[1]王府存,刘春红△,覃诗华,等.养阴清热汤联合甲巯咪唑治疗初发弥漫性毒性甲状腺肿临床研究*[J].陕西中医,2019,(9):1238-1240.
　WANG Fucun,LIU Chunhong,QIN Shihua,et al.Clinical observation on treatment of initial graves disease with Yangyin Qingre decoction and methimazole[J].,2019,(9):1238-1240.
点击复制

养阴清热汤联合甲巯咪唑治疗初发弥漫性毒性甲状腺肿临床研究*

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年9期
页码:
1238-1240
栏目:
临床研究
出版日期:
2019-09-05

文章信息/Info

Title:
Clinical observation on treatment of initial graves disease with Yangyin Qingre decoction and methimazole
文章编号:
DOI:10.3969/j.issn.10007369.2019.09.025
作者:
王府存1; 刘春红2△; 覃诗华1; 陈芝燕1; 张正阳1; 陶坚愈1
1.广西中医药大学（南宁 530001）；2.广西中医药大学第一附属医院（南宁530023）
Author(s):
WANG Fucun; LIU Chunhong; QIN Shihua; et al.
Guangxi University of Traditional Chinese Medicine(Nanning 530001)
关键词:
养阴清热汤; 甲巯咪唑片; 弥漫性甲状腺肿; FT3; FT4; TSH
Keywords:
Key words Yangyin Qingre decoction; Methimazole tablets; Initial Graves disease; FT3; FT4; TSH
分类号:
R581
文献标志码:
A
摘要:
摘 要 目的：观察养阴清热汤治疗初发弥漫性毒性甲状腺肿（Graves病）的临床疗效及对甲状腺功能的影响。方法：将诊断的77例Graves病患者随机分为治疗组（n=38）和对照组（n=39），对照组单纯使用甲巯咪唑片治疗，治疗组在对照组的基础上加用养阴清热汤，总疗程为12周。观察两组的临床疗效、不良反应，检测两组治疗前后甲状腺功能、TRAb水平变化并比较。结果：治疗后治疗组和对照组的总有效率分别为94.74%、87.20%，差异有统计学意义（P＜0.05）。治疗后两组血清FT3、FT4明显下降，TSH水平明显上升，且治疗组改善程度优于对照组（P＜0.05）。治疗组治疗后TRAb水平较治疗前显著降低（P＜0.05）。结论：养阴清热汤联合甲巯咪唑治疗初发Graves病可以较快地缓解患者临床症状，改善患者甲状腺功能，降低TRAb水平，减少免疫缓解时间，减少患者痛苦，且不良反应低。
Abstract:
Abstract Objective：To observe the clinical efficacy of Yangyin Qingre decoction in the treatment of initial Graves disease and its effect on thyroid function.Methods：77 patients with Graves disease who were newly diagnosed were randomly divided into treatment group and control group.The control group was treated with methimazole tablets alone.The treatment group was supplemented with Yangyin Qingre decoction on the basis of the control group for a total course of 12 weeks.The clinical efficacy and adverse reactions of the two groups were observed.The changes of thyroid function and TRAb levels before and after treatment were detected and compared.Results:After treatment,the total effective rates of the treatment group and the control group were 94.74% and 87.20%,respectively.After treatment,serum FT3 and FT4 decreased significantly,TSH levels increased significantly,and the improvement of treatment group was significantly better than that of the control group (P＜0.05).The TRAb level in the treatment group was significantly lower than that before treatment (P＜0.05).There was no significant difference between the control group and the treatment group (P＞0.05).The TRAb level in the treatment group was higher than that before treatment.There was a significant decrease (P＜0.05).Results：Treatment of initial Graves disease with Yangyin Qingre decoction combined with methimazole can quickly relieve clinical symptoms,improve thyroid function,reduce TRAb levels,reduce immune remission time,reduce patient suffering,and have low adverse reactions.

参考文献/References:

[1] Burch HB ,Cooper DS .Management of Graves Disease:A Review[J] .Jama,2015,314(23):25442554.
[2] 罗 英,张 锐.甲硫咪唑联合左甲状腺素治疗弥漫性甲状腺肿伴甲状腺功能亢进的疗效观察及对 hsCRP 及 IL6 水平的影响[J] .陕西医学杂志,2017,46 (8) :11111112.
[3] 葛均波,徐永健,王 辰，等.内科学[M] .9版.北京:人民卫生出版社,2017:680688.
[4] 国家食品药品监督管理总局.中药新药临床研究指导原则（试行）\[S\].北京:中国医药出版社,2002:227.
[5] Effraimidis G ,Wiersinga WM .Mechanisms in endocrinology:autoimmune thyroid disease:old and new players[J] .European Journal of Endocrinology,2014,170(6):241252.
[6] 张晓丽,刘馨悦,刘 波.TRAb动态监测在Graves病在的临床意义[J] .中国实验诊断学,2016,20(4):651653.
[7] 张香玲.血清TRAb检测在Graves病中的应用效果[J] .中西医结合心血管病电子杂志,2016,36:135.
[8] 翁苓苓,王 璇,丁婕妤,等.天冬免疫调节的研究进展[J] .现代中西医结合杂志,2016,21(7):789792.
[9] 张金华,邱俊娜,王 路,等.夏枯草化学成分及药理作用研究进展[J] .中草药,2018,32(14):34323440.
[10] 李 敏,高 凯,王华林,等.柴胡皂苷d黄芩苷配伍对CCl_4诱导大鼠HSC的TLR4NFKB通路作用研究[J] .陕西中医,2018,39(1):35.
[11] 李 鹏,贺 颂,朱鸿翔,等.白术多糖对小鼠免疫调节作用的影响[J] .中西医结合心血管病电子杂志,2016,32(2):95.
[12] 李津津.中药黄芩药理作用的研究进展[J] .内蒙古中医药,2018,22（10）:117118.
[13] 张天锡,史 磊,刘 雯,等.连翘化学成分、药理活性现代研究[J] .辽宁中医药大学学报,2016,34(12):222224.

备注/Memo

备注/Memo:
*广西壮族自治区研究生教育创新计划项目（YCSY2018032）
更新日期/Last Update: 2019-09-24