夏枯草胶囊联合左甲状腺素治疗结节性甲状腺肿的疗效观察
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摘要
目的探究夏枯草胶囊联合左甲状腺素治疗结节性甲状腺肿的临床疗效。方法选取2015年1月—2018年1月天津医科大学第二医院收治的136例结节性甲状腺肿患者为研究对象,随机分为对照组和治疗组,每组各68例。对照组口服左甲状腺素钠片,100μg/次,1次/d。治疗组患者在对照组治疗基础上口服夏枯草胶囊,2粒/次,2次/d。两组均连续治疗30 d。观察两组的临床疗效,比较两组治疗前后甲状腺和甲状腺结节的最大直径、甲状腺激素水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别是83.82%、94.12%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组甲状腺和甲状腺结节最大直径均较治疗前显著缩小,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组甲状腺和甲状腺结节最大直径均显著小于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)均较治疗前显著降低,促甲状腺激素(TSH)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组FT3、FT4均显著低于对照组,TSH显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的总有效率分别是20.59%、7.35%,两组比较差异具有统计学意义(P<0.05)。结论夏枯草胶囊联合左甲腺素治疗结节性甲状腺肿具有较好的临床疗效,可显著缩小甲状腺和甲状腺结节的最大直径,改善甲状腺功能,具有一定的临床推广应用价值。
Objective To investigate the efficacy of Xiakucao Capsules combined with levothyroxine in treatment of nodular goiter. Methods Patients(136 cases) with nodular goiter in Second Hospital of Tianjin Medical University from January 2015 to February 2018 were randomly divided into control(68 cases) and treatment(68 cases) groups. Patients in the control group were po administered with Levothyroxine Sodium Tablets, 100 μg/time, once daily. Patients in the treatment group were po administered with Xiakucao Capsules on the basis of the control group, 2 grains/time, twice daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the changes thyroid and thyroid nodules maximum diameter, thyroid hormone levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 83.82% and 94.12%, and there were differences between two groups(P < 0.05). After treatment, the thyroid and thyroid nodules maximum diameter were significantly reduced, and there were differences in the same group(P < 0.05). After treatment, the thyroid and thyroid nodules maximum diameter in the treatment group were smaller than those in the control group, and there were differences between two groups(P < 0.05). After treatment, FT3, and FT4 were significantly decreased in two groups, but TSH was significantly increased, and there were differences in the same group(P < 0.05). After treatment, FT3, and FT4 in the treatment group were lower than those in the control group, but TSH was higher than that in the control group, and there were differences between two groups(P < 0.05). After treatment, the adverse reaction rates in the control and treatment group were 20.59% and 7.35%, and there were differences between two groups(P < 0.05). Conclusion Xiakucao Capsules combined with levothyroxine has significant clinical effect in treatment of nodular goiter, can significantly reduce the maximum diameter of thyroid and thyroid nodules, also can improve thyroid function, which has a certain clinical application value.
Objective To investigate the efficacy of Xiakucao Capsules combined with levothyroxine in treatment of nodular goiter. Methods Patients(136 cases) with nodular goiter in Second Hospital of Tianjin Medical University from January 2015 to February 2018 were randomly divided into control(68 cases) and treatment(68 cases) groups. Patients in the control group were po administered with Levothyroxine Sodium Tablets, 100 μg/time, once daily. Patients in the treatment group were po administered with Xiakucao Capsules on the basis of the control group, 2 grains/time, twice daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the changes thyroid and thyroid nodules maximum diameter, thyroid hormone levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 83.82% and 94.12%, and there were differences between two groups(P < 0.05). After treatment, the thyroid and thyroid nodules maximum diameter were significantly reduced, and there were differences in the same group(P < 0.05). After treatment, the thyroid and thyroid nodules maximum diameter in the treatment group were smaller than those in the control group, and there were differences between two groups(P < 0.05). After treatment, FT3, and FT4 were significantly decreased in two groups, but TSH was significantly increased, and there were differences in the same group(P < 0.05). After treatment, FT3, and FT4 in the treatment group were lower than those in the control group, but TSH was higher than that in the control group, and there were differences between two groups(P < 0.05). After treatment, the adverse reaction rates in the control and treatment group were 20.59% and 7.35%, and there were differences between two groups(P < 0.05). Conclusion Xiakucao Capsules combined with levothyroxine has significant clinical effect in treatment of nodular goiter, can significantly reduce the maximum diameter of thyroid and thyroid nodules, also can improve thyroid function, which has a certain clinical application value.
引文
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[9]李楠,杜丽坤.中医药治疗结节性甲状腺肿的研究进展[J].吉林中医药,2016,36(8):850-852.
[10]Carr J A,Murali S,Hu F,Goleman W L,et al.Changes in gastric sodium-iodide symporter(NIS)activity are associated with differences in thyroid gland sensitivity to perchlorate during metamorphosis[J].General Comparative Endocrinol,2015,219:16-23.
[11]Dorota Katarzyńska,Anna Hrabia,Kinga Kowalik,et al.Comparison of the in vitro effects of TCDD,PCB 126and PCB 153 on thyroid-restricted gene expression and thyroid hormone secretion by the chicken thyroid gland[J].Environmental Toxicol Pharmacol,2015,39(2):496-503.
[12]范智媛,张淋淋,米蕊,等.夏枯草胶囊治疗桥本甲状腺炎的效果及治疗前后甲状腺形态的超声诊断变化[J].河北医科大学学报,2017,38(4):446-449.
[13]代轶楠.活血消瘿片联合夏枯草胶囊结节性甲状腺肿的临床疗效观察[D].武汉:湖北中医药大学,2017.
[2]黄仲杰.结节性甲状腺肿并存甲状腺癌的临床研究进展[J].承德医学院学报,2017,34(2):148-151.
[3]吕铁钢,郝健,刘佳,等.CT检查在甲状腺微小癌和结节性甲状腺肿患者诊断中的临床价值分析[J].中国实验诊断学,2017,21(9):1542-1543.
[4]武翔宇,曹世光.左甲状腺素钠治疗甲状腺功能减退症效果观察[J].解放军医药杂志,2017,29(11):76-79.
[5]范智媛,张淋淋,米蕊,等.夏枯草胶囊治疗桥本甲状腺炎的效果及治疗前后甲状腺形态的超声诊断变化[J].河北医科大学学报,2017,38(4):446-449.
[6]中华医学会内分泌学会《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-甲状腺结节[J].中华内科杂志,2008,47(10):867-868.
[7]滕卫平,曾正陪,李光伟,等.中国甲状腺疾病诊治指南[M].北京:中国医学会内分泌学分会,2007:67-69.
[8]刘欣雅,李果,唐治蓉,等.甲状腺腺瘤和单纯结节性甲状腺肿的临床病理特征分析[J].医学临床研究,2017,34(9):1708-1710.
[9]李楠,杜丽坤.中医药治疗结节性甲状腺肿的研究进展[J].吉林中医药,2016,36(8):850-852.
[10]Carr J A,Murali S,Hu F,Goleman W L,et al.Changes in gastric sodium-iodide symporter(NIS)activity are associated with differences in thyroid gland sensitivity to perchlorate during metamorphosis[J].General Comparative Endocrinol,2015,219:16-23.
[11]Dorota Katarzyńska,Anna Hrabia,Kinga Kowalik,et al.Comparison of the in vitro effects of TCDD,PCB 126and PCB 153 on thyroid-restricted gene expression and thyroid hormone secretion by the chicken thyroid gland[J].Environmental Toxicol Pharmacol,2015,39(2):496-503.
[12]范智媛,张淋淋,米蕊,等.夏枯草胶囊治疗桥本甲状腺炎的效果及治疗前后甲状腺形态的超声诊断变化[J].河北医科大学学报,2017,38(4):446-449.
[13]代轶楠.活血消瘿片联合夏枯草胶囊结节性甲状腺肿的临床疗效观察[D].武汉:湖北中医药大学,2017.