辨证分型治疗甲状腺功能亢进症35例临床观察

目的]观复辨证分型治疗甲状腺功能亢进症疗效。方法]使用前瞻性设计方法,对30例门诊患者辨证治疗。肝郁痰火,海藻玉壶汤(海藻、昆布各15g,海带、法半夏各20g,陈皮10g,青皮8g,连翘、象贝、当归各15g,川芎8g,独活10g,甘草5g)。阴虚火旺,清肝芦荟丸合玉女煎(夏枯草25g,黄芩20g,黄连15g,生石膏先煎30g,知母、地骨皮、昆布各15g,海藻20g,白芍、生地、玉竹、麦冬各15g,牡蛎先煎30g,芦荟1.5g);胃腑热甚,津液耗伤,大便秘结加大黄后下30g,芒硝12g。气阴两虚,黄芪汤(黄芪、党参各20g,天冬15g,生地20g,白芍、花粉、茯神各15g,五味子10g,甘草5g);心烦善怒、性情急躁加夏枯草、龙胆草、黄芩各15g,栀子20g;心悸、口舌生疮加黄连、枣仁、远志各10g;大便稀溏加白术、山药各15g,神曲10g,谷芽15g。连续治疗30d为1疗程。1剂/d,水煎350m L。病情稳定后,配制蜜丸,9g/丸,1丸/d,早晚温水服用,巩固疗效,防止复发。观测临床症状、血清总三碘甲腺原氨酸(TT3)、血清总甲状腺素(TT4)、血清游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、促甲状腺激素(TSH)、不良反应。连续治疗3疗程,判定疗效。结果]临床治愈8例,基本治愈7例,显效6例,好转9例,无效5例,总有效率为85.71%(30/35)结论]辨证分型治疗甲状腺功能亢进症疗效显著,无严重不良反应,值得推广。

Clinical Observation on 35 cases of Treatment of Hyperthyroidism Syndrome

Objective ] View complex differentiation effect in treatment of hyperthyroidism. Method ] Using a prospectivedesign method, differential treatment of 30 cases of outpatients. Syndrome of stagnation of liver qi and phlegm fire,the seaweed Yuhu soup （seaweed, kelp, kelp each 15g, pinellia tuber each 20g, orange peel log, green 8g,forsythia, like shellfish, angelica each 15g, 8g of the rhizome of chuanxiong, angelica lOg, licorice 5g）. Hyperactivity of fire due to yin deficiency, liver aloe pills Decoction （Radix Scutellariae Coptis Pr unella 25g, 20g, 15g, gypsum,Anemarrhena rhizome, Cortex Lycii Radicis first decoct 30g, kelp seaweed each 15g, 20g, white peony root,rehmannia, fragrant solomonseal rhizome, Ophiopogon japonicus 15g, first fried oyster 30g, aloe 1.5g）; stomachheat, body fluid consumption injury, constipation and enlarged yellow after 30g, Glauber＇s salt 12g. Deficiency of both qi and Yin, “Benshi Fang” Huangqi decoction, Radix Astragali, Radix Codonopsi s 20g, asparagus 15g, to 20g,Radix Paeoniae Alba, pollen, Poria each 15g, Sehisandra lOg, licorice 5g; such as dysphoria, tempered with good anger Prunella vulgaris, Long Dan grass, scutellaria root 15g, gardenia 20g; palpit ations, mouth sores and Rhizoma Coptidis, semen Ziziphi Spinosae, polygala root each lOg; loose stool with white atractylodes rhizome, Chinese yameach 15g 10g, the Divine Comedy, millet sprout 15g. Continuous treatment with 30d for 1 courses. 1 agent /d,Decoction 350mL. The stable condition, pill, prepared according to the following prescribed 9g/ pills, 1 pills, /d,sooner or later, warm water taking, consolidate curative effect, prevent recurrence. Observation of clinical symptoms,blood biochemical index and adverse reaction. Continuous treatment of 3 courses of treatment, curative effect. Result ] 18 cases were cured, 11 cases improved, 1 cases ineffective, the total efficiency of 96.67% （29/30）. Conclusion ] Differentiation significant poin ts of curative effect of treatment of hyperthyroidism, worthy o