中西医结合治疗甲状腺功能亢进症近期疗效及远期复发率观察

目的:观察中西医结合治疗甲状腺功能亢进症的近期疗效和远期复发率。方法:将符合标准的74例患者随机分为两组,对照组40例采用甲巯咪唑治疗,治疗组34例在对照组基础上加用中药辨证论治,肝郁气滞化火者用柴胡疏肝散加减,阴虚火旺、痰瘀凝结者用知柏地黄丸合消瘰丸加减,气阴两虚兼痰瘀互结者予以生脉散、二至丸合消瘰丸加减。观察患者临床症状、体征和甲状腺功能变化情况、不良反应发生情况和复发率。结果:治疗组临床痊愈率和总有效率分别为44.12%、88.24%,对照组临床痊愈率和总有效率分别为25.00%、77.50%。两组比较,差异有统计学意义(P0.05)。治疗1个月后,治疗组症状总积分低于对照组,但差异无统计学意义;自治疗3个月起,组间比较,差异均有统计学意义(P0.05)。治疗后两组TT3、TT4、FT3、FT4和TRAb均降低,TSH升高,组间比较,差异均有统计学意义(P0.05)。治疗组和对照组不良反应率分别为5.88%、15.00%,差异有统计学意义(P0.05),以肝功能损害最为常见。临床痊愈患者中,治疗组复发6例,复发率40.00%,对照组复发6例,复发率60.00%。结论:甲巯咪唑联合中药辨证论治用于甲状腺功能亢进症,可有效改善患者临床症状和甲状腺功能,降低药物不良反应发生率,减少复发。

Therapeutic Efficacy of Combined Treatment of Traditional Chinese and Western Medicine on Hyperthyroidism and Long-term Recurrence

Objective：To observe therapeutic efficacy of combined treatment of traditional Chinese and western medicine on hyperthy -roidism and long-term recurrence.Methods：Seventy four patients were randomly divided into two groups , control group （40 cases） used Methyl mercaptoacetate imidazole , observation group （34 cases） used Methyl mercaptoacetate imidazole plus Chinese medicine treatment based on syndrome differentiation：liver stagnation resulting in exuberating fire used modified bupleurum Powder , Yin-deficiency , fire-ex-uberant phlegm-stagnation used modified Zhibai Dihang Pill and Xiaoluo Pill , qi-yin deficiency , phlegm stagnation used modified Shengmai Powder, Erzhi Pill and Xiaoluo Pill.After treatment, we compared changes of thyroid function , symptoms, physical signs, ad-verse reaction and recurrence .Results：Clinical cure rates and total effective rate of observation group were respectively , 44.12% and 88.24%, those of the control group were 25.00%and 77.50%（P＆lt;0.05）.After 1-month treatment, the observer group’s total symp-tom score was lower than the control group （P＆gt;0.05）, the difference showed statistic significance after 3-months treatment （P＆lt;0. 05）.After treatment TT3、TT4、FT3、FT4and TRAb were reduced and TSH elevated in both groups with significant difference between the groups （P＆lt;0.05）.AE occurrence rates of observation group and control group were respectively , 5.88% and 15.00% （P＆lt;0.05）, liver damage was most noticeable .The observer group had 6 reoccurrences, recurrence rate =40%, the control group had 6 cases, re-currence rate =60%.Conclusion：Thiamazole combined with traditional Chinese medicine can effectively treat clinical symptoms and thyroid function of hyperthyroidism , control adverse reaction and recurrence .