小柴胡汤加减治疗肝经蕴热型复发性亚急性甲状腺炎的疗效观察

摘要

目的 观察小柴胡汤加减治疗肝经蕴热型复发性亚急性甲状腺炎的临床疗效.方法 肝经蕴热型复发性亚急性甲状腺炎患者90例,随机分为观察组和对照组,每组各45例.对照组给予口服强的松片治疗.观察组在对照组治疗基础上服用中药小柴胡汤加减,两组均治疗8周.比较治疗前后游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、C反应蛋白(CRP)、血沉(ESR)、中医症候积分、副反应发生率等指标,并进行疗效判定.随访6个月记录复发情况.结果 两组治疗后FT3、FT4水平均较治疗前明显降低(P<0.05),TSH水平较治疗前明显升高(P<0.05).观察组治疗后FT3、FT4水平明显低于对照组(P<0.05),TSH水平明显高于对照组(P<0.05).两组治疗后血CRP水平、ESR均明显低于治疗前(P<0.05).观察组治疗后血CRP水平、ESR均明显低于对照组(P<0.05).观察组治疗后中医症候积分明显低于对照组(P<0.05),治疗总有效率明显高于对照组(P<0.05).治疗过程中,观察组激素相关性副反应发生率明显低于对照组(P<0.05).经随访统计,观察组复发率明显低于对照组(P<0.05).结论 小柴胡汤加减联合强的松治疗肝经蕴热型复发性亚急性甲状腺炎临床疗效确切,可有效促进甲状腺功能恢复,减轻炎症,有效缓解和控制病情的发生与发展.%Objective To explore the clinical effect of Modified Xiaochaihutang on the type of Gan Jing Yun Re recurrent subacute thyroiditis. Methods 90 cases of the type of Gan Jing Yun Re Recurrent Subacute Thyroiditis were randomly divided into observation group and control group, 45 cases in each group. Control group was given piece of oral prednisone with treatment time for eight weeks. Observation group was treated with Modified Xiaochaihutang on the basis of the control group,treatment for 8 weeks. Before and after treatment,the thyroid function indicators including FT3,FT4,TSH were automatically detected by electrochemical iuminescence instrument. CRP and ESR were detected by full automatic immune biochemical analyzer. Each group before and after treatment of Chinese medicine were detected with symptom integral and outcome. Hormone appeared in the process of each treatment related to the incidence of adverse events were recorded. The patients were followed up for 6 months and to determine the efficacy. Results After treatment,The FT3,FT4 level were significantly lower than before treatment in the two groups(P<0.05),the TSH levels significantly increased before the treatment(P<0.05). Observation group after treatment of FT3,FT4 levels significantly lower than the control group after treatment(P<0.05),the TSH level obviously was higher than the control group after treatment(P<0.05).Two groups after treatment the blood levels of CRP and ESR were significantly lower than before treatment(P<0.05).Blood CRP levels after treatment,the ESR observation group were significantly lower than the control group after treatment(P<0.05).Observation group after treatment of TCM symptom score significantly lower than the control group after treatment(P<0.05),the total effective rate was significantly higher than control group(P<0.05).The course of treatment, hormone correlation side effects incidence of observation group was obviously lower than the control group(P<0.05).The recurrence rate by follow-up statistics,observation group was obviously lower than the control group(P<0.05). Conclusion The treatment of the type of Gan Jing Yun Re recurrent subacute thyroiditis with Xiao Chai Hu Tang combined prednisone can obviously improve the clinical symptoms of patients. It has obvious advantages compared with simple western medicine treat recurrent subacute thyroiditis and provides ideas for the combination of traditional Chinese and Western medicine prevention of recurrent subacute thyroiditis.