温肾方在桥本甲状腺炎合并分化型甲状腺癌术后脾肾阳虚证患者中的应用

Application of Wenshen Formula in patients with spleen and kidney yang deficiency syndrome after operation of Hashimoto's thyroiditis complicated with differentiated thyroid carcinoma

  • 摘要:
    目的 观察温肾方在桥本甲状腺炎合并分化型甲状腺癌(DTC)术后脾肾阳虚证患者中的应用效果。
    方法 将2019年11月—2022年2月医院收治的98例桥本甲状腺炎合并DTC术后脾肾阳虚证患者纳入本研究, 根据随机数字表法分为观察组(n=49)与对照组(n=49)。2组患者均予以促甲状腺激素(TSH)抑制治疗,对照组在此基础上联合金水宝胶囊治疗。结合全国名老中医陈如泉教授对脾肾阳虚症治疗以温肾、健脾、利湿为原则,观察组患者给予自拟的温肾方治疗。观察2组患者临床疗效、中医症候积分、甲状腺激素指标血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、TSH水平,并统计2组治疗期间的不良反应发生情况。
    结果 治疗后,观察组治疗总有效率高于对照组,差异有统计学意义(P < 0.05); 观察组四肢畏寒、神疲倦怠、头晕乏力、视物模糊、口干咽燥、少气懒言、胸闷气短和形态消瘦评分低于对照组,差异有统计学意义(P < 0.05); 观察组患者TSH水平低于对照组,而血清FT3、FT4水平高于对照组,差异有统计学意义(P < 0.05); 2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。
    结论 温肾方对桥本甲状腺炎合并DTC脾肾阳虚证术后患者有较好的治疗效果,能够明显改善患者临床症状,调节患者甲状腺激素水平,改善甲状腺功能,且不会增高不良反应发生率。

     

    Abstract:
    Objective To observe the application effect of Wenshen Formula in treating patients with spleen and kidney yang deficiency syndrome after operation of Hashimoto's thyroiditis complicated with differentiated thyroid carcinoma (DTC).
    Methods Ninety-eight patients with Hashimoto's thyroiditis combined with spleen-kidney Yang deficiency syndrome after DTC surgery admitted to the hospital from November 2019 to February 2022 were included in this study, and were divided into observation group (n=49) and control group (n=49) according to random number table method. Both groups were treated with thyroid stimulating hormone (TSH) inhibition therapy, and the control group was treated with Jinshuibao Capsule on this basis. Combined with the principle of warming kidney, strengthening spleen and removing dampness. in treatment of spleen and kidney yang deficiency syndrome by Professor Chen Ruquan, a famous TCM doctor, the patients in the observation group were treated with self-made Wenshen Formula. The clinical efficacy, TCM symptom score, thyroid hormone indexesserum free triiodothyronine (FT3), serum free thyroxine (FT4), TSHlevels of the two groups were observed after treatment, and the occurrence of adverse reactions of the two groups during treatment were recorded.
    Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The observation group had lower scores of aversion to chills of four limbs, fatigue, dizziness, blurred vision, dry mouth and throat, lack of breath and laziness to speak, chest tightness and shortness of breath than the control group (P < 0.05). Compared with control group, the level of TSH in the observation group was lower, and the levels of serum FT3 and FT4 were higher (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05).
    Conclusion Wenshen Formula has a good therapeutic effect in patients with Hashimoto's thyroiditis complicated with DTC differentiated as spleen and kidney Yang deficiency syndrome after surgery, can significantly improve the clinical symptoms, regulate the thyroid hormone level, improve thyroid function, and has no increase in the incidence of adverse reactions.

     

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