摘要
【目的】观察调神平亢汤治疗肝郁化火型甲状腺功能亢进症(简称甲亢)失眠患者的临床疗效。【方法】将78例肝郁化火型甲亢失眠患者随机分为观察组和对照组,每组各39例。2组患者均给予基础抗甲状腺药物治疗及睡眠卫生教育,在此基础上,对照组给予口服艾司唑仑片治疗,观察组给予调神平亢汤治疗,疗程为4周。观察2组患者治疗前后匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分以及血清甲状腺功能指标[促甲状腺激素(TSH)、游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状原氨酸(T3)、甲状腺素(T4)]的变化情况,并评价2组患者的睡眠改善疗效和安全性。【结果】(1)治疗4周后,观察组的总有效率为89.74%(35/39),对照组为71.79%(28/39),组间比较,观察组的睡眠改善疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的PSQI、SAS、SDS评分均较治疗前明显降低(P<0.05),且观察组对PSQI、SAS、SDS评分的降低作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者血清T3、T4、FT3、FT4水平均较治疗前明显下降(P<0.05),且观察组对血清T3、T4、FT3、FT4水平的下降作用均明显优于对照组(P<0.05),而2组患者治疗前后血清TSH水平比较,差异均无统计学意义(P>0.05)。(4)治疗过程中,2组患者均未发生明显的不良反应,且患者的血常规、肝肾功能、心电图等安全性指标均无明显异常变化。【结论】调神平亢汤可明显改善肝郁化火型甲亢失眠患者的睡眠质量,缓解焦虑及抑郁情绪,改善患者的甲状腺功能,具有较好的临床疗效和安全性。
Objective To observe the clinical efficacy of Tiaoshen Pingkang Decoction in treating insomnia patients with hyperthyroidism differentiated as stagnated liver qi transforming into fire syndrome type.Methods Seventyeight insomnia patients with hyperthyroidism differentiated as stagnated liver qi transforming into fire syndrome type were randomly divided into the observation group and the control group,with 39 patients in each group.Both groups of patients were given basic antithyroid drugs(ATD)and sleep hygiene education,and additionally,the control group was given oral use of Estazolam Tablets while the observation group was given Tiaoshen Pingkang Decoction.The treatment for both groups lasted for 4 weeks.The changes in the scores of Pittsburgh Sleep Quality Index(PSQI),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)scores and serum levels of thyroid function indicators of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),triiodothyronine(T3),and thyroxine(T4)were observed in the two groups before and after treatment.After treatment,the efficacy of sleep improvement and clinical safety in the two groups of patients were also evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 89.74%(35/39)and that of the control group was 71.79%(28/39).The intergroup comparison showed that the efficacy of sleep improvement in the observation group was significantly superior to that in the control group(P<0.05).(2)After treatment,the scores of PSQI,SAS and SDS in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on reducing the scores of PSQI,SAS and SDS in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the serum T3,T4,FT3 and FT4 levels in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on decreasing serum T3,T4,FT3 and FT4 levels in the observation group was significantly superior to that in the control group(P<0.05).However,the difference in the serum TSH level of the two groups before and after treatment was not statistically significant(P>0.05).(4)During the treatment,there was no significant adverse reaction occurring in the two groups,and no significant abnormal changes happened in the safety indicators such as blood routine,liver and kidney function and electrocardiogram of the patients in the two groups.Conclusion Tiaoshen Pingkang Decoction is effective and safe in treating insomnia patients with hyperthyroidism differentiated as stagnated liver qi transforming into fire syndrome type,which can improve the sleep quality,relieve anxiety and depression,and improve thyroid function.
作者
章美花
陈彦灵
林基伟
吴海滨
宋晓容
程波敏
汪栋材
ZHANG Mei-Hua;CHEN Yan-Ling;LIN Ji-Wei;WU Hai-Bin;SONG Xiao-Rong;CHENG Bo-Min;WANG Dong-Cai(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第12期2787-2792,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局科研项目(编号:20211325)
深圳市卫生健康委员会医防融合中医药组项目(深卫健体改[2019]25号)。
关键词
甲状腺功能亢进症
失眠
肝郁化火型
调神平亢汤
甲状腺功能
睡眠质量
焦虑
抑郁
hyperthyroidism
insomnia
stagnated liver qi transforming into fire type
Tiaoshen Pingkang Decoction
thyroid function
sleep quality
anxiety
depression
