全腔镜甲状腺切除术联合养阴益肾法治疗分化型甲状腺癌疗效及对患者生存质量的影响

摘要

目的 探讨全腔镜甲状腺切除术联合养阴益肾法治疗分化型甲状腺癌的疗效及对患者生存质量的影响.方法 将104例早期分化型甲状腺癌患者随机分为对照组52例和治疗组52例,2组患者均行全腔镜甲状腺切除术,对照组患者术后给予131I清甲+左旋甲状腺素钠片治疗,治疗组患者在对照组治疗基础上给予养阴益肾方加减调理.治疗2个月后,应用卡氏评分量表评估2组患者生存质量,观察术后常见并发症及中医症状变化情况,检测甲状腺激素相关指标水平,对不良反应发生情况及程度进行评分.结果 治疗2个月后,治疗组患者卡氏评分提高稳定率和声嘶、便干、心悸、口疮消失率均明显高于对照组(P均＜0.05);2组患者中医症状评分均明显降低(P均＜0.05),且治疗组明显低于对照组(P＜0.05);2组患者血清游离甲状腺激素(FT4)、游离三碘甲状腺原氨酸(FT3)水平均明显升高(P均＜0.05),促甲状腺激素(TSH)和甲状腺球蛋白(TG)水平均明显降低(P均＜0.05),且治疗组改善更明显(P均＜0.05);治疗组不良反应评分明显低于对照组(P＜0.05).结论 全腔镜甲状腺切除术联合养阴益肾法治疗分化型甲状腺癌可明显提高患者生存质量,促进患者术后常见并发症消失,减轻中医症状,调节甲状腺激素水平,且不良反应少.%Objective It is to investigate the efficacy of total laparoscopic thyroidectomy combined with Yangyin Yishen therapy in the treatment of differentiated thyroid cancer and its impact on patients' quality of life. Methods 104 patients with early-differentiated thyroid carcinoma were randomly divided into the control group (n=52) and the treatment group (n=52). Both groups were treated with total laparoscopic thyroidectomy. The patients in the control group were given 131 I therapy+levothyroxine sodium tablets after operation, while the patients in the treatment group were given Yangyin Yishen decoction on the basis of the treatment of the control group. After treatment for 2 months, the quality of life of the two groups was evaluated by Karl Fischer scale. The postoperative complications and changes of TCM symptoms were observed. The levels of thyroid hormone related indicators were detected, and the incidence and extent of adverse reactions were assessed. Results After 2 months of treatment, the stability rate of Carr's score in the treatment group was significantly higher, the disappearance rate of hoarseness, dryness, palpitations and aphthous ulcer was significantly higher in the treatment group than that of the control group (P＜0.05); The TCM symptom scores of the two groups were significantly decreased (P＜0.05), and the decrease in the treatment group was more significant than the control group (P＜0.05); The levels of serum free thyroid hormone (FT4) and free triiodothyronine (FT3) were significantly increased (P＜0.05), while that of thyroid stimulating hormone (TSH) and thyroglobulin (TG) were significantly decreased in the two groups (P＜0.05), and the improvements in the treatment group were more significant (P＜0.05). The adverse reaction scores of the treatment group were significantly lower than that of the control group (P＜0.05). Conclusion Total laparoscopic thyroidectomy combined with Yangyin Yishen therapy can significantly improve the quality of life, promote the disappearance of common complications after surgery, reduce the clinical symptoms, regulate levels of thyroid hormone with fewer adverse reactions in the patients with differentiated thyroid cancer.