R582.2
河南省中医药科学研究专项课题(2016ZY2063)
目的:观察黄芪桂枝五物汤加减治疗甲状腺全切术后甲状旁腺功能减退症的临床疗效。方法:选取 60 例甲状腺全切术后并发甲状旁腺功能减退症患者,按随机数字表法分为观察组和对照组各 30 例。2 组术后均给予预防性补钙治疗,对照组术后第 3 天给予口服药物补钙,观察组在对照组基础上给予黄芪桂枝五物汤加减口服。比较 2 组临床疗效,检测术后不同时间点血清甲状旁腺激素(PTH)及钙值。结果:观察组总有效率为 93.3%,高于对照组 70.0%,差异有统计学意义(P<0.05)。观察组和对照组术前、术后第 1、3、5 天血清 PTH、钙水平比较,差异无统计学意义(P>0.05)。观察组术后第 9、15、21 天血清PTH、钙水平明显高于对照组,差异均有统计学意义(P<0.05)。结论:黄芪桂枝五物汤加减能够减轻甲状腺全切术后甲状旁腺的缺血再灌注损伤,缩短患者术后甲状旁腺功能的恢复时间,改善低钙血症状,疗效显著。
Abstract: Objective: ToobservethecurativeeffectofmodifiedHuangqiGuizhiWuwutangonpatientswith hypoparathyroidismaftertotalthyroidectomy. Methods:Atotalof 60 casesofpatientscomplicatedwithhypoparathyroidism aftertotalthyroidectomywereselectedanddividedintotheobservationgroupandthecontrolgroupaccordingtotherandom numbertablemethod,30 casesineachgroup.Bothgroupsweretreatedwithpreventivecalciumsupplementaftersurgery.Onthe 3rd dayaftersurgery,thecontrolgroupwasgiventheoraladministrationofmedicineforcalciumsupplement,andthe observationgroupwasadditionallygiventheoraladministrationofmodifiedHuangqiGuizhiWuwutangbasedonthe treatmentofthecontrolgroup.Theclinicaleffectwascomparedbetweenthetwogroups.Thevaluesofparathyroidhormone (PTH)andcalciuminserumatdifferenttimepointsaftersurgeryweredetected. Results:Thetotaleffectiveratewas 93.3% intheobservationgroup,higherthanthatof 70.0%inthecontrolgroup,thedifferencebeingsignificant(P<0.05).When comparedlevelsofPTHandcalciuminserumbetweenthetwogroupsbeforetreatmentaswellasonthe 1st,3rd,and 5th daysaftersurgery,therewasnosignificanceinthedifference(P>0.05).Onthe 9th,15th,and 21stdaysaftersurgery,levels ofPTHandcalciuminserumintheobservationgroupweresignificantlyhigherthanthoseinthecontrolgroup,differences beingsignificant(P<0.05). Conclusion: ModifiedHuangqiGuizhiWuwutangcanrelieveischemia-reperfusioninjuryof parathyroidglandaftertotalthyroidectomy,shortenrecoverytimeofparathyroidglandtimeaftersurgery,andimprove hypocalcemiasymptoms,withsignificantcurativeeffect.
陈红跃,杨萌萌,武红园,栗粟.黄芪桂枝五物汤加减治疗甲状腺全切术后甲状旁腺功能减退症临床研究[J].新中医,2021,53(8):22-25