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段姗姗,王永恒,彭书旺,胡维.加味逍遥散联合甲巯咪唑片对Graves病气滞痰凝证患者的临床疗效[J].湖南中医药大学学报,2023,43(7):1283-1289[点击复制] |
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| 加味逍遥散联合甲巯咪唑片对Graves病气滞痰凝证患者的临床疗效 |
| 段姗姗,王永恒,彭书旺,胡维 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 观察加味逍遥散联合甲巯咪唑片治疗Graves病气滞痰凝证患者的临床疗效。方法 选取2020年6月至2022年6月湖南中医药大学第一附属医院门诊及病房的80例患者随机分为对照组和观察组，每组40例，对照组在基础治疗的基础上给予甲巯咪唑片，观察组在对照组基础上加用加味逍遥散，4周为1个疗程，连续治疗3个疗程。观察两组患者治疗前后临床疗效、中医证候积分、临床症状评分、甲状腺体积大小、甲状腺上动脉收缩期峰值血流速度（peak systolic velocity of the superior thyroid artery，STA-PSV）、简易生活质量量表（36-item short form，SF-36）评分变化，检测血清中促甲状腺激素（thyroid stimulating hormone，TSH）、游离三碘甲状腺原氨酸（free triiodothyronine，FT3）、游离甲状腺素（free thyroxine，FT4）、促甲状腺液素受体抗体（thyrotropin receptor antibody，TRAb）以及甲状腺过氧化物酶自身抗体（thyroid peroxidase autoantibody，TPOAb）水平变化，同时评估两组患者治疗方案的安全性。结果 观察组总有效率为87.18%（34/39），对照组总有效率为68.42%（26/38），观察组总有效率高于对照组（P<0.05）。治疗后两组患者中医证候积分、临床症状评分、甲状腺体积、STA-PSV及血清FT3、FT4、TRAb、TPOAb含量均较治疗前降低（P<0.01），且观察组低于对照组（P<0.01）。治疗后两组患者SF-36评分、血清TSH含量均较治疗前升高（P<0.01），且观察组高于对照组（P<0.01）。在治疗期间，两组患者均未发生明显不良反应，且患者的肝肾功能、血常规、心肌酶、心率、脉搏、血压等安全性指标均未见异常。结论 加味逍遥散联合甲巯咪唑片对Graves病气滞痰凝证患者的临床疗效以及安全性良好，其作用机制可能与调节免疫、改善甲状腺激素及相关抗体水平有关。 |
| 关键词: 加味逍遥散 甲巯咪唑片 甲状腺功能亢进症 Graves病 气滞痰凝证 |
| DOI：10.3969/j.issn.1674-070X.2023.07.021 |
| 投稿时间：2023-02-06 |
| 基金项目:湖南省卫生健康委员会科研计划课题项目（D202304018086，202104010382）；湖南省临床医疗技术创新引导项目（2021SK1415）。 |
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| Clinical efficacy of Jiawei Xiaoyao Powder combined with Methimazole Tablet in treating Graves disease of qi stagnation with phlegm retention pattern |
| DUAN Shanshan,WANG Yongheng,PENG Shuwang,HU Wei |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To observe the clinical efficacy of Jiawei Xiaoyao Powder (JWXYP) combined with Methimazole Tablet in treating Graves disease of qi stagnation with phlegm retention pattern. Methods From June 2020 to June 2022, 80 outpatients and wards of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into the control group and the observation group, with 40 cases in each group. Control group was given Methimazole Tablet based on conventional treatment, while observation group was treated with JWXYP based on the treatment of control group, 4 weeks as a course of treatment, for 3 continuous courses. Then the changes in clinical efficacy, TCM pattern score, clinical symptom score, thyroid volume, peak systolic velocity of the superior thyroid artery (STA-PSV), and score of 36-item short form (SF-36) before and after treatment were observed. Meanwhile, the level changes of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin receptor antibody (TRAb), and thyroid peroxidase autoantibody (TPOAb) in serum was determined. At the same time, the safety of both regimens was evaluated. Results The total effective rate was 87.18% (34/39) in observation group, which was higher than that in control group with 68.42% (26/38) (P<0.05). After treatment, the TCM pattern score, clinical symptom score, thyroid volume, STA-PSV, and the content of FT3, FT4, TRAb, and TPOAb in serum in both groups were lower than those before treatment (P<0.01), and those in observation group were lower than those in control group (P<0.01). After treatment, the SF-36 score and serum TSH content in both groups were higher than those before treatment (P<0.01), and those in observation group were higher than those in control group (P<0.01). During the treatment, no obvious adverse reactions occurred in the two groups, and there were no abnormalities in liver and kidney function, blood routine, myocardial enzymes, heart rate, pulse, blood pressure, and other safety indicators. Conclusion JWXYP combined with Methimazole Tablet has high clinical efficacy and safety in treating Graves disease of qi stagnation with phlegm retention pattern, and its mechanism of action may be related to regulating immunity as well as improving the levels of thyroid hormone and related antibodies. |
| Key words: Jiawei Xiaoyao Powder Methimazole Tablet hyperthyroidism Graves disease qi stagnation with phlegm retention pattern |
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