甲亢经行汤联合甲巯咪唑治疗甲状腺功能亢进伴月经过少的临床观察
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摘要
目的观察甲亢经行汤治疗甲状腺功能亢进(甲亢)伴月经过少的临床疗效,评估其有效性,探求甲亢经行汤治疗甲亢伴月经过少的作用机制,为研究甲亢经行汤治疗甲亢伴月经过少提供新的治疗思路。方法将甲亢伴月经过少60例患者,随机分为治疗组30例,对照组30例。治疗组予甲亢经行汤联合甲巯咪唑,对照组仅予甲巯咪唑,观察12周。观察患者在治疗前后甲状腺激素水平、中医证候积分、月经量的变化。结果治疗后两组的促甲状腺激素(TSH)升高(P <0. 01),血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)降低(P <0. 01);治疗组与对照组比较,治疗组的甲状腺激素水平、中医证候积分、月经量方面,治疗前后差值更大(P <0. 01)。结论甲亢经行汤治疗甲亢伴月经过少在缓解甲亢的临床症状、增加月经量、改善甲状腺功能效果明显优于单一的甲巯咪唑治疗,其机制可能与减少机体炎症因子的表达,提高机体的免疫水平,改善子宫血液循环有关。
Objective To observe the clinical therapeutic effects of jiakang jingxing decoction on hyperthyroidism complicated with hypomenorrhea,evaluate the effectiveness and explore the mechanisms of jiakang jingxing decoction in the treatment so as to provide the new approach to the treatment of the disease. Methods A total of 60 patients of hyperthyroidism complicated with hypomenorrhea were randomized into a treatment group( 30 cases) and a control group( 30 cases). In the treatment group,the combined medication with jiakang jingxing decoction and methimazole was applied. In the control group,only methimazole was used. The observation lasted for 12 weeks. Before and after treatment,the changes in the thyroid hormone levels,TCM symptom scores and menstrual flow were observed. Results After treatment,TSH was increased( P < 0. 01),FT3 and FT4 reduced( P < 0. 01) in the two groups. Compared with the control group,the difference values of thyroid hormone levels,TCM symptom scores and menstrual flow in the treatment group were of the larger amplitude before and after treatment( P < 0. 01). Conclusion Jiakang jingxing decoction achieves the better effects for relieving the clinical symptoms,increasing menstrual flow and improving thyroid functions as compared with the simple medication with methimazole in the treatment of hyperthyroidism complicated with hypomenorrhea. The mechanism is probably related to the decrease of body inflammatory factor expression and improvement of immune function and uterine blood circulation. A further study is required in the future.
Objective To observe the clinical therapeutic effects of jiakang jingxing decoction on hyperthyroidism complicated with hypomenorrhea,evaluate the effectiveness and explore the mechanisms of jiakang jingxing decoction in the treatment so as to provide the new approach to the treatment of the disease. Methods A total of 60 patients of hyperthyroidism complicated with hypomenorrhea were randomized into a treatment group( 30 cases) and a control group( 30 cases). In the treatment group,the combined medication with jiakang jingxing decoction and methimazole was applied. In the control group,only methimazole was used. The observation lasted for 12 weeks. Before and after treatment,the changes in the thyroid hormone levels,TCM symptom scores and menstrual flow were observed. Results After treatment,TSH was increased( P < 0. 01),FT3 and FT4 reduced( P < 0. 01) in the two groups. Compared with the control group,the difference values of thyroid hormone levels,TCM symptom scores and menstrual flow in the treatment group were of the larger amplitude before and after treatment( P < 0. 01). Conclusion Jiakang jingxing decoction achieves the better effects for relieving the clinical symptoms,increasing menstrual flow and improving thyroid functions as compared with the simple medication with methimazole in the treatment of hyperthyroidism complicated with hypomenorrhea. The mechanism is probably related to the decrease of body inflammatory factor expression and improvement of immune function and uterine blood circulation. A further study is required in the future.
引文
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[14]张海燕,邬伟魁,杨军宣,等.栀子对心脑血管系统的作用研究[J].中国实验方剂学杂志,2011,17(14):294-297.
[15]刘金海.益母草对子宫微循环影响的实验研究[J].临床医药实践,2008,1(7):546-548.
[16]王英,张尚智,朱田田,等.当归有效成分的提取与分析研究进展[J].中兽医医药杂志,2016(2):75-79.
[2]中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南[J].中华内科杂志,2007,10(46):10.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:21-25.
[4]马宝璋.中医妇科学[M]. 9版.北京:中国中医药出版社,2012:75.
[5]孙宁,林守清.甲状腺功能与月经失调的相关性研究[J].中国妇幼健康研究,2011,22(3):389-391.
[6]赵胜利,林育忠,杨晴,等.一些滋阴和助阳药对氢考模型(3AR-CAMP系统的影响[J].中药药理与临床,1990,6(1):12-14.
[7]王祝举,赵玉英,涂光忠,等.夏枯草化学成分的研究[J].药学学报,1999,10(9):42-43.
[8]庄玲玲.夏枯草药理作用研究进展[J].中国中医药信息杂志,2009,9(1):100-102.
[9]刘敬顺.夏枯草药理作用实验研究简况[J].山西中医,2002,7(2):53-54.
[10]杨梅香,乔亭祥,赵立山,等.“龟板对甲亢型阴虚证”大鼠的影响[J].中药理与临床,1987,3(4):7-13.
[11]冯国平,荣征星,易宁育,等.生地、龟板和附子、肉桂对“甲亢”大鼠β肾上腺素能受体的影响[J].中西医结合杂志,1986,6(10):606-608.
[12]赵胜利,林育忠,杨晴,等.一些滋阴和助阳药对氢考模型βAR-CAMP系统的影响[J].中药药理与临床,1990,6(1):12
[13]易宁育,赵胜利.一些滋阴助阳药调整β肾上腺素能受体c AMP系统及M胆碱受体c GMP系统间失平衡的分子机理[J].中药药理与临床,1994,10(6):10.
[14]张海燕,邬伟魁,杨军宣,等.栀子对心脑血管系统的作用研究[J].中国实验方剂学杂志,2011,17(14):294-297.
[15]刘金海.益母草对子宫微循环影响的实验研究[J].临床医药实践,2008,1(7):546-548.
[16]王英,张尚智,朱田田,等.当归有效成分的提取与分析研究进展[J].中兽医医药杂志,2016(2):75-79.