天王补心丹联合丙硫氧嘧啶治疗甲状腺功能亢进的疗效观察

目的探讨丙硫氧嘧啶联合天王补心丹治疗甲状腺功能亢进患者的治疗效果。方法选取2018年1月—2019年6月许昌市人民医院收治甲状腺功能亢进患者86例,随机分为对照组和治疗组,每组各43例。对照组患者口服丙硫氧嘧啶片,初始剂量为100 mg/次,3次/d,然后依据患者甲状腺激素水平改变剂量。治疗组在对照组基础上口服天王补心丹,1丸/次,3次/d。两组患者治疗30 d。观察两组患者临床疗效,同时比较治疗前后两组患者中医证候积分,三碘甲状腺原氨酸(FT3)、四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)和促甲状腺素受体抗体(TRAb)指标水平,及随访结果情况。结果治疗后,对照组临床有效率为79.07%,显著低于治疗组的95.35%,两组比较差异具有统计学意义(P0.05)。治疗后,两组中医证候积分均明显降低(P0.05),且治疗组降幅明显大于对照组(P0.05)。治疗后,两组患者FT3、FT4、TRAb的指标均明显下降(P0.05),而TSH指标则明显上升(P0.05),且治疗组明显好于对照组(P0.05)。随访期间治疗组患者的症状控制时间、肝脏损伤时间、TSH指标恢复正常时间均显著短于对照组(P0.05)。结论丙硫氧嘧啶联合天王补心丹治疗甲状腺功能亢进患者疗效显著,并改善患者的甲状腺激素水平,同时安全性好。

Clinical observation of Tiangwang BuxinPills combined with prothiouracil in treatment of hyperthyroidism

Objective To investigate the clinical effects of Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease. Methods Patients (120 cases) with chronic kidney disease in the Second Affiliated Hospital of Nanjing Medical University from September 2016 to February 2019 were divided into control and observation group accorded to the random number table method, and each group had 60 cases. Patients in the control group were iv administered with Acetylcysteine Injection, 40 mL was diluted with 5% glucose injection 250 mL, once daily. Patients in the observation group were po administered with Niaoduqing Granules on the basis of control group, 1 bag/time, and washed with warm water for 3 times daliy. Both groups were observed for 1 month. After treatment, the clinical efficacy in two groups was observed, and the levels of PCT, NAG, BUN, and Scr before and after treatment were compared, and the incidence of adverse reactions during the treatment were compared. Results After treatment, the total effective rate in the observation group was 98.3%, which was significantly higher than 88.3% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of serum PCT and urinary NAG in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, serum PCT and urine NAG levels in the observation group were significantly lower than those in the control group, and the differences between two groups were statistically significant (P<0.05). After treatment, the levels of serum BUN and Scr in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the levels of BUN and Scr in the observation group were significantly lower than those in the control group, and the difference between two groups was statistically significant (P<0.05). The incidence of adverse reactions such as dizziness, headache and dry cough was 3.3% in the observation group, which was significantly lower than 16.7% in the control group (P<0.05). Conclusion Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease has a good clinical effect, can inhibit PCT, reduce the level of urinary NAG, promote the recovery of renal function, and reduce the occurrence of adverse reactions, has a certain clinical promotion and application value.