中成药在桥本氏甲状腺炎中的应用
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摘要
临床中能用于治疗桥本氏甲状腺炎的中成药有很多,如桂枝茯苓胶囊、鳖甲煎丸、逍遥丸、柴胡疏肝丸、控涎丸、平消片等,以及一些医院的自制中成药。但尚缺乏多中心、大样本的临床随机对照试验提供循证医学证据,需要进一步的临床和实验研究。依据HT的临床特点及药物研究,可分为免疫调节类和散结消瘿类。当然,两者不是绝对分开的,如夏枯草制剂既有免疫调节作用,又能散结消瘿。尽管治疗HT的中成药种类多,必须将辨病、辨证、药物组方配伍特点结合,合理用药。只有依据中医药理论,以中医辨证思维来指导中成药的应用,才能发挥中成药多靶点治疗的优势。
In clinical practice,many Chinese Patent Medicine can be used to treat hashimoto' s thyroiditis( HT),such as Cinnamon Twig and Poria Capsules,Turtle Shell Decocted Pill,Free Wanderer Pill; Bupleurum Liver-Soothing Pill,Controlling PhlegmFluid Pill,Pingxiao Tablets( PXP),as well as some self-control Chinese patent medicine by hospital. However,there is a lack of multi center,large sample randomized controlled trials to provide evidence of evidence-based medicine,so it is necessary for the need for further clinical and experimental research. According to the clinical characteristics and drug research of HT,these medicines can be divided into immune regulation type and knot-dispersing type. Of course,the two are not absolutely separated,such as Prunella vulgaris preparations have immune regulatory role,but also can dispel the knot. Although there are many kinds of Chinese patent medicine for treating HT,it is necessary to combine the characteristics of disease differentiation,syndrome differentiation and drug combination. Only based on the theory of traditional Chinese medicine and the application of traditional Chinese medicine dialectical thinking to guide the application of Chinese patent medicine,can the advantages of multi-target therapy be taken.
In clinical practice,many Chinese Patent Medicine can be used to treat hashimoto' s thyroiditis( HT),such as Cinnamon Twig and Poria Capsules,Turtle Shell Decocted Pill,Free Wanderer Pill; Bupleurum Liver-Soothing Pill,Controlling PhlegmFluid Pill,Pingxiao Tablets( PXP),as well as some self-control Chinese patent medicine by hospital. However,there is a lack of multi center,large sample randomized controlled trials to provide evidence of evidence-based medicine,so it is necessary for the need for further clinical and experimental research. According to the clinical characteristics and drug research of HT,these medicines can be divided into immune regulation type and knot-dispersing type. Of course,the two are not absolutely separated,such as Prunella vulgaris preparations have immune regulatory role,but also can dispel the knot. Although there are many kinds of Chinese patent medicine for treating HT,it is necessary to combine the characteristics of disease differentiation,syndrome differentiation and drug combination. Only based on the theory of traditional Chinese medicine and the application of traditional Chinese medicine dialectical thinking to guide the application of Chinese patent medicine,can the advantages of multi-target therapy be taken.
引文
[1]杨敏,都昌吉,王引萍,等.桥本甲状腺炎患者外周血调节性B淋巴细胞和抑制性T细胞亚群的免疫改变[J].中华内分泌代谢杂志,2015,31(5):427-433.
[2]曾慧妍,赵玲,王璟霖,等.金水宝胶囊对桥本氏甲状腺炎自身抗体的影响及量效关系[J].广州中医药大学学报,2014,31(3):357-360.
[3]宋士玉,张苑青,陈加华,等.金水宝胶囊治疗自身免疫性甲状腺炎36例分析[J].井冈山医专学报,2002,9(3):35-36.
[4]谭丽玲.金水宝胶囊对桥本氏甲状腺炎过氧化物酶抗体免疫调节的疗效观察[J].海南医学院学报,2012,18(6):777-778,781.
[5]丁保金,邱相君.虫草真菌对机体的免疫调节作用[J].中国临床药理学与治疗学,2004,9(1):17-19.
[6]王苏娅,孟雪芹,陈江华,等.人工培养冬虫夏草(百令胶囊)免疫抑制作用细胞因子及可溶性细胞间粘附分子-1调控机制探讨[J].中国中西医结合杂志,2001,21(6):152-153.
[7]罗敏,顾燕云,李果,等.百令胶囊对自身免疫性甲状腺疾病(AITD)免疫调节作用[J].中国中医基础医学杂志,2006,12(4):261-262.
[8]刘宝忠,张花,杨坤,等.百令胶囊对自身免疫性甲状腺炎患者自身免疫性抗体的影响[J].医药导报,2009,28(6):727-728.
[9]黄虹,杨丕坚,李舒敏,等.百令胶囊对Graves病患者T淋巴细胞亚群的影响[J].中国实验方剂学杂志,2013,19(20):296-299.
[10]程如林,高寅香,叶正宝,等.雷公藤多甙片和甲状腺素片治疗慢性淋巴细胞性甲状腺炎疗效观察[J].中西医结合杂志,1988,8(11):676.
[11]华川,许芝银.雷公藤治疗桥本氏甲状腺炎实验研究[J].实用中医药杂志,2003,19(8):397-399.
[12]燕树勋,王颖,彭扣芝,等.雷公藤治疗自身免疫性甲状腺疾病[J].中医学报,2000,25(3):576-577.
[13]周强,甄仲,刘超,等.单味中药治疗甲状腺功能亢进的机制研究概况[J].辽宁中医杂志,2000,37(3):343-345.
[14]王彩玲,李海珍,侯钦芝.火把花根片治疗桥本氏甲状腺炎35例临床观察[J].山东中医药大学学报,2007,31(4):306-307.
[15]周卫惠.火把花根片联合丙基硫氧嘧啶片对Graves病患者甲状腺抗体的影响[J].辽宁中医药大学学报,2008,10(3):5-6.
[16]赵敏,周安方,徐安莉,等.右归胶囊对肾阳虚大鼠免疫功能影响的实验研究[J].湖北中医药大学学报,2013,15(1):18-20.
[17]章育正,张雅琴,姚颂一,等.右归丸对免疫细胞的调节作用[J].上海中医药杂志,1985,19(6):47-48.
[18]吴素琴,邹耀武.硒酵母片联合右归丸、左甲状腺素钠治疗原发性甲状腺功能减退症60例疗效观察[J].河北中医,2012,34(8):1177-1180.
[19]杨菲,许进,张雪珂,等.夏枯草胶囊治疗单纯甲状腺自身抗体异常的桥本甲状腺炎疗效观察[J].河北中医,2014,36(11):1693-1694.
[20]魏静,田建卿,陈江辉,等.左甲状腺素钠与夏枯草胶囊对桥本甲状腺炎的临床疗效[J].检验医学与临床,2014,11(24):3430-3432.
[21]刘新宇,刘春娜,郑久明.夏枯草水提液对人甲状腺细胞NO生成及其与摄碘率相关性影响[J].中成药,2013,35(5):1065-1067.
[22]曹羽.小金胶囊治疗甲状腺结节86例临床观察[J].北京中医药大学学报(中医临床版),2009,16(2):36.
[23]秦树光,孔繁荣,杨宝良.小金丸联合甲状腺素片治疗甲状腺肿的临床分析[J].现代中西医结合杂志,2005,14(8):1018.
[24]杨春青,陈晓雯.陈晓雯治疗桥本甲状腺炎的经验[J].中医药临床杂志,2010,22(7):612-614.
[25]赵勇,徐文华,陈如泉.治疗甲状腺结节常见中成药的辨证选用[J].中成药,2014,36(6):1334-1336.
[26]张维丽,裴迅,陈如泉.通心络胶囊治疗桥本氏甲状腺炎的临床观察[J].湖北中医杂志,2009,31(11):13-14.
[27]李莉,税文辉,王新英.温阳与通络并用治疗甲状腺功能减退症33例[J].陕西中医,2008,29(5):546-547.
[28]王小洁,郭菊秋,许绍忠,等.丹红注射液联合通心络胶囊治疗阿尔茨海默病临床观察[J].中成药,2014,36(11):2438-2440.
[29]苏志强.医院开展中成药合理应用评价的实践与探讨[J].中成药,2014,36(2):428-431.
[2]曾慧妍,赵玲,王璟霖,等.金水宝胶囊对桥本氏甲状腺炎自身抗体的影响及量效关系[J].广州中医药大学学报,2014,31(3):357-360.
[3]宋士玉,张苑青,陈加华,等.金水宝胶囊治疗自身免疫性甲状腺炎36例分析[J].井冈山医专学报,2002,9(3):35-36.
[4]谭丽玲.金水宝胶囊对桥本氏甲状腺炎过氧化物酶抗体免疫调节的疗效观察[J].海南医学院学报,2012,18(6):777-778,781.
[5]丁保金,邱相君.虫草真菌对机体的免疫调节作用[J].中国临床药理学与治疗学,2004,9(1):17-19.
[6]王苏娅,孟雪芹,陈江华,等.人工培养冬虫夏草(百令胶囊)免疫抑制作用细胞因子及可溶性细胞间粘附分子-1调控机制探讨[J].中国中西医结合杂志,2001,21(6):152-153.
[7]罗敏,顾燕云,李果,等.百令胶囊对自身免疫性甲状腺疾病(AITD)免疫调节作用[J].中国中医基础医学杂志,2006,12(4):261-262.
[8]刘宝忠,张花,杨坤,等.百令胶囊对自身免疫性甲状腺炎患者自身免疫性抗体的影响[J].医药导报,2009,28(6):727-728.
[9]黄虹,杨丕坚,李舒敏,等.百令胶囊对Graves病患者T淋巴细胞亚群的影响[J].中国实验方剂学杂志,2013,19(20):296-299.
[10]程如林,高寅香,叶正宝,等.雷公藤多甙片和甲状腺素片治疗慢性淋巴细胞性甲状腺炎疗效观察[J].中西医结合杂志,1988,8(11):676.
[11]华川,许芝银.雷公藤治疗桥本氏甲状腺炎实验研究[J].实用中医药杂志,2003,19(8):397-399.
[12]燕树勋,王颖,彭扣芝,等.雷公藤治疗自身免疫性甲状腺疾病[J].中医学报,2000,25(3):576-577.
[13]周强,甄仲,刘超,等.单味中药治疗甲状腺功能亢进的机制研究概况[J].辽宁中医杂志,2000,37(3):343-345.
[14]王彩玲,李海珍,侯钦芝.火把花根片治疗桥本氏甲状腺炎35例临床观察[J].山东中医药大学学报,2007,31(4):306-307.
[15]周卫惠.火把花根片联合丙基硫氧嘧啶片对Graves病患者甲状腺抗体的影响[J].辽宁中医药大学学报,2008,10(3):5-6.
[16]赵敏,周安方,徐安莉,等.右归胶囊对肾阳虚大鼠免疫功能影响的实验研究[J].湖北中医药大学学报,2013,15(1):18-20.
[17]章育正,张雅琴,姚颂一,等.右归丸对免疫细胞的调节作用[J].上海中医药杂志,1985,19(6):47-48.
[18]吴素琴,邹耀武.硒酵母片联合右归丸、左甲状腺素钠治疗原发性甲状腺功能减退症60例疗效观察[J].河北中医,2012,34(8):1177-1180.
[19]杨菲,许进,张雪珂,等.夏枯草胶囊治疗单纯甲状腺自身抗体异常的桥本甲状腺炎疗效观察[J].河北中医,2014,36(11):1693-1694.
[20]魏静,田建卿,陈江辉,等.左甲状腺素钠与夏枯草胶囊对桥本甲状腺炎的临床疗效[J].检验医学与临床,2014,11(24):3430-3432.
[21]刘新宇,刘春娜,郑久明.夏枯草水提液对人甲状腺细胞NO生成及其与摄碘率相关性影响[J].中成药,2013,35(5):1065-1067.
[22]曹羽.小金胶囊治疗甲状腺结节86例临床观察[J].北京中医药大学学报(中医临床版),2009,16(2):36.
[23]秦树光,孔繁荣,杨宝良.小金丸联合甲状腺素片治疗甲状腺肿的临床分析[J].现代中西医结合杂志,2005,14(8):1018.
[24]杨春青,陈晓雯.陈晓雯治疗桥本甲状腺炎的经验[J].中医药临床杂志,2010,22(7):612-614.
[25]赵勇,徐文华,陈如泉.治疗甲状腺结节常见中成药的辨证选用[J].中成药,2014,36(6):1334-1336.
[26]张维丽,裴迅,陈如泉.通心络胶囊治疗桥本氏甲状腺炎的临床观察[J].湖北中医杂志,2009,31(11):13-14.
[27]李莉,税文辉,王新英.温阳与通络并用治疗甲状腺功能减退症33例[J].陕西中医,2008,29(5):546-547.
[28]王小洁,郭菊秋,许绍忠,等.丹红注射液联合通心络胶囊治疗阿尔茨海默病临床观察[J].中成药,2014,36(11):2438-2440.
[29]苏志强.医院开展中成药合理应用评价的实践与探讨[J].中成药,2014,36(2):428-431.
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