益气养阴方联合左甲状腺素钠片干预甲状腺癌术后临床研究
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Clinical Study on Combination Use of Yiqi Yangyin Prescription and Levothyroxine Sodium Tablets as Intervention for Patients After Surgery of Thyroid Cancer
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    摘要:

    目的:分析采用益气养阴方联合左甲状腺素钠片干预甲状腺癌术后患者的临床效果。方法:回顾 性分析67 例气阴两虚型甲状腺癌术后患者的临床疗效,根据治疗方法的不同,分为对照组33 例与观察组 34例。2组均经腋窝微创甲状腺切除术治疗,术后积极抗感染。对照组服用左甲状腺素钠片,观察组予益气养 阴方联合左甲状腺素钠片治疗。2 组均连续治疗2 个月。治疗前后评定中医证候评分、生活质量核心量 表(EORTC QLQ-C30) 评分,检测甲状腺相关激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游 离甲状腺素(FT4) ],比较2组的临床疗效,统计治疗期间不良反应的发生情况。结果:2组术后1 个月、术 后2个月的中医证候积分均低于术前(P<0.05);观察组术后2个月的中医证候积分低于术后1个月(P< 0.05)。术后1个月、术后2个月,观察组的中医证候积分均低于对照组(P<0.05)。术后2个月,2组TSH水平 均较术前下降,FT3、FT4水平均较术前升高(P<0.05)。观察组FT3、FT4水平均高于对照组(P<0.05)。 2 组TSH水平比较,差异无统计学意义(P>0.05)。术后1个月、术后2个月,2组EORTC QLQ-C30评分均较 术前升高(P<0.05);观察组术后2个月的EORTC QLQ-C30评分较术后1个月升高(P<0.05)。术后1个月, 观察组EORTC QLQ-C30评分高于对照组(P<0.05)。术后2个月,观察组总有效率91.18%,对照组66.67%, 2组比较,差异有统计学意义(P<0.05)。术后2个月内,对照组发生腹泻、失眠各1例,经调整药量后缓解; 观察组无不良反应发生。结论:采用益气养阴方联合左甲状腺素钠片治疗气阴两虚型甲状腺癌术后患者,能提 升疗效,改善患者的甲状腺功能与生活质量,安全性好。

    Abstract:

    Abstract:Objective:To observe the clinical effect of the combination use of Yiqi Yangyin Prescription and Levothyroxine Sodium Tablets as intervention for patients after surgery of thyroid cancer. Methods:The clinical effect of 67 patients with qi and yin deficiency syndrome after receiving surgery of thyroid cancer were retrospectively analyzed. They were divided into control group (33 cases) and the observation group (34 cases) according to the different treatment methods. Both groups were treated with minimally invasive thyroidectomy through axillary fossa and given anti-infection after surgery. The control group was treated with Levothyroxine Sodium Tablets,and the observation group was treated with Yiqi Yangyin Prescription combined with Levothyroxine Sodium Tablets. Both groups were treated for two months. The traditional Chinese medicine (TCM) syndrome scores and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire 30 (EORTC QLQ-C30) scores were evaluated, the thyroidrelated hormones [thyroid-stimulating hormone (TSH),free triiodothyronine (FT3) and free thyroxine (FT4)] were detected;the clinical effects were compared between the two groups,and the incidence of adverse reactions during treatment was counted. Results:One and two months after surgery,the TCM syndrome scores in the two groups were respectively lower than those before surgery (P<0.05); two months after surgery, the TCM syndrome score in the observation group was lower than that one month after surgery (P<0.05). One and two months after surgery, the TCM syndrome scores in the observation group were lower than those in the control group (P<0.05). Two months after surgery, the levels of TSH in the two groups were reduced when compared with those before surgery, and the levels of FT3 and FT4 were elevated when compared with those before surgery (P<0.05). The levels of FT3 and FT4 in the observation group were higher than those in the control group (P<0.05). There was no significant difference being found in the comparison of TSH level between the two groups (P>0.05). One and two months after surgery,the EORTC QLQ-C30 scores in the two groups were increased when compared with those before surgery (P< 0.05);the EORTC QLQ-C30 score in the observation group two months after surgery was higher than that one month after surgery (P<0.05). One months after operation, the EORTC QLQ-C30 score in the observation group was higher than that in the control group (P<0.05). Two months after surgery,the total effective rate was 91.18% in the observation group and 66.67 % in the control group, difference being significant (P<0.05). Within two months after surgery, there was one case of diarrhea and one case of insomnia in the control group, which were relieved after adjusting the dosage; no adverse reactions occurred in the observation group. Conclusion: The combination use of Yiqi Yangyin Prescription and Levothyroxine Sodium Tablets can significantly enhance the curative effect on patients with qi and yin deficiency syndrome after surgery of thyroid cancer,and improve the thyroid function and quality of life of patients with great safety.

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刘英巧.益气养阴方联合左甲状腺素钠片干预甲状腺癌术后临床研究[J].新中医,2024,56(17):139-143

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  • 在线发布日期: 2024-09-11
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