摘要
目的观察化浊解毒方治疗激素依赖性亚急性甲状腺炎(SAT)浊毒内蕴证的临床疗效。方法选取激素依赖性SAT浊毒内蕴证患者60例,按照随机数字表法分为2组。对照组30例继续应用醋酸泼尼松片口服,治疗组30例在对照组治疗基础上加化浊解毒方口服,疗程4周。比较2组临床疗效及治疗前后中医证候各项评分及总积分、红细胞沉降率(ESR)、促甲状腺激素(TSH)、血清游离三碘甲状腺原氨酸(FT 3)、血清游离甲状腺素(FT 4)水平变化,以及治疗期间不良反应发生率。比较2组治疗2周及4周时停用激素的患者例数和总例数,停药后1个月随访,比较2组复发率。结果治疗组总有效率70.00%(21/30),对照组总有效率20.00%(6/30),治疗组总有效率高于对照组(P<0.05)。治疗组治疗后中医证候各项评分及总积分均较本组治疗前降低(P<0.05),且停激素后发热、颈前肿大或疼痛反复发作、面色晦黯、大便黏腻、纳差、乏力、头重、舌苔、脉象评分及总积分均低于对照组治疗后(P<0.05)。对照组治疗后停激素后发热、颈前肿大或疼痛反复发作、面色晦黯、纳差、烦躁、心悸、乏力、舌苔、脉象评分及总积分均较本组治疗前降低(P<0.05)。2组治疗后ESR、TSH、FT 3、FT 4水平较本组治疗前均无明显变化(P>0.05),且组间比较差异也均无统计学意义(P>0.05)。治疗2周及4周时,治疗组停用激素例数及总例数均多于对照组同期(P<0.05)。治疗组随访1个月复发率8.70%(2/23),对照组45.45%(5/11),治疗组复发率低于对照组(P<0.05)。治疗组不良反应发生率3.33%(1/30),对照组为26.67%(8/30),治疗组不良反应发生率低于对照组(P<0.05)。结论化浊解毒方治疗激素依赖性SAT浊毒内蕴证疗效显著,可有效改善患者的临床症状,使激素顺利撤减,缩短病程,减少不良反应,降低复发率。
Objective To observe the clinical effect of Huazhuo Jiedu Formula on hormone dependent subacute thyroiditis(SAT)with"Zhuoduneiyun"syndrome.Methods Totally 60 patients with hormone dependent SAT("Zhuoduneiyun"syndrome)were randomized into the treatment group(n=30)and the control group(n=30),in addition of prednisone acetate tablets,the treatment group additionally received oral Huazhuo Jiedu Formula.A continued 4-week treatment was performed to compare clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,erythrocyte sedimentation rate(ESR),thyroid-stimulating hormone(TSH),serum free triiodothyronine(FT 3),serum free thyroxine(FT 4)before and after treatment.After two and four-week treatment,the numbers of patients with hormone withdrawal were calculated;and the follow-up was performed after one-month of drug withdrawal,and the recurrence rates were compared between the two groups.Results The overall effective rate was higher in the treatment group than in the control group(70.00%[21/30])vs(20.00%[6/30]),(P<0.05).After treatment,TCM symptom scores in the treatment group were decreased(P<0.05);whereas,TCM symptom(fever,neck enlargement or recurrent pain,dim complexion,sticky stool,anorexia,fatigue,head weight,tongue coating,pulse)scores decreased in the treatment group relative to the control group after drug withdrawal(P<0.05);compared with before treatment,TCM symptom(fever,neck enlargement or recurrent pain,dim complexion,anorexia,dysphoria,palpitation,fatigue,tongue coating,pulse)scores in the control group were decreased after drug withdrawal than before treatment(P<0.05).None of the ESR,TSH,FT 3,FT 4 differed significantly in groups before and after treatment(P>0.05).After two and four-week treatment,the numbers of patients with hormone withdrawal in the treatment group were increased but not the control group(P<0.05).The recurrence on 1-month follow-up in the treatment group was superior to the control group(8.70%[2/23]vs 45.45%[5/11],[P<0.05],respectively);the adverse reactions was 3.33%(1/30)in the treatment group,lower than those of 26.67%(8/30)in the control group(P<0.05).Conclusion Huazhuo Jiedu Formula is effective on hormone dependent SAT("Zhuoduneiyun"syndrome).It can effectively improve the clinical symptoms for withdrawing hormone smoothly,thus,shortening the disease course,reducing adverse reactions and recurrence rate.
作者
梅寒晓
戎士玲
朱浩维
黄仕喆
MEI Hanxiao;RONG Shiling;ZHU Haowei;HUANG Shizhe(Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050091;Department of Endocrinology,The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050011)
出处
《河北中医》
2022年第2期181-185,共5页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2018年度中医药类科研计划项目(编号:2018027)。
关键词
甲状腺炎
亚急性
激素依赖性
中药疗法
Thyroiditis,subacute
Hormone dependence
Traditional Chinese medicine therapy
