温运阳气法治疗老年淡漠型甲状腺功能亢进症临床研究
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摘要
目的:观察温运阳气法治疗老年淡漠型甲状腺功能亢进症的临床效果。方法:选取老年淡漠型甲状腺功能亢进症患者63例,按随机数字表法分为对照组31例和观察组32例。对照组予常规西医治疗,观察组在对照组基础上给予温运阳气法治疗,口服附子理中丸合小柴胡汤加减。比较2组患者临床疗效、甲状腺功能及不良反应情况。结果:观察组临床总有效率为93.75%,对照组为70.97%,2组比较,差异有统计学意义(P <0.05)。治疗前,2组甲状腺功能比较,差异无统计学意义(P> 0.05)。治疗后,2组甲状腺功能均较治疗前改善(P <0.05),观察组甲状腺功能改善显著优于对照组(P <0.05)。观察组不良反应发生率为3.1%,对照组为16.1%,观察组低于对照组(χ~2=6.23,P=0.030)。结论:温运阳气法治疗老年淡漠型甲状腺功能亢进症,在增强临床疗效、改善甲状腺功能的同时可减少西药不良反应,值得临床推广应用。
Objective: To observe the clinical effect of method of warm transporting yang-qi for senile apathetic hyperthyroidism. Methods: Selected 63 cases of senile patients with apathetic hyperthyroidism and divided them into the control group(31 cases) and the observation group(32 cases) according to random number table. The control group was treated with routine western medicine, while the observation group was additionally treated with method of warm transporting yang-qi and given the oral application Fuzi Lizhong pills combined with Xiaochaihu tang. Compared the clinical effect,thyroid function and adverse reactions of the two groups. Results:The total effective rate was 93.75% in the observation group and70.97% in the control group,compared the two groups,difference being significant(P < 0.05). Before treatment,there was no significant difference being found in the comparison of the thyroid function between the two groups(P > 0.05). After treatment,the thyroid function of the two groups was improved when compared with that before treatment(P < 0.05);the improvement of the thyroid function in the observation group was better than that of the control group(P < 0.05). The incidence of adverse reactions was 3.1% in the observation group and 16.1% in the control group,this in the observation group was lower than that in the control group(χ~2=6.23, P=0.030). Conclusion: The application of the method of warm transporting yang-qi in treatment determination for senile apathetic hyperthyroidism can enhance the clinical effect,improve the thyroid function and reduce the adverse reactions of western medicine. It is worthy of clinical promotion and application.
Objective: To observe the clinical effect of method of warm transporting yang-qi for senile apathetic hyperthyroidism. Methods: Selected 63 cases of senile patients with apathetic hyperthyroidism and divided them into the control group(31 cases) and the observation group(32 cases) according to random number table. The control group was treated with routine western medicine, while the observation group was additionally treated with method of warm transporting yang-qi and given the oral application Fuzi Lizhong pills combined with Xiaochaihu tang. Compared the clinical effect,thyroid function and adverse reactions of the two groups. Results:The total effective rate was 93.75% in the observation group and70.97% in the control group,compared the two groups,difference being significant(P < 0.05). Before treatment,there was no significant difference being found in the comparison of the thyroid function between the two groups(P > 0.05). After treatment,the thyroid function of the two groups was improved when compared with that before treatment(P < 0.05);the improvement of the thyroid function in the observation group was better than that of the control group(P < 0.05). The incidence of adverse reactions was 3.1% in the observation group and 16.1% in the control group,this in the observation group was lower than that in the control group(χ~2=6.23, P=0.030). Conclusion: The application of the method of warm transporting yang-qi in treatment determination for senile apathetic hyperthyroidism can enhance the clinical effect,improve the thyroid function and reduce the adverse reactions of western medicine. It is worthy of clinical promotion and application.
引文
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[12]丁继存.黄芪平甲方联合他巴唑治疗老年性甲状腺功能亢进症42例[J].中医学报,2010,25(2):290-291.
[13]程煜,魏军平,林江涛.20例老年淡漠型甲亢中医诊治[J].长春中医药大学学报,2014,30(3):483-485.
[14]潘竞霞,何小莲,张瑾,等.丹栀逍遥散联合西药治疗甲亢疗效观察及对血流动力学的影响[J].新中医,2016,48(12):52-54.
[15]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[J].世界中医药,2015,10(3):464-467.
[16]林明欣,朱章志,吕英,等.再探中医学“圆运动”规律[J].中华中医药杂志,2013,28(5):1516-1519.
[17]朱章志,林明欣,樊毓运.立足“阳主阴从”浅析糖尿病的中医治疗[J].江苏中医药,2011,43(4):7-8.
[18]谢欣颖,朱章志,张莹莹,等.“温运阳气”法论治甲亢[J].中华中医药杂志,2014,29(10):3066-3068.
[19]朱章志,林明欣,吴伟.内分泌疾病“高实验室指标”之“五行圆运动”浅探[J].世界中医药,2012,7(5):374-376.
[20]张萌,谢欣颖,林明欣,等.朱章志教授论治甲状腺结节之“五行圆运动”观[J].中华中医药杂志,2015,30(9):3149-3151.
[21]裴倩,王芳芳,朱章志.甲状腺疾病责之阳气异常[J].辽宁中医药大学学报,2011,13(3):92-93.
[2]索艳君.老年甲亢40例临床诊治体会[J].河北医学,2009,15(11):1295-1298.
[3]刘幼硕.老年人甲状腺功能亢进症[J].中华老年医学杂志,2005,24(11):878-880.
[4]朱垚,陆明.淡漠型甲亢中医辨治思路初探[J].甘肃中医,2010,23(4):67-69.
[5]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[J].中华中医药杂志,2011,26(5):1119-1122.
[6]耿华,林明欣,韩蕊,等.“首辨阴阳,再辨六经”论治糖尿病前期医案浅析[J].世界中医药,2014,9(8):1044-1047.
[7]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[J].中华中医药杂志,2018,33(9):4240-4244.
[8]谭宏韬.甲亢的六经辨证探讨[D].广州:广州中医药大学,2013.
[9]ROSS D S,BURCH H B,COOPER D S,et al.2016American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis[J].Thyroid,2016,26(10):1343-1421.
[10]毛绍蓉,唐小玲.淡漠型甲亢患病危险因素的Logistic回归分析[J].四川医学,2014,35(2):224-227.
[11]郑筱萸.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,2002:226-230.
[12]丁继存.黄芪平甲方联合他巴唑治疗老年性甲状腺功能亢进症42例[J].中医学报,2010,25(2):290-291.
[13]程煜,魏军平,林江涛.20例老年淡漠型甲亢中医诊治[J].长春中医药大学学报,2014,30(3):483-485.
[14]潘竞霞,何小莲,张瑾,等.丹栀逍遥散联合西药治疗甲亢疗效观察及对血流动力学的影响[J].新中医,2016,48(12):52-54.
[15]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[J].世界中医药,2015,10(3):464-467.
[16]林明欣,朱章志,吕英,等.再探中医学“圆运动”规律[J].中华中医药杂志,2013,28(5):1516-1519.
[17]朱章志,林明欣,樊毓运.立足“阳主阴从”浅析糖尿病的中医治疗[J].江苏中医药,2011,43(4):7-8.
[18]谢欣颖,朱章志,张莹莹,等.“温运阳气”法论治甲亢[J].中华中医药杂志,2014,29(10):3066-3068.
[19]朱章志,林明欣,吴伟.内分泌疾病“高实验室指标”之“五行圆运动”浅探[J].世界中医药,2012,7(5):374-376.
[20]张萌,谢欣颖,林明欣,等.朱章志教授论治甲状腺结节之“五行圆运动”观[J].中华中医药杂志,2015,30(9):3149-3151.
[21]裴倩,王芳芳,朱章志.甲状腺疾病责之阳气异常[J].辽宁中医药大学学报,2011,13(3):92-93.