红花逍遥片联合左甲状腺素钠片治疗气滞血瘀型甲状腺结节患者的临床疗效被引量：3

Clinical Efficacy of Honghua Xiaoyao Tablets Combined with Euthyrox in the Treatment of Thyroid Nodules with Qi Stagnation and Blood Stasis Syndrome

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摘要目的:探讨红花逍遥片联合左甲状腺素钠片治疗围绝经期气滞血瘀型甲状腺结节患者的临床疗效。方法:选取2020年6月至2022年6月石家庄市中医院收治的围绝经期甲状腺结节患者180例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组90例。对照组给予左甲状腺素钠片口服,观察组在对照组基础上采用红花逍遥片。比较2组患者治疗前后的临床总有效率、中医证候积分、甲状腺结节大小、甲状腺功能3项、血清胰岛素生长因子-1(IGF-1)、转化生长因子-β_(1)(TGF-β_(1))、血管内皮生长因子(VEGF)及白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平。结果:观察组和对照组的临床总有效率分别为94.44%和82.22%,差异有统计学意义(P<0.05)。2组患者中医证候总积分较治疗前均明显降低,差异有统计学意义(P<0.05),相较于对照组,观察组的中医证候积分降低程度更大,差异有统计学意义(P<0.01);相较治疗前,对照组的甲状腺结节最大直径无明显变化,差异无统计学意义(P>0.05),相较于治疗后的对照组,观察组的甲状腺结节最大直径明显减小,差异有统计学意义(P<0.05);相较于治疗前,2组患者的促甲状腺激素(TSH)均有下降,其中观察组下降幅度更大,与对照组比较,差异有统计学意义(P<0.05);治疗后,2组患者FT_(3)和FT_(4)水平显著升高,差异有统计学意义(P<0.05),相较于对照组,观察组治疗后的FT_(4)水平差异有统计学意义(P<0.05)。相较治疗前,对照组的IGF-1、VEGF、IL-1β水平无明显变化,差异无统计学意义(P>0.05),对照组与观察组的TGF-β、IL-6、IL-1β较治疗前明显升高(P<0.05);观察组的IGF-1、VEGF较治疗前明显降低,差异有统计学意义(P<0.05)。相较于对照组,观察组治疗后的IGF-1、TGF-β、VEGF及IL-1β、IL-6水平差异均有统计学意义(均P<0.05)。结论:红花逍遥片联合左甲状腺素钠片治疗气滞血瘀型围绝经期甲状腺结节患者的临床效果佳,无明显不良反应,值得临床推广。 Objective:To investigate the clinical efficacy of Honghua Xiaoyao Tablets combined with Euthyrox(levothyroxine sodium tablets)in the treatment of perimenopausal thyroid nodules with qi stagnation and blood stasis syndrome.Methods:A total of 180 female patients with perimenopausal thyroid nodules treated in the Shijiazhuang Hospital of Traditional Chinese Medicine from June 2020 to June 2022 were enrolled and randomly divided into a control group(n=90)and an observation group(n=90)by random number table method.All patients were treated with oral Euthyrox,and those in the observation group received additional Honghua Xiaoyao Tablets.The total clinical effective rate,traditional Chinese medicine(TCM)syndrome score,thyroid nodule volume,thyroid function,and serum levels of insulin-like growth factor-1(IGF-1),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF),interleukin-1β(IL-1β),and IL-6 were compared between the two groups before and after treatment.Results:The total effective rates of the observation group and the control group were 94.44%and 82.22%,respectively,and the difference between the two groups was statistically significant(P<0.05).The total scores of TCM syndrome in the two groups were lower than those before treatment(P<0.05).The observation group was superior to the control group in terms of the reduction degree of TCM syndrome score(P<0.01).The maximum diameter of thyroid nodule in the control group had no significant change before and after treatment(P>0.05),and after treatment,the maximum diameter of thyroid nodule in the observation group decreased compared with that of the control group(P<0.05).Compared with the results before treatment,the thyroid-stimulating hormone(TSH)of the two groups decreased,and the reduction degree of the observation group was greater than that of the control group(P<0.05).After treatment,the levels of FT 3 and FT 4 in the two groups significantly increased(P<0.05).Compared with the FT 4 level in the control group,that in the observation group after treatment was significantly different(P<0.05).Compared with the results before treatment,the levels of IGF-1,VEGF,and IL-1βin the control group had no significant changes(P>0.05),while the levels of TGF-β,IL-6,and IL-1βin the control group and the observation group were significantly higher than those before treatment(P<0.05).IGF-1 and VEGF levels in the observation group decreased compared with those before treatment(P<0.05).The levels of IGF-1,TGF-β,VEGF,IL-1β,and IL-6 in the observation group after treatment were significantly different from those in the control group(P<0.05).Conclusion:Honghua Xiaoyao Tablets combined with Euthyrox in the treatment of perimenopausal thyroid nodules in patients with qi stagnation and blood stasis syndrome have good clinical efficacy and no obvious adverse reactions,which are worthy of clinical promotion.

作者袁亚兰郑倩刘博张倩倩孙素涛盖丽珍冯博帅谷丽娜 YUAN Yalan;ZHENG Qian;LIU Bo;ZHANG Qianqian;SUN Sutao;GAI Lizhen;FENG Boshuai;GU Lina(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China;The No.4 People′s Hospital of Hengshui,Hengshui 053099,China)

机构地区河北省石家庄市中医院河北省衡水市第四人民医院

出处《世界中医药》 CAS 2023年第4期503-507,共5页 World Chinese Medicine

基金河北省中医药管理局科研计划项目(2020328)。

关键词围绝经期妇女甲状腺结节气滞血瘀红花逍遥片左甲状腺素钠炎症介质促生长因子血管内皮生长因子 Perimenopausal Women Thyroid nodule Qi stagnation and blood stasis Honghua Xiaoyao Tablets Euthyrox Inflammatory factors Growth-promoting factor Vascular endothelial growth factor