【摘要】：目的：本研究通過觀察養(yǎng)陰清熱消癭方治療甲狀腺功能亢進(jìn)癥陰虛火旺證,明確該方的療效和安全性,為治療該病提供有效方藥。方法：將符合納入標(biāo)準(zhǔn)的陰虛火旺證甲亢患者60例按1:1平行對照原則分為治療組和對照組,每組30例。治療組給予養(yǎng)陰清熱消癭方,每日一劑,分早晚兩次服用。對照組給予甲巰咪唑(他巴唑)5～10mg,每日3次。兩組均以4周為1個(gè)療程,觀察3療程。觀察治療前后證候積分,甲狀腺激素(TT3、TT4、FT3、FT4、TSH)及相關(guān)抗體(TRAb)甲狀腺B超等指標(biāo)變化,進(jìn)行療效的判定和評估。結(jié)果：①兩組病人的性別、年齡、病程基線值進(jìn)行組間均衡性比較,無顯著性差異(P0.05)。治療前中醫(yī)證候積分、實(shí)驗(yàn)室相關(guān)檢測指標(biāo)組間均衡性比較,無顯著性差異(P0.05)。②在中醫(yī)證候療效方面,兩組患者證候積分比較,兩者均有明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。③兩組治療后TT3、TT4、FT3、FT4均見顯著下降(P0.05),而且治療組下降的幅度優(yōu)于對照組,兩組之間進(jìn)行比較,具有統(tǒng)計(jì)學(xué)意義(P0.05)。④兩組治療后TRAb均見顯著下降(P0.05),而且治療組下降的幅度優(yōu)于對照組,具有統(tǒng)計(jì)學(xué)意義。⑤兩組治療后甲狀腺腫大均有一定程度的改善,前后比較,有顯著性差異(P0.05)。⑥兩組治療后指顫方面明顯減輕,有顯著性差異(P0.05)。組間比較,在無指顫和中度指顫明顯減少方面治療組療效顯著優(yōu)于對照組,經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,有明顯差異。⑦安全性：兩組肝腎功能檢查均為’見異常,對照組有5例出現(xiàn)白細(xì)胞減少經(jīng)常規(guī)治療恢復(fù)正常。兩組其余均未見其他不良反應(yīng)結(jié)論：養(yǎng)陰清熱消癭方用于治療甲狀腺功能亢進(jìn)癥陰虛火旺證,可以改善患者的臨床癥狀和證候積分,調(diào)節(jié)甲狀腺激素水平和甲狀腺相關(guān)抗體,減慢心率,改善甲狀腺腫大,并且無肝腎功能損害。從研究結(jié)果可以初步判定,養(yǎng)陰清熱消癭方與口服西藥相比,治療甲狀腺功能亢進(jìn)陰虛火旺證更明顯優(yōu)勢,臨床療效明顯,安全又有效,值得臨床上推廣應(yīng)用。
[Abstract]:Objective: to observe the effect and safety of Yangyin Qingre Xiaoying recipe in treating hyperthyroidism with Yin deficiency and fire and hyperthyroidism, and to provide effective prescription for the treatment of hyperthyroidism. Methods: sixty patients with hyperthyroidism of yin deficiency and fire hyperthyroidism were divided into treatment group (30 cases) and control group (30 cases) according to the principle of parallel control at 1:1. The treatment group was given Yangyin Qingre Xiaoying prescription, one dose daily, two times in the morning and evening. The control group was treated with methimazole (methimazole) of 10 mg, 3 times a day. In both groups, 4 weeks were used as a course of treatment, and 3 courses of treatment were observed. The changes of syndromes score, thyroid hormone (TT3TSH) and related antibody (TRAB) were observed before and after treatment, and the curative effect was evaluated. Results there was no significant difference in sex, age and course of disease baseline between the two groups (P0.05). There was no significant difference between the two groups before treatment (P0.05) in the curative effect of TCM syndromes, the two groups had significant improvement in the syndromes integral, both of which were significantly improved, and the scores of TCM syndromes were not significantly different between the two groups before treatment, and there was no significant difference between the two groups (P0.05). The difference was statistically significant (P0.05). 3 after treatment, TT _ 3H _ 3T _ 4T _ 3H _ 3FT _ 4 decreased significantly in both groups (P0.05), and the extent of decrease in the treatment group was better than that in the control group, which was compared between the two groups. There was statistical significance (P0.05) .4 TRAB decreased significantly after treatment in both groups (P0.05), and the extent of decrease in the treatment group was better than that in the control group, and there was a certain degree of improvement in thyroid enlargement after treatment in the two groups with statistical significance (P0.05), and there was no significant difference between the two groups before and after treatment. There was significant difference (P0.05) .6 the two groups after treatment significantly alleviated finger fibrillation, there was a significant difference (P0.05). The efficacy of the treatment group was significantly better than that of the control group in the aspect of no finger fibrillation and moderate finger fibrillation reduction. There was a significant difference in safety between the two groups (P 0.05). The liver and kidney function of the two groups were abnormal. In the control group, 5 cases had leukopenia and returned to normal after routine treatment. Conclusion: Yangyin Qingre Xiaoying prescription can improve the clinical symptoms and syndromes of patients with hyperthyroidism, regulate the level of thyroid hormone and thyroid-related antibodies, and improve the clinical symptoms and syndromes of patients with hyperthyroidism. Slow heart rate, improve goitre, and no damage to liver and kidney function. From the results of the study, it can be preliminarily determined that compared with oral western medicine, Yangyin Qingre Xiaoying prescription has more obvious advantages in treating hyperthyroidism with Yin deficiency and fire and flourishing syndrome. The clinical curative effect is obvious, and it is safe and effective. It is worth popularizing and applying in clinic.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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