慢性淋巴细胞性甲状腺炎体检者中医体质分布及合并甲状腺结节研究
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R581.4

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徐蓉娟上海市名老中医学术经验研究工作室建设项目(SHGZS-2017016);徐蓉娟上海中医药大学名老中医药专家学术经验研究工作 室建设项目(SZYMZYGZS4005)


Study on Traditional Chinese Medicine Constitution Distribution in Patients with Chronic Lymphocytic Thyroiditis Complicated with Thyroid Nodules
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    摘要:

    目的:观察慢性淋巴细胞性甲状腺炎(CLT) 体检者中医体质分布规律及其与甲状腺结节的关 系。方法:纳入体检人群CLT 患者233 例,进行中医体质辨识和甲状腺超声检查,探讨其中医体质分布规律 及其与甲状腺结节的关系。结果:单一体质占比较高者依次为气虚质(83.69%)、血瘀质(78.54%)、气郁 质(58.80%)、湿热质(42.92%)、痰湿质(30.90%) 和阴虚质(30.90%)。气虚、血瘀、气郁、特禀质人群年 龄明显高于无相应体质者(P<0.05),阴虚质人群年龄明显低于无阴虚质者(P<0.05)。二质相兼人群中,气 虚血瘀(71.67%)、气虚痰湿(63.95%)、痰湿血瘀(58.80%)、气虚气郁(52.79%)、气郁血瘀(47.64%)、气 郁痰湿(47.21%) 体质较多,其年龄均明显高于无相应体质者(P<0.05),阴虚痰湿质人群年龄明显低于无该 体质者(P<0.05)。三质相兼人群中,气虚痰湿血瘀(44.64%)、气虚气郁血瘀(39.06%)、气郁痰湿血 瘀(38.63%)、气虚气郁痰湿(38.20%) 体质较多。四质相兼人群中气虚血瘀痰湿气郁质(34.76%) 最多见, 其年龄明显高于无该体质者(P<0.05)。体质类型中四质相兼最多见(51.93%)。三质、四质、五质相兼体质 人群年龄明显高于单一体质和二质相兼者(P<0.05),多发甲状腺结节占比明显高于单一体质者(P<0.05)。 四质、五质相兼人群年龄明显高于三质相兼者(P<0.05),多发甲状腺结节占比明显高于二质和三质相兼 者(P<0.05)。结论:CLT 患者以偏颇体质、兼夹体质为主,年龄越大,体质越复杂,相兼体质越多,多发甲 状腺结节占比越高,提示临床诊治该病需从多重体质因素考虑,避免辨证过于单一化,以提高临床疗效。

    Abstract:

    Abstract:Objective:To observe the distribution rule of traditional Chinese medicine (TCM) constitution distribution in patients with chronic lymphocytic thyroiditis (CLT) and its relationship with thyroid nodules. Methods:A total of 233 CLT physical examination patients were included and performed TCM constitution identification and thyroid ultrasonography. The TCM constitution distribution and its relationship with thyroid nodules were investigated. Results: The highest proportion of single constitution was qi deficiency constitution (83.69%),blood stasis constitution (78.54%),qi constraint constitution (58.80%),damp-heat constitution (42.92%),phlegm- damp (30.90%) and yin deficiency constitution (30.90%). Patients with qi deficiency constitution, blood stasis constitution, qi constraint constitution and inherited special constitution were significantly older than those without corresponding constitution (P<0.05),and patients with yin deficiency constitution were younger than those without yin deficiency constitution (P<0.05). In patients with two constitutions, there were more with qi deficiency and blood stasis constitution (71.67% ), qi deficiency and phlegm- damp constitution (63.95% ), phlegm- damp and blood stasis constitution (58.80%),qi deficiency and qi constraint constitution (52.79%),qi constraint and blood stasis constitution (47.64% ) and qi constraint and phlegm- damp constitution (47.21% ), who were significantly older than those without corresponding constitution (P<0.05),and patients with qi deficiency and phlegmdamp constitution were significantly younger than those without that constitution (P<0.05). In patients with three constitutions, there were more with constitution of qi deficiency, phlegm- damp and blood stasis (44.64% ), constitution of qi deficiency, qi constraint and blood stasis (39.06% ), constitution of qi constraint,phlegm-damp and blood stasis (38.63%),and constitution of qi deficiency,qi constraint and phlegm- damp (38.20% ). In patients with four constitutions, there were more with constitution of qi deficiency,blood stasis,phlegm-damp and qi constraint (34.76%),and they were significantly older than those without that constitution (P<0.05). The majority of constitution type was four constitutions (51.93%). Patients with three,four and five constitutions were significantly older than those with single constitution and two constitutions (P<0.05),and they had a higher proportion of multiple thyroid nodules than that in patients with single constitution (P<0.05). Patients with four and five constitutions were significantly older than those with three constitutions,and they had a higher proportion of multiple thyroid nodules than that in patients with two constitutions and three constitutions (P<0.05). Conclusion: CLT patients are mainly characterized by biased constitution and mixed constitution. The older the age, the more complex the constitution, the more mixed constitution, and the higher the proportion of multiple thyroid nodules. It suggests that the clinical diagnosis and treatment of the disease should be taken into account the multiple constitution factors,and should avoid over-simple syndrome differentiation,so as to improve the clinical effect.

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彭欣,徐蓉娟,许轶君,银浩强.慢性淋巴细胞性甲状腺炎体检者中医体质分布及合并甲状腺结节研究[J].新中医,2023,55(12):53-57

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  • 在线发布日期: 2023-06-27
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