甲状腺功能亢进症的“阴阳六经”证型分布规律及相关因素分析
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摘要
目的:探讨甲状腺功能亢进症(甲亢)的"阴阳六经"证型分布规律及相关因素分析。方法:采用回顾性研究,记录360例甲亢住院患者临床信息,构建"阴阳六经"证型,并探讨证型与临床信息的相关性。结果:阴证男性占64.6%,阳证女性占81.5%,阴阳寒热错杂证男性和女性分别占46.1%和53.9%(P<0.01);阴证60岁以上者占70.8%,阳证、阴阳寒热错杂证60岁以下者分别占92.6%和87.6%(P<0.01);阴证、阳证、阴阳寒热错杂证合并糖尿病比例分别为4.9%、5.3%、5.6%,合并重症肌无力比例分别为18.3%、5.3%、2.2%(P<0.05),并发甲亢性心脏病比例分别为57.3%、16.4%、15.7%(P<0.01),突眼比例分别为11.0%、61.4%、43.8%(P<0.01),甲状腺肿大比例分别为19.5%、89.9%、85.4%(P<0.01)。结论:甲亢之"阴阳六经"证型与性别、年龄、合并症、并发症、突眼度、甲状腺肿大程度相关,呈一定的规律性,在临床辨治甲亢方面具有参考价值和指导意义。
Objective: To study the distribution regularity of 'yin-yang and six channels' syndrome type in hyperthyroidism and analyze their correlative factors. Methods: Retrospective study was applied to record clinical information of 360 patients with hyperthyroidism, construct 'yin-yang and six channels syndrome type', and study the correlation between the syndrome types and the clinical information. Results: Male with yin syndrome occupied 64.6%, while a female with yang syndrome occupied 81.5%. Male and female with yin-yang cold-heat complex syndrome occupied 46.1% and 53.9%, respectively(P<0.01). Patients aged 60 or above with yin syndrome occupied 70.8%. Patients aged below 60 with yang syndrome and yinyang cold-heat complex syndrome occupied 92.6% and 87.6%, respectively(P<0.01). For those patients with yin syndrome,yang syndrome and yin-yang cold-heat complex syndrome, the ones combined with diabetes occupied 4.9%, 5.3% and 5.6%respectively, the ones combined with myasthenia gravis occupied 18.3%, 5.3% and 2.2% respectively(P<0.05), the ones combined with hyperthyroid heart disease occupied 57.3%, 16.4% and 15.7% respectively(P<0.01), the ones combined with exophthalmos occupied 11.0%, 61.4%, and 43.8% respectively(P<0.01), and the ones combined with thyromegaly occupied 19.5%, 89.9% and85.4% respectively(P<0.01). Conclusion: Yin-yang six channels syndrome type in hyperthyroidism has a correlation with gender,age, comorbidity, complications, exophthalmos level, and thyromegaly level, which has certain regularity. It has referential value and significance in distinguishing and treating hyperthyroidism clinically.
Objective: To study the distribution regularity of 'yin-yang and six channels' syndrome type in hyperthyroidism and analyze their correlative factors. Methods: Retrospective study was applied to record clinical information of 360 patients with hyperthyroidism, construct 'yin-yang and six channels syndrome type', and study the correlation between the syndrome types and the clinical information. Results: Male with yin syndrome occupied 64.6%, while a female with yang syndrome occupied 81.5%. Male and female with yin-yang cold-heat complex syndrome occupied 46.1% and 53.9%, respectively(P<0.01). Patients aged 60 or above with yin syndrome occupied 70.8%. Patients aged below 60 with yang syndrome and yinyang cold-heat complex syndrome occupied 92.6% and 87.6%, respectively(P<0.01). For those patients with yin syndrome,yang syndrome and yin-yang cold-heat complex syndrome, the ones combined with diabetes occupied 4.9%, 5.3% and 5.6%respectively, the ones combined with myasthenia gravis occupied 18.3%, 5.3% and 2.2% respectively(P<0.05), the ones combined with hyperthyroid heart disease occupied 57.3%, 16.4% and 15.7% respectively(P<0.01), the ones combined with exophthalmos occupied 11.0%, 61.4%, and 43.8% respectively(P<0.01), and the ones combined with thyromegaly occupied 19.5%, 89.9% and85.4% respectively(P<0.01). Conclusion: Yin-yang six channels syndrome type in hyperthyroidism has a correlation with gender,age, comorbidity, complications, exophthalmos level, and thyromegaly level, which has certain regularity. It has referential value and significance in distinguishing and treating hyperthyroidism clinically.
引文
[1]司富春,宋雪杰.中医治疗甲亢的证候和方药分析研究.中华中医药杂志,2013,28(11):3250-3255
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[11]江丹,林明欣,朱章志.朱章志教授从“三阴病”论治糖尿病肾病经验.中华中医药杂志,2013,28(9):2635-2638
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[14]Tunbridge W M,Evered D C,Hall R,et al.The spectrum of thyroid disease in a community:The Whickham survey.Clinical Endocrinology,2010,7(6):481-493
[15]伍宁玲,吕朝晖,杨国庆,等.Graves病患者中与性别相关的临床特点分析.中华内分泌代谢杂志,2011,27(4):311-314
[16]李云楚,倪青.甲状腺功能亢进症对性腺的影响及中医临床策略.中国临床医生杂志,2015,43(6):4-5
[17]程煜,魏军平,林江涛.20例老年淡漠型甲亢中医诊治.长春中医药大学学报,2014,30(3):483-485
[18]王张阳,宋捷,敬思思,等.伴与不伴甲状腺功能亢进重症肌无力患者的临床资料比较研究.中国临床神经科学,2018,26(3):281-286
[19]裴倩,王芳芳,朱章志.甲状腺疾病责之阳气异常.辽宁中医药大学学报,2011,13(3):92-93
[20]琚星萌,宋雅芳,郭丽娜,等.95例脾气虚证重症肌无力病例回顾及用药规律探析.中华中医药杂志,2017,32(10):4705-4707
[21]张菀桐,翁维良,高蕊,等.翁维良治疗甲亢性心脏病致难治性心力衰竭经验.世界中医药,2017,12(8):1863-1866
[22]王树林,徐云生,戴汉源.辛开苦降法治疗甲状腺肿大的临证心得.四川中医,2011,29(4):39-40
[2]王秋虹,易泳鑫,林兰.中医药治疗甲状腺功能亢进症的临床研究进展.世界中医药,2015,10(3):464-467
[3]林明欣,谢欣颖,朱建平,等.论治糖尿病之“通阳三法”初探.中华中医药杂志,2014,29(9):2896-2898
[4]Ross D S,Burch H B,Cooper D S,et al.2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis.Thyroid Official Journal of the American Thyroid Association,2016,26(10):1343-1421
[5]孟祥,倪青.甲状腺功能亢进中医药治疗进展.北京中医药,2017,36(6):571-575
[6]程相稳,张广德,魏子孝.含碘中药在甲状腺功能亢进症中的应用评述.中华中医药杂志,2017,32(9):3901-3904
[7]谢欣颖,朱章志,张莹莹,等.“温运阳气”法论治甲亢.中华中医药杂志,2014,29(10):3066-3068
[8]张莉,刘怀珍,夏梦琳,等.中医对甲状腺功能亢进症的治疗概述.中医药临床杂志,2016,28(6):892-894
[9]梁苹茂,黄梦哲,刘倩,等.瘿病原道说解.中华中医药杂志,2011,26(9):1943-1946
[10]林明欣,赵英英,朱章志.立足“首辨阴阳,再辨六经”浅析糖尿病论治.中华中医药杂志,2011,26(5):1119-1122
[11]江丹,林明欣,朱章志.朱章志教授从“三阴病”论治糖尿病肾病经验.中华中医药杂志,2013,28(9):2635-2638
[12]谭宏韬,刘树林,朱章志,等.“首辨阴阳,再辨六经”论治惠州地区2型糖尿病的临床观察.中华中医药杂志,2018,33(9):4240-4244
[13]谭宏韬.甲亢的六经辨证探讨.广州:广州中医药大学,2013
[14]Tunbridge W M,Evered D C,Hall R,et al.The spectrum of thyroid disease in a community:The Whickham survey.Clinical Endocrinology,2010,7(6):481-493
[15]伍宁玲,吕朝晖,杨国庆,等.Graves病患者中与性别相关的临床特点分析.中华内分泌代谢杂志,2011,27(4):311-314
[16]李云楚,倪青.甲状腺功能亢进症对性腺的影响及中医临床策略.中国临床医生杂志,2015,43(6):4-5
[17]程煜,魏军平,林江涛.20例老年淡漠型甲亢中医诊治.长春中医药大学学报,2014,30(3):483-485
[18]王张阳,宋捷,敬思思,等.伴与不伴甲状腺功能亢进重症肌无力患者的临床资料比较研究.中国临床神经科学,2018,26(3):281-286
[19]裴倩,王芳芳,朱章志.甲状腺疾病责之阳气异常.辽宁中医药大学学报,2011,13(3):92-93
[20]琚星萌,宋雅芳,郭丽娜,等.95例脾气虚证重症肌无力病例回顾及用药规律探析.中华中医药杂志,2017,32(10):4705-4707
[21]张菀桐,翁维良,高蕊,等.翁维良治疗甲亢性心脏病致难治性心力衰竭经验.世界中医药,2017,12(8):1863-1866
[22]王树林,徐云生,戴汉源.辛开苦降法治疗甲状腺肿大的临证心得.四川中医,2011,29(4):39-40