六味地黄丸联合西药治疗儿童甲状腺功能亢进症肾阴虚型32例临床观察
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摘要
目的观察六味地黄丸联合西药治疗儿童甲状腺功能亢进症肾阴虚型的临床疗效。方法将64例甲状腺功能亢进症肾阴虚型患儿随机分为对照组和治疗组,各32例。对照组口服甲巯咪唑10 mg/次,3次/d,左甲状腺素钠片12.5μg/次,1次/d。治疗组在对照组治疗方法的基础上口服六味地黄丸,8粒/次,2次/d。2组均连续治疗4周后,统计2组的临床疗效、甲状腺功能变化及不良反应发生情况。结果治疗组总有效率为93.75%,明显优于对照组的78.13%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平比较,差异无统计学意义(P>0.05),具有可比性;与同组治疗前比较,治疗后2组血清FT3、FT4呈下降趋势,TSH呈上升趋势,差异均有统计学意义(P<0.05)。与对照组治疗2周、4周后比较,治疗组FT3、FT4明显下降,TSH明显上升,差异有统计学意义(P<0.05)。治疗组不良反应总发生率为9.39%,对照组为31.26%,2组比较,差异有统计学意义(P<0.05)。结论六味地黄丸联合西药能提高甲状腺功能亢进症肾阴虚型患儿的临床疗效,降低亢进的甲状腺功能,不良反应小,值得临床推广应用。
Objective To observe the clinical efficacy of Liuwei Dihuang Wan( 六味地黄丸,LDH) combined with Western medicine in the treatment of hyperthyroidism with kidney yin deficiency type in children.Methods Sixty-four cases of hyperthyroidism with kidney yin deficiency type were randomly divided into control group and treatment group,32 cases in each one. The control group was given oral methimazole 10 mg per time,3 times per day and oral levothyroxine 12.5 μg per time,once per day,while the treatment group was added with LDH on the basis of the control group,8 granulae per time,twice per day. The 2 groups were both treated for 4 consecutive weeks.After treatment,we kept statistics of the clinical efficacy,changes in thyroid function and the incidence of adverse reactions of the 2 groups.Results The total effective rate of the treatment group was 93.75%,which was significantly superior to 78.13% of the control group,the difference between the two groups was statistically significant( P<0.05).Before treatment,there was no significant difference in FT3,FT4 and TSH levels between the two groups( P>0.05),and they were comparable.Compared with those in the same group before treatment,serum FT3 and FT4 of the two groups showed a decreasing trend,while TSH showed an increasing trend,with statistically significant differences( P<0.05).Compared with the control group at two and four weeks into the treatment process,FT3 and FT4 decreased significantly,while TSH increased significantly in the treatment group,and the difference was statistically significant( P<0.05).The total incidence of adverse reactions in the treatment group was 9.39%,that of the control group was 31.26%,the difference between the two groups was statistically significant( P<0.05).Conclusion It can improve the clinical efficacy to use LDH combined with Western medicine in the treatment of hyperthyroidism with kidney yin deficiency type in children,and reduce hyperthyroidism with the low incidence of adverse reactions,which is worthy of clinical promotion.
Objective To observe the clinical efficacy of Liuwei Dihuang Wan( 六味地黄丸,LDH) combined with Western medicine in the treatment of hyperthyroidism with kidney yin deficiency type in children.Methods Sixty-four cases of hyperthyroidism with kidney yin deficiency type were randomly divided into control group and treatment group,32 cases in each one. The control group was given oral methimazole 10 mg per time,3 times per day and oral levothyroxine 12.5 μg per time,once per day,while the treatment group was added with LDH on the basis of the control group,8 granulae per time,twice per day. The 2 groups were both treated for 4 consecutive weeks.After treatment,we kept statistics of the clinical efficacy,changes in thyroid function and the incidence of adverse reactions of the 2 groups.Results The total effective rate of the treatment group was 93.75%,which was significantly superior to 78.13% of the control group,the difference between the two groups was statistically significant( P<0.05).Before treatment,there was no significant difference in FT3,FT4 and TSH levels between the two groups( P>0.05),and they were comparable.Compared with those in the same group before treatment,serum FT3 and FT4 of the two groups showed a decreasing trend,while TSH showed an increasing trend,with statistically significant differences( P<0.05).Compared with the control group at two and four weeks into the treatment process,FT3 and FT4 decreased significantly,while TSH increased significantly in the treatment group,and the difference was statistically significant( P<0.05).The total incidence of adverse reactions in the treatment group was 9.39%,that of the control group was 31.26%,the difference between the two groups was statistically significant( P<0.05).Conclusion It can improve the clinical efficacy to use LDH combined with Western medicine in the treatment of hyperthyroidism with kidney yin deficiency type in children,and reduce hyperthyroidism with the low incidence of adverse reactions,which is worthy of clinical promotion.
引文
[1]张志宇.甲巯咪唑联合左甲状腺素治疗儿童甲状腺功能亢进症的临床疗效观察[J].中国实用医药,2016,11(11):157-158.
[2]中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南——甲状腺功能亢进症[J].中华内科杂志,2007,46(10):876-882.
[3]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:85-86.
[4]陈灏珠.实用内科学[M].10版.北京:人民卫生出版社,2005:1031-1037.
[5]白红玲.甲巯咪唑联合左甲状腺素治疗小儿甲状腺功能亢进症的疗效及不良反应分析[J].中国全科医学,2017,20(2):168-169.
[2]中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南——甲状腺功能亢进症[J].中华内科杂志,2007,46(10):876-882.
[3]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:85-86.
[4]陈灏珠.实用内科学[M].10版.北京:人民卫生出版社,2005:1031-1037.
[5]白红玲.甲巯咪唑联合左甲状腺素治疗小儿甲状腺功能亢进症的疗效及不良反应分析[J].中国全科医学,2017,20(2):168-169.