从热毒辨治亚急性甲状腺炎急性期临床疗效
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摘要
目的:探讨从热毒辨治亚急性甲状腺炎急性期的临床疗效观察。方法:选择2015年1月—2016年1月医院亚急性甲状腺炎患者72例,按照随机随机数字表发分为观察组和对照组,每组各36例,治疗组采用中药治疗以清热解毒为治疗大法,佐以理气化痰祛湿,对照组采用阿司匹林合用泼尼松治疗。统计并对比分析两组患者临床疗效、不良反应、复发率情况。结果:观察组36例患者,治疗总有效率94.4%,明显高于对照组治疗总有效率77.8%,两组比较有统计学差异(P<0.05);两组在甲状腺肿消退时间、疼痛消失时间、疗程有显著性差异;对照组患者恶心呕吐者、头痛等不良反应发生率为16.7%,观察组的不良反应发生率2.8%;观察组明显低于对照组,两组比较有统计学差异(P<0.05);治疗后随访12个月,观察组复发率为2.8%明显低于对照组的19.4%,两组比较有显著性差异(P<0.05)。结论:清热解毒之法在亚急性甲状腺炎急性期有良好的临床疗效,且不良反应发生率和复发率低,值得临床推广应用。
Objective: To study the clinical effect of the treatment of acute phase of subacute thyroiditis from heat. Methods: Between January 2015 and January 2016,52 cases of subacute thyroiditis patients,according to the stochastic random number table were divided into observation group and control group,each group 26 patients. The observation group was treated by traditional Chinese medicine with heat-clearing and detoxifying treatment,helping with expelling phlegm and dampness method. The control group used aspirin and prednisone. We analyzed two groups' clinical efficacy,adverse reaction and recurrence rate. Results: The observation group's total effective rate was 94. 4%,significantly higher than the control group's 77. 8%. The two groups were statistically significant( P < 0. 05). Control group's incidence of adverse reactions like nausea and vomiting and headache was 16. 7% and that of the treatment gorup was 2. 8%.The observation group's was significantly lower than that of the control group and there was a statistical significance( P <0. 05). After followed up for 12 months after treatment,the recurrence rate was 2. 8% in the observation group was obviously lower than the control group's 19. 4% and the two groups had significant difference( P < 0. 05). Conclusion: The method of heat-clearing and detoxifying in the acute phase of subacute thyroiditis has good clinical efficacy,and the incidence of adverse reactions and the recurrence rate is low,worthy of popularization and application.
Objective: To study the clinical effect of the treatment of acute phase of subacute thyroiditis from heat. Methods: Between January 2015 and January 2016,52 cases of subacute thyroiditis patients,according to the stochastic random number table were divided into observation group and control group,each group 26 patients. The observation group was treated by traditional Chinese medicine with heat-clearing and detoxifying treatment,helping with expelling phlegm and dampness method. The control group used aspirin and prednisone. We analyzed two groups' clinical efficacy,adverse reaction and recurrence rate. Results: The observation group's total effective rate was 94. 4%,significantly higher than the control group's 77. 8%. The two groups were statistically significant( P < 0. 05). Control group's incidence of adverse reactions like nausea and vomiting and headache was 16. 7% and that of the treatment gorup was 2. 8%.The observation group's was significantly lower than that of the control group and there was a statistical significance( P <0. 05). After followed up for 12 months after treatment,the recurrence rate was 2. 8% in the observation group was obviously lower than the control group's 19. 4% and the two groups had significant difference( P < 0. 05). Conclusion: The method of heat-clearing and detoxifying in the acute phase of subacute thyroiditis has good clinical efficacy,and the incidence of adverse reactions and the recurrence rate is low,worthy of popularization and application.
引文
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[2] 王霜,杨正国,杨波.米松局部注射治疗亚急性甲状腺炎[J].实用医药杂志,2014,31(1):36
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[5] 顾黎,余江毅.余江毅教授治疗亚急性甲状腺炎经验[J].浙江中医药大学学报,2017,41 (11)883-886.
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[8] 翁莉不同方法治疗亚急性甲状腺炎的临床观察[J].中医临床研究,2015,9(3):27-29.
[9] 刘雅林.强的松联合吲哚美辛在亚急性甲状腺炎治疗中的应用效果[J].中国现代药物应用,2017,11(22):8-10.
[10] 王庆浩,陈如泉,方居正.穿山龙对Graves’病大鼠甲状腺激素的影响[J].中医药学报,2007,35(2):26-28.
[11] 唐丽香.福建穿山龙抗炎镇痛作用的实验研究[J].海峡医药,2000,12(3):38-40.
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[14] 张霞,李红.亚急性甲状腺炎中医研究进展[J]. 辽宁中医药大学学报,2017,19(5):113-115.
[15] 张霞,李红.颈动脉炎误诊为亚急性甲状腺炎1例病例分析[J].安徽医药,2017,21(6):1076-1078.
[16] 贺凯,高建莉,赵光树延胡索化学成分、药理作用及质量控制研究进展[J].辽宁中医杂志,2007,38(12):1909-1932.
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[19] 崔征, 齐美玲, 殷军, 等. 东北延胡索的化学成分及近缘植物的植物化学分类学[C].北京: 中国植物学会七十五周年年会论文摘要汇编, 2008.
[20] 张海男,黎古辟,李学义.清肝泻火汤对内毒素诱发家兔肝火证的疗效和机理[J].中国中西医结合杂志,1996,16(2):98.
[21] 金艺璇.辨证分型治疗亚急性甲状腺炎50例临床观察[J].亚太传统医药,2014,10(22):62-63.
[22] 闵婕,李红.李红教授治疗重症亚急性甲状腺炎学术思想研究[J].中国中医急症,2017,26(12):2118-2120.
[2] 王霜,杨正国,杨波.米松局部注射治疗亚急性甲状腺炎[J].实用医药杂志,2014,31(1):36
[3] 李倩,张克勤,刘超.亚急性甲状腺炎[J].中国实用乡村医生杂志,2006,13(10):20-21.
[4] 刘晶,冉颖卓.冉颖卓运用小柴胡汤治疗甲状腺炎经验[J].山东中医杂志,2017,36(11):964-966.
[5] 顾黎,余江毅.余江毅教授治疗亚急性甲状腺炎经验[J].浙江中医药大学学报,2017,41 (11)883-886.
[6] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社 2013:696.
[7] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:226-228.
[8] 翁莉不同方法治疗亚急性甲状腺炎的临床观察[J].中医临床研究,2015,9(3):27-29.
[9] 刘雅林.强的松联合吲哚美辛在亚急性甲状腺炎治疗中的应用效果[J].中国现代药物应用,2017,11(22):8-10.
[10] 王庆浩,陈如泉,方居正.穿山龙对Graves’病大鼠甲状腺激素的影响[J].中医药学报,2007,35(2):26-28.
[11] 唐丽香.福建穿山龙抗炎镇痛作用的实验研究[J].海峡医药,2000,12(3):38-40.
[12] Medzhitov R. Origin and physiological roles of inflammation[J]. Nature, 2014,454(7203): 428.
[13] 雷载权.中药学[M].上海:上海科学技术出版社,2001:200-201.
[14] 张霞,李红.亚急性甲状腺炎中医研究进展[J]. 辽宁中医药大学学报,2017,19(5):113-115.
[15] 张霞,李红.颈动脉炎误诊为亚急性甲状腺炎1例病例分析[J].安徽医药,2017,21(6):1076-1078.
[16] 贺凯,高建莉,赵光树延胡索化学成分、药理作用及质量控制研究进展[J].辽宁中医杂志,2007,38(12):1909-1932.
[17] 蔡定芳,孟澍江.抗戾散治疗病毒性高热的临床研究[J ].中国医药学报,1990,5(5):19.
[18] 周琼. 延胡索化学成分研究及其中草药特色体系化学特征表达[D].北京:北京协和医学院, 2012:15-17.
[19] 崔征, 齐美玲, 殷军, 等. 东北延胡索的化学成分及近缘植物的植物化学分类学[C].北京: 中国植物学会七十五周年年会论文摘要汇编, 2008.
[20] 张海男,黎古辟,李学义.清肝泻火汤对内毒素诱发家兔肝火证的疗效和机理[J].中国中西医结合杂志,1996,16(2):98.
[21] 金艺璇.辨证分型治疗亚急性甲状腺炎50例临床观察[J].亚太传统医药,2014,10(22):62-63.
[22] 闵婕,李红.李红教授治疗重症亚急性甲状腺炎学术思想研究[J].中国中医急症,2017,26(12):2118-2120.