摘要
目的探讨益气化瘀汤联合131Ⅰ治疗老年分化型甲状腺癌(differentiated thyroid cancer,DTC)的疗效及预后相关因素。方法选取2017年3月—2019年4月该院收治的老年DTC患者328例,采用随机数法将其分为对照组(164例)和观察组(164例)。对照组采用基础治疗+131Ⅰ进行治疗,观察组在对照组的基础上采用益气化瘀汤进行治疗,两组均连续治疗2个月。比较两组治疗2个月后的患者的临床疗效;对比两组治疗前、治疗2个月后的血细胞角蛋白19(CK19)、多态性上皮黏蛋白(MUC1)表达水平及甲状腺功能相关指标水平;并分析影响患者复发的因素。结果治疗2个月后,观察组总有效率为87.20%(143/164),显著高于对照组76.83%(126/164),(P <0.05)。与治疗前比较,治疗2个月后,两组CK19、MUC1阳性表达率及甲状腺激素(TSH)、甲状腺球蛋白(TG)水平均降低,且观察组均显著低于对照组(P <0.05);两组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均升高,且观察组均显著高于对照组(P <0.05)。多因素Logistic回归分析结果显示,年龄≥65岁、性别为男性、分期为Ⅲ、Ⅳ期、肿瘤直径≥4 cm、TG水平≥0.3ng/mL以及未使用131Ⅰ为老年分化型甲状腺癌患者复发的危险因素(P <0.05)。结论益气化瘀汤联合131Ⅰ治疗DTC可明显降低患者CK19、MUC1阳性表达率,同时可改善患者甲状腺功能,且分析疾病复发的因素可预防或减少患者疾病复发。
Objective To explore the efficacy and prognostic factors of Yiqi Huayu Decoction( 益气化瘀汤) combined with131Ⅰ in the treatment of elderly differentiated thyroid cancer( DTC). Methods A total of 328 elderlypatients with DTC admitted to our hospital between March 2017 and April 2019 were selected. The patients were divided into the control group( 164 cases) and the observation group( 164 cases) by random number method. The control group was treated with basic therapy +131Ⅰ. The observation group was treated with Yiqi Huayu Decoction on the basis of the control group. Both groups were treated for 2 months. The clinical efficacy after 2 months treatment between the two groups was compared. The expression levels of cytokeratin 19( CK19)and polymorphic epithelial mucin( MUC1) and thyroid function related index levels before and after 2 months treatment between the two groups were compared. The factors affecting the recurrence of the patients was analyzed. Results After 2 months of treatment,the total effective rate in the observation group was 87. 20%( 143/164),significantly higher than that of the control group( 76. 83%,126/164,P < 0. 05). Compared with those before treatment,the positive expression rates of CK19 and MUC1,and levels of thyroid stimulating hormone( TSH) and thyroglobulin( TG) after 2 months of treatmentin the two groups decreased,and the observation group’s were significantly lower than those of the control group( P < 0. 05). The levels of free triiodothyronine( FT3)and free thyroxine( FT4) in the two groups were increased,and the observation group’s were significantly higher than those of the control group. Multivariate Logistic regression analysis results showed that age≥65 years,gender for men,stage III and IV,tumor diameter≥4 cm,TG level≥0. 3 ng/mL and131Ⅰ not used for elderly patients with differentiated thyroid cancer were the risk factors( P < 0. 05). Conclusion Yiqi Huayu Decoction combined with131Ⅰ can significantly reduce the positive expression rate of CK19 and MUC1 of DTC patients,and at the same time improve the thyroid function of patients. Analysis of the factors ofrecurrence can prevent or reduce the disease recurrence in patients.
作者
霍占江
田亮
王志杰
张强
郝敏丽
董陆玲
HUO Zhanjiang;TIAN Liang;WANG Zhijie;ZHANG Qiang;HAO Minli;DONG Luling(Department of Otorhinolaryngology Head and Neck Surgery,The First Hospital of Zhangjiakou,Zhangjiakou 075000,Hebei,China)
出处
《辽宁中医杂志》
CAS
2021年第5期105-108,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
张家口市重点研发计划(1921086D)。
关键词
老年分化型甲状腺癌
益气化瘀汤
血细胞角蛋白
多态性上皮黏蛋白
甲状腺球蛋白
elderly differentiated thyroid cancer
Yiqi Huayu Decoction(益气化瘀汤)
blood cytokeratin
polymorphic epi-thelial mucin
thyroglobulin
