in reducing FT3,FT4 and increasing TSH(P<0.05).Compared with before treatment,the levels of ESR,CRP,TNF-αand IL-6 in the treatment group decreased at 1 and 2 weeks after treatment(P<0.05),and significantly decreased at the 4 th week(P<0.01);the control group decreased at 2 and 4 weeks after treatment(P<0.05).Compared with the control group,the improvement in the treatment group decreased more significantly at 2 and 4 weeks after treatment(P<0.05).The integral of the treatment group decreased more significantly than that of the control group at 1,2 and 4 weeks after treatment(P<0.05).The total effective rate was 97.50%and 84.62%,the recurrence rate 2.63%and 15.15%,the incidence of hypothyroidism2.63%and 15.15%in the treatment group and the control group,respectively.There was significant difference between the two groups(P<0.05).There were no adverse reactions during the treatment in both groups.Conclusion:Jiedu Xiaoying Decoction can significantly improve the clinical symptoms of subacute thyroiditis,regulate thyroid function and reduce the level of related inflammatory factors.It has the advantages of low recurrence rate,high safety and good curative effect,and can be used in clinic.
作者
张允申
方勇
丁晓雯
杨万富
倪毓生
龚旭初
Zhang Yunshen;Fang Yong;Ding Xiaowen(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Nantong 226000,China)
出处
《中国中医急症》
2019年第11期1950-1953,1969,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
第2批江苏省名老中医药专家传承工作室建设项目(苏中医科教[2016]6号)
关键词
亚急性甲状腺炎
热毒壅盛证
解毒消瘿汤
中医药治疗
临床疗效
Subacute thyroiditis
Toxic heat flourishing type
Jiedu Xiaoying Decoction
Chinese medicine treatment
Clinical efficacy
