| 柴淑芳,沈培英,杨其良,等.化瘀消瘿汤联合消瘿散结膏治疗桥本甲状腺炎合并甲状腺结节(痰瘀互结证)的临床研究[J].安徽医药,2025,29(6):1251-1255. |
| 化瘀消瘿汤联合消瘿散结膏治疗桥本甲状腺炎合并甲状腺结节(痰瘀互结证)的临床研究 |
| Clinical study of Huayu Xiaoying decoction and Xiaoying Sanjie ointment in treating Hashimoto's thyroiditis with thyroid nodules (syndrome of phlegm and blood stasis) |
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| DOI：10.3969/j.issn.1009-6469.2025.06.039 |
| 中文关键词: 桥本甲状腺炎 甲状腺结节 痰瘀互结证 化瘀消瘿汤 消瘿散结膏 |
| 英文关键词: Hashimoto's thyroiditis Thyroid nodule Syndrome of phlegm and blood stasis Huayu Xiaoying decoction Xiaoy. ing Sanjie ointment |
| 基金项目:上海市卫生健康委员会中医药科研项目( 2022QN019) |
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| 中文摘要: |
| 目的探讨化瘀消瘿汤联合消瘿散结膏治疗桥本甲状腺炎合并甲状腺结节(痰瘀互结证)的临床效果。方法选取 2021年 10月至 2023年 7月在上海市金山区亭林医院就诊的桥本甲状腺炎合并甲状腺结节，且中医辨证为痰瘀互结证的病人 294例为研究对象，采用随机数字表法将其分为西药组、中药内服组和中药外敷 +内服组，各 98例。三组均给予健康宣教、情绪管理和饮食调控等常规基础治疗，西药组病人采用硒酵母片治疗，中药内服组采用化瘀消瘿汤治疗，中药外敷 +内服组采用化瘀消瘿汤联合消瘿散结膏治疗，三组均连续治疗 12周。比较三组治疗前后中医症状改善情况、甲状腺结节长径大小、甲状腺功能及相关抗体和细胞因子水平，并统计治疗期间不良反应发生情况。结果与治疗前比较，治疗后中药内服组、中药外敷 +内服组病人中医证候积分及甲状腺结节长径［(1.95±0.42)cm、(1.32±0.34)cm］均明显减小，中药外敷 +内服组最低，且组间两两比较差异有统计学意义( P<0.05)。与治疗前比较，治疗后三组病人血清甲状腺过氧化物酶抗体( TPOAb)、甲状腺球蛋白抗体(TGAb)及白细胞介素( IL)-8水平均降低， IL-10水平升高，中药外敷 +内服组变化效果更显著( P<0.05)；与治疗前比较，治疗后三组病人血清促甲状腺激素( TSH)、游离三碘甲腺原氨酸( FT3)、游离甲状腺素( FT4)水平均无明显变化( P>0.05)，且均在正常范围。治疗期间三组总不良反应发生率比较差异无统计学意义( P>0.05)。结论化瘀消瘿汤联合消瘿散结膏内服外用可缩小甲状腺结节，减轻桥本甲状腺炎合并甲状腺结节(痰瘀互结型)病人机体炎症反应，调节甲状腺抗体水平，改善中医症状，安 |
| 英文摘要: |
| Objective To investigate the clinical effects of Huayu Xiaoying decoction combined with Xiaoying Sanjie ointment in treating Hashimoto's thyroiditis with thyroid nodule (syndrome of phlegm and blood stasis). Methods A total of 294 patients withHashimoto's thyroiditis and thyroid nodules, diagnosed with phlegm and blood stasis syndrome in traditional Chinese medicine, wereselected from Tinglin Hospital in Jinshan District, Shanghai between October 2021 and July 2023. They were divided into three groupsusing a random number table method: Western medicine group, Chinese medicine oral group, and Chinese medicine external + oralgroup, with 98 cases in each group. All three groups received routine basic treatments, including health education, emotional manage-ment, and dietary regulation. The Western medicine group was treated with selenium yeast tablets. The Chinese medicine oral groupwas treated with Huayu Xiaoying decoction, and the Chinese medicine external application + oral group was treated with Huayu Xiaoy. ing decoction combined with Xiaoying Sanjie ointment. The treatment lasted for 12 weeks. The improvement of TCM symptoms, diame-ter of thyroid nodules, thyroid function, and levels of related antibodies and cytokines were compared before and after treatment amongthe three groups. The incidence of adverse reactions during the treatment period was also calculated.Results Compared with beforetreatment, the TCM syndrome score and thyroid nodule diameter [(1.95±0.42) cm, (1.32±0.34) cm] in the Chinese medicine oral groupand external + oral group were significantly reduced, with the external + oral group showing the lowest scores (P<0.05). In all three groups, serum TPOAb, TGAb, and IL-8 levels decreased after treatment, while IL-10 levels increased, with the most significant changes in the external + oral group (P<0.05). Serum TSH, FT3, and FT4 levels remained within normal ranges with no significant changes in any group (P>0.05). There was no significant difference in the incidence of adverse reactions among the three groups during the treat-ment period (P>0.05).Conclusion The combination of Huayu Xiaoying decoction and Xiaoying Sanjie ointment for internal and exter-nal use can reduce thyroid nodule size, mitigate inflammation in Hashimoto's thyroiditis patients with thyroid nodules (phlegm andblood stasis type), regulate thyroid antibody levels, improve TCM symptoms, and is safe and effective. |
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