银甲丹治疗Graves病甲亢近期疗效及对远期复发率的影响.pdf

南京中医药大学学报2021年5月第37卷第3期—356—JNanjingUnivTraditChinMedVol.37No.3May2021·临床研究·银甲丹治疗Graves病甲亢近期疗效及对远期复发率的影响孙心怡,缪鋆鋆,葛静(南京中医药大学附属医院,江苏南京210029)摘要:目的探讨银甲丹治疗弥漫性甲状腺肿(Graves病)甲状腺功能亢进(简称甲亢)的近期疗效及对远期复发率的影响。方法选取江苏省中医院Graves病甲亢痰火郁结证患者80例利用SAS系统随机分为2组,治疗组使用银甲丹联合西药治疗,对照组单用西药治疗,疗程6个月,观察近期疗效;停药后继续观察2年,评估复发率。结果治疗后2组甲亢突眼分级及中医证候积分均有改善(P<0.01),治疗组优于对照组(P<0.05,P<0.01);2组促甲状腺素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、促甲状腺素受体抗体(TRAb)水平均有改善(P<0.05,P<0.01),治疗组优于对照组(P<0.05,P<0.01),且甲状腺相关指标恢复正常时间更短(P<0.01)。治疗组总有效率高于对照组(P<0.01)。停药后随访2年,治疗组复发率低于对照组(P<0.05)。结论银甲丹联合西药治疗Graves病甲亢疗效显著,甲状腺功能恢复正常时间短,且能减少甲亢复发。关键词:甲状腺功能亢进;Graves病;中药;复发中图分类号:R259.581文献标志码:A文章编号:16720482(2021)03035604DOI:10.14148/j.issn.1672ခ¼0482.2021.0356引文格式:孙心怡,缪鋆鋆,葛静.银甲丹治疗Graves病甲亢近期疗效及对远期复发率的影响[J].南京中医药大学学报,2021,37(3):356ခ¼359.TheEffectofYinjiaPelletontheShortTermEfficacyandLongTermRecurrenceRateofTreatingGraves'HyperthyroidismSUNXinခ¼yiMIAOJunခ¼junGEJinTheAffiliatedHospitalofNanjingUniversityofChineseMedicineNanjing210029ChinaABSTRACTOBJECTIVETodiscusstheeffectofYinjiapelletontheshorttermefficacyandlongtermrecurrencerateoftreatinghyperthyroidismindiffusegoiterGraves'diseaseMETHODS80patientswithGraves'diseaseandhyperthyroidisminJiangsuHospitaloftraditionalChinesemedicinewererandomlydividedintotwogroupsbySASsystemThetreatmentgroupwasgivenYinjiapelletcombinedwithwesternmedicinewhilethecontrolgroupwasonlygivenwesternmedicineAftersixခ¼monthcoursetheshorttermefficacywasobservedWefollowedupthepatientsfortwoyearsafterthetreatmentandesti-matedtherecurrencerateRESULTSAftertreatmentthedegreeofproptosisandtraditionalChinesemedicinesyndromescoresinthetwogroupswereimprovedP<001andthetreatmentgroupwasbetterthanthecontrolgroupP<005P<001ThelevelsoftotaltriiodothyronineTT3totalthyroxineTT4freetriiodothyronineFT3freethyroxineFT4thyroidstimulatinghormoneTSHandthyrotrophinreceptorantibodyTRAbwereimprovedP<005P<001whichinthetreatmentgroupwerebetterthanthoseinthecontrolgroupP<005P<001andtooklesstimetorecoverthanthoseinthecontrolgroupP<00