[1]邓俊林,王小平,朱小雨,等.消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效研究[J].陕西中医,2022,(3):309-313.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.009]
 DENG Junlin,WANG Xiaoping,ZHU Xiaoyu,et al.Study on clinical effect of Xiaoying prescription combined with microwave ablation on Hashimoto' thyroiditis with nodule[J].,2022,(3):309-313.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.009]
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消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年3期
页码:
309-313
栏目:
临床研究
出版日期:
2022-03-05

文章信息/Info

Title:
Study on clinical effect of Xiaoying prescription combined with microwave ablation on Hashimoto' thyroiditis with nodule
作者:
邓俊林1王小平1朱小雨2姜张烨1
(1.上海中医药大学附属市中医医院,上海 200071; 2.上海中医药大学,上海 201203)
Author(s):
DENG JunlinWANG XiaopingZHU XiaoyuJIANG Zhangye
(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)
关键词:
桥本甲状腺炎 甲状腺结节 消瘿方 微波消融术 甲状腺功能
Keywords:
Hashimoto' thyroiditis Thyroid nodule Xiaoying prescription Microwave ablation Thyroid function
分类号:
R 581
DOI:
DOI:10.3969/j.issn.1000-7369.2022.03.009
文献标志码:
A
摘要:
目的:探讨消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效。方法:将108例桥本甲状腺炎伴结节患者随机分为三组,中药组行消瘿方联合微波消融术治疗,西药组行微波消融术联合左甲状腺素钠片治疗,对照组行微波消融术治疗。治疗后,比较三组甲状腺功能、甲状腺体积、结节体积、缩瘤率、临床证候积分、临床疗效。结果:与治疗前比较,治疗后6个月中药组、西药组FT3、FT4水平比较,差异无统计学意义(均P>0.05),而TSH、TgAb、TPOAb降低,差异有统计学意义(均P<0.05)。治疗后6个月中药组、西药组TgAb、TPOAb水平低于对照组,且中药组低于西药组,差异有统计学意义(均P<0.05)。与治疗前比较,治疗后6个月中药组、西药组甲状腺体积均缩小、临床证候积分降低,差异有统计学意义(均P<0.05)。治疗后6个月对照组甲状腺体积、临床证候积分与治疗前比较,差异无统计学意义(均P>0.05)。与治疗前比较,治疗后6个月三组结节体积均缩小,差异有统计学意义(P<0.05)。治疗后6个月,中药组的缩瘤率、有效率均高于西药组、对照组,差异有统计学意义(均P<0.05)。结论:消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效较好,可促进甲状腺结节消融灶吸收,改善患者临床症状及甲状腺功能,且安全性较好。
Abstract:
Objective:To investigate the effect of Xiaoying prescription combined with microwave ablation in the treatment of Hashimoto' thyroiditis with nodule.Methods:108 cases of Hashimoto' thyroiditis with nodule were randomly divided into three groups.The traditional Chinese medicine group were received Xiaoying prescription combined with microwave ablation,the western medicine group received microwave ablation combined with levothyroxine sodium tablet,and the control group received microwave ablation.After treatment,thyroid function,thyroid volume,nodule volume,tumor reduction rate,clinical symptom score and clinical efficacy of the three groups were compared.Results:Compared with before treatment,there were no significant difference in FT3 and FT4 levels between the traditional Chinese medicine group and the western medicine group after treatment(all P>0.05),while TSH,TgAb and TPOAb decreased,difference statistically significant(all P<0.05).After 6 months treatment,the levels of TgAb and TPOAb in the traditional Chinese medicine group and the western medicine group were lower than those in the control group,and the levels of TgAb and TPOAb in the traditional Chinese medicine group were lower than those in the western medicine group,difference statistically significant(all P<0.05).Compared with before treatment,thyroid volume and clinical symptom score of the traditional Chinese medicine group and western medicine group decreased 6 months after treatment(all P<0.05).Compared with before treatment,there were no significant differences in thyroid volume and clinical symptom score of the control group after 6 months treatment,difference not statistically significant(all P>0.05).Compared with before treatment,nodule volume in the three groups decreased after 6 months treatment,difference statistically significant(all P<0.05).After 6 months treatment,the tumor reduction rate and effective rate in the traditional Chinese medicine group were higher than those in the western medicine group and the control group,difference statistically significant(all P<0.05).Conclusion:Xiaoying prescription combined with microwave ablation has good efficacy in the treatment of Hashimoto' thyroiditis with nodules,which can promote the absorption of thyroid nodules ablation,improve clinical symptoms and thyroid function of patients with better safety.

参考文献/References:

[1] Durante C,Grani G,Lamartina L,et al.The diagnosis and management of thyroid nodules.A review[J].JAMA,2018,319(9):914-924.
[2] 沈冬花,李 蓉,周玲莉,等.实时剪切波弹性成像超声检查在甲状腺良恶性结节鉴别诊断中的应用[J].陕西医学杂志,2021,50(8):999-1002.
[3] 吕燕芬,陆永萍,徐 飞,等.桥本甲状腺炎合并乳头状癌的病理和超声特征分析[J].中国临床医学影像杂志,2018,29(8):592-594.
[4] 杨志芳,詹维伟,周建桥.超声对桥本甲状腺炎甲状腺微小乳头状癌的诊断价值[J].中华医学超声杂志:电子版,2014,11(10):840-844.
[5] 暴雪丽,李 平,白 颖,等.肝脾肾同调法治疗甲状腺结节浅析[J].中华中医药杂志,2020,35(9):4496-4499.
[6] 李 冉,任继鹏,范会军,等.八珍汤在甲状腺结节细针穿刺术后的应用价值[J].陕西中医,2019,40(6):777-780.
[7] 崔伟更,张 兰.慢性淋巴细胞性甲状腺炎亚临床期病机探析[J].陕西中医,2021,42(5):632-634.
[8] 韩 静,刘守尧,夏仲元.中医药干预桥本甲状腺炎作用机制的实验研究进展[J].中华中医药杂志,2019,34(9):4207-4209.
[9] 吴泽宇,王小平.甲状腺肿瘤微创消融治疗精要[M].上海:上海科学技术出版社,2018:8-9.
[10] 中华医学会内分泌学分会,中国甲状腺疾病诊治指南编写组.中国甲状腺疾病诊治指南——甲状腺炎[J].中华内科杂志,2008,47(9):784-788.
[11] 李晓曦.2016年美国临床内分泌医师协会《甲状腺结节诊断和治疗临床实践医学指南》解读[J].中国实用外科杂志,2017,37(2):157-161.
[12] 黄国政,雷梅花,李 平.活血消瘿片合夏枯草胶囊治疗桥本甲状腺炎伴结节临床研究[J].新中医,2020,52(10):53-56.
[13] 任 意,赵铁铮,王玉文,等.小金胶囊联合左甲状腺素钠片治疗桥本甲状腺炎的临床研究[J].中国中西医结合外科杂志,2020,26(3):465-470.
[14] 刘颖洁,王小平,张 宇,等.消瘿方凝胶治疗消融术后甲状腺结节疗效研究[J].陕西中医,2019,40(9):1241-1243.
[15] 陈婷婷,帕提玛,赵迎忠,等.超声引导下经皮微波消融治疗甲状腺良性结节的临床价值[J].临床超声医学杂志,2016,18(8):532-534.
[16] 马树花.超声引导下经皮微创消融治疗甲状腺结节的应用[J].分子影像学杂志,2018,41(3):297-301.
[17] Korkusuz Y,Groner D,Raczynski N,et al.Thermal ablation of thyroid nodules are radiofrequency ablation microwave ablation and high intensity focused ultrasound equally safe and effective methods[J].Eur Radiol,2018,28(3):929-935.
[18] 董丽琴,王小平,陈奎铭,等.甲状腺结节消融的治疗[J].临床外科杂志,2017,25(2):158-160.
[19] 陈奎铭,王小平,沈 睿,等.微波消融术结合定向皮内透药法治疗甲状腺结节30例[J].中国中西医结合外科杂志,2016,22(4):362-366.
[20] 王珂珂,陈宝定,吴新财,等.超声引导下微波消融治疗压迫性甲状腺实性良性结节的近期疗效观察[J].医学影像学杂志,2020,30(9):1587-1591.
[21] 方建强,赵维安,李 庆.超声引导微波消融术治疗甲状腺良性结节的疗效与安全性分析[J].中国临床医学影像杂志,2019,30(4):250-252.
[22] 陈振翼,方邦江,彭 博,等.消瘿散结方联合优甲乐对脾肾阳虚型桥本甲状腺炎合并甲状腺功能减退患者免疫功能的影响[J].中华中医药杂志,2020,35(6):3231-3235.
[23] 李 玉,罗 荔.祛瘀补肾方结合西药治疗桥本甲状腺炎的疗效及对患者免疫功能的影响[J].陕西中医,2016,37(10):1370-1371.
[24] 孟凡萍,郝 坡,范 慧.甲状腺乳头状癌并发桥本甲状腺炎患者BRAF-V600E基因表达及T淋巴细胞亚群分析[J].现代检验医学杂志,2020,35(1):32-34,48.
[25] 郑慕阳,黄大荣,唐健强,等.解郁通络消瘿汤治疗对桥本甲状腺炎患者临床疗效及血清TPO-Ab、TG-Ab水平的影响[J].黑龙江医药科学,2021,44(3):137-138.
[26] 汪 翔,陈振翼,方邦江,等.消瘿散结方对脾肾阳虚型桥本甲状腺炎合并甲减患者临床疗效观察[J].时珍国医国药,2020,31(4):888-890.
[27] 周国威,马丙娥,夏天卫,等.温阳法治疗桥本甲状腺炎伴甲减的研究进展[J].中国中医基础医学杂志,2020,26(8):1223-1226.
[28] 吴佳芸,金 昕,陶 枫.基于文本挖掘的中医治疗甲状腺功能正常桥本甲状腺炎临床研究用药特征分析[J].世界中西医结合杂志,2021,16(2):259-263.
[29] 李思思,华 川,杨金月,等.中医药治疗桥本甲状腺炎用药规律研究[J].陕西中医,2021,42(3):389-392.
[30] 李 姗.消瘿方治疗气阴两虚型桥本甲状腺炎及对甲状腺自身抗体水平的影响[J].陕西中医,2017,38(11):1581-1582.

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备注/Memo

备注/Memo:
基金项目:国家中医药管理局科研项目(2018ZY03005); 上海市科学技术委员会科研项目(17401933400)
更新日期/Last Update: 2022-03-09