Article(id=1322927020115632192, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.11.012, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339980390, onlineDateStr=2026-10-30, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339980390, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339980390, creator=13701087609, updateTime=1793339980390, updator=13701087609, issue=Issue{id=1322926985957221241, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='11', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339972247, creator='13701087609', updateTime=1793340743335, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930220201804556, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930220201804557, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=51, endPage=54, ext={EN=ArticleExt(id=1322927020367290433, articleId=1322927020115632192, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Randomized Controlled Clinical Study of Modified Haizao Yuhu Decoction(海藻玉壶汤)in Treatment of Goiter, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze a randomized controlled study on the treatment of goiter patients with Modified Haizao Yuhu Decoction(海藻玉壶汤).

Methods

A hundred goiter patients admitted to Quzhou Hospital of Traditional Chinese Medicine from May 2021 to May 2024 were selected as the study objects. The patients were divided into two groups by random number table method. Fifty patients treated with Western medicine were established as the control group,and the other fifty patients treated with Modified Haizao Yuhu Decoction were established as the experimental group,all of whom were treated for 12 weeks. After treatment,the clinical effects of the two groups were observed and compared.

Results

After treatment,the single symptom scores of both groups were decreased(P<0.05),and the score of the experimental group was more significantly decreased than that of the control group(P<0.05). After treatment,the levels of free triiodothyronine(FT3)and free thyroid hormone(FT4)were increased in both groups,and the level of thyroid stimulating hormone(TSH)was decreased(P<0.05). Compared with those in the control group,the levels of FT3 and FT4 were higher and the level of TSH was lower in the experimental group(P<0.05). After treatment,the maximum diameter and volume of thyroid nodules in both groups were decreased(P<0.05),and the decrease was more significant in the experimental group compared with that in the control group(P<0.05). After treatment,the levels of thyroid autoantibodies thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TGAb)were decreased in both groups(P<0.05),and the levels in the experimental group were more significantly decreased than those in the control group(P<0.05).

Conclusion

After the treatment of goiter patients with Modified Haizao Yuhu Decoction,it can effectively regulate the immunity and improve the clinical symptoms of patients with good results.

, authors=Chunyan CHEN, Penglei JU, Yuwei XU, Longlong YU, authorsList=Chunyan CHEN, Penglei JU, Yuwei XU, Longlong YU, authorCompany=null, correspAuthors=Longlong YU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927022271504466, articleId=1322927020115632192, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=海藻玉壶汤化裁治疗甲状腺肿的随机对照临床研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

甲状腺肿患者采取海藻玉壶汤化裁治疗的随机对照研究分析。

方法

选取衢州市中医医院乳甲外科2021年5月—2024年5月收治的100例甲状腺肿患者作为研究对象,采取随机数字表法将患者分为两组,采取西药治疗的50例患者既定为对照组,采取海藻玉壶汤化裁治疗的50例患者既定为试验组,均治疗12周。治疗后,观察对比两组患者的临床效果。

结果

治疗后两组单项症状积分均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。治疗后两组游离三碘甲状腺原氨酸(Free Triiodothyronine,FT3)、游离甲状腺激素(Free Thyroxine,FT4)均升高,促甲状腺激素(Thyroid Stimulating Hormone,TSH)降低(P<0.05),且与对照组比较,试验组FT3、FT4更高,TSH更低(P<0.05)。治疗后两组甲状腺结节最大直径、体积均降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。治疗后两组甲状腺自身抗体甲状腺过氧化物酶抗体(Thyroid Peroxidase Antibody,TPOAb)、甲状腺球蛋白抗体(Thyroglobulin Antibody,TGAb)水平均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。

结论

甲状腺肿患者采取海藻玉壶汤化裁治疗后,可有效调节机体免疫,改善患者的临床症状,效果良好。

, authors=陈春燕, 琚鹏磊, 徐雨薇, 余龙龙, authorsList=陈春燕, 琚鹏磊, 徐雨薇, 余龙龙, authorCompany=null, correspAuthors=余龙龙, authorNote=

陈春燕(1984-),女,浙江衢州人,副主任医师,硕士,研究方向:乳甲疾病。

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余龙龙(1963-),男,浙江衢州人,主任中医师,硕士,研究方向:肿瘤相关。E-mail:。
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陈春燕(1984-),女,浙江衢州人,副主任医师,硕士,研究方向:乳甲疾病。

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陈春燕(1984-),女,浙江衢州人,副主任医师,硕士,研究方向:乳甲疾病。

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keyword=甲状腺肿), Keyword(id=1322927024045695086, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, orderNo=2, keyword=海藻玉壶汤), Keyword(id=1322927024125386863, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, orderNo=3, keyword=临床效果)], refs=[Reference(id=1322927025295597692, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=3, pageStart=63, pageEnd=66, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=田晓君, 王金曦, 韦冰晨, journalName=中华中医药学刊, refType=null, unstructuredReference=田晓君,王金曦,韦冰晨,等. 基于“阳化气,阴成形”理论探析自身免疫性甲状腺炎中医病机与治疗思路[J]. 中华中医药学刊,2023,42(3):63-66., articleTitle=基于“阳化气,阴成形”理论探析自身免疫性甲状腺炎中医病机与治疗思路, refAbstract=null), Reference(id=1322927025366900861, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, doi=null, pmid=null, 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组别例数男/女年龄/(岁±s)病程/(月,±s)甲状腺肿部位(左/右)
试验组5025/2528.45±3.2340.34±7.3420/30
对照组5023/2729.01±3.1741.11±7.2222/28
χ2值0.160 30.875 00.528 80.164 2
P值0.688 90.383 70.598 10.685 3
), ArticleFig(id=1322927024347684977, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, label=表1, caption=

两组甲状腺肿患者基线表(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数男/女年龄/(岁±s)病程/(月,±s)甲状腺肿部位(左/右)
试验组5025/2528.45±3.2340.34±7.3420/30
对照组5023/2729.01±3.1741.11±7.2222/28
χ2值0.160 30.875 00.528 80.164 2
P值0.688 90.383 70.598 10.685 3
), ArticleFig(id=1322927024423182450, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数颈部肿胀不适胸胁胀闷情志不畅
治疗前治疗后治疗前治疗后治疗前治疗后
试验组502.23±0.500.68±0.17*2.61±0.210.47±0.14*2.54±0.310.45±0.20*
对照组502.28±0.491.41±0.25*#2.59±0.251.14±0.19*#2.49±0.291.37±0.31*#
t值0.505 017.074 00.433 120.073 90.799 617.633 7
P值0.614 70.000 00.665 90.000 00.425 90.000 0
), ArticleFig(id=1322927024494485619, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, label=表2, caption=

两组甲状腺肿患者治疗前后单项症状积分比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数颈部肿胀不适胸胁胀闷情志不畅
治疗前治疗后治疗前治疗后治疗前治疗后
试验组502.23±0.500.68±0.17*2.61±0.210.47±0.14*2.54±0.310.45±0.20*
对照组502.28±0.491.41±0.25*#2.59±0.251.14±0.19*#2.49±0.291.37±0.31*#
t值0.505 017.074 00.433 120.073 90.799 617.633 7
P值0.614 70.000 00.665 90.000 00.425 90.000 0
), ArticleFig(id=1322927024599343220, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TSH/(μIU/mL)FT3/(ρmol/L)FT4/(ρmol/L)
治疗前治疗后治疗前治疗后治疗前治疗后
试验组501.95±0.191.51±0.13*3.76±0.486.54±0.91*13.25±2.5519.21±3.67*
对照组501.94±0.181.72±0.15*#3.77±0.494.89±0.58*#13.29±2.5116.23±3.12*#
t值0.270 27.480 90.103 110.811 80.079 04.374 5
P值0.787 60.000 00.918 10.000 00.937 20.000 0
), ArticleFig(id=1322927024674840693, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, label=表3, caption=

两组甲状腺肿患者TSH、FT3、FT4治疗前后比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TSH/(μIU/mL)FT3/(ρmol/L)FT4/(ρmol/L)
治疗前治疗后治疗前治疗后治疗前治疗后
试验组501.95±0.191.51±0.13*3.76±0.486.54±0.91*13.25±2.5519.21±3.67*
对照组501.94±0.181.72±0.15*#3.77±0.494.89±0.58*#13.29±2.5116.23±3.12*#
t值0.270 27.480 90.103 110.811 80.079 04.374 5
P值0.787 60.000 00.918 10.000 00.937 20.000 0
), ArticleFig(id=1322927024767115382, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数甲状腺结节最大直径/(cm)甲状腺结节最大体积/(cm3)
治疗前治疗后治疗前治疗后
试验组502.55±0.771.79±0.54*36.98±10.2824.76±7.44*
对照组502.54±0.742.16±0.68*#36.67±10.8328.78±8.67*#
t值0.066 23.013 00.146 82.488 1
P值0.947 30.003 30.883 60.014 5
), ArticleFig(id=1322927024851001463, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, label=表4, caption=

两组甲状腺肿患者治疗前后甲状腺结节最大直径、体积比较(±s)

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组别例数甲状腺结节最大直径/(cm)甲状腺结节最大体积/(cm3)
治疗前治疗后治疗前治疗后
试验组502.55±0.771.79±0.54*36.98±10.2824.76±7.44*
对照组502.54±0.742.16±0.68*#36.67±10.8328.78±8.67*#
t值0.066 23.013 00.146 82.488 1
P值0.947 30.003 30.883 60.014 5
), ArticleFig(id=1322927024918110328, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TPOAb/(IU/mL)TGAb/(IU/mL)
治疗前治疗后治疗前治疗后
试验组50711.52±207.21240.92±120.22*518.62±192.23175.19±82.19*
对照组50701.54±199.29441.21±120.53*#512.63±203.25316.95±93.07*#
t值0.245 58.319 40.151 48.073 0
P值0.806 60.000 00.880 00.000 0
), ArticleFig(id=1322927025022967929, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927020115632192, language=CN, label=表5, caption=

两组甲状腺肿患者治疗前后甲状腺自身抗体TPOAb、TGAb水平比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TPOAb/(IU/mL)TGAb/(IU/mL)
治疗前治疗后治疗前治疗后
试验组50711.52±207.21240.92±120.22*518.62±192.23175.19±82.19*
对照组50701.54±199.29441.21±120.53*#512.63±203.25316.95±93.07*#
t值0.245 58.319 40.151 48.073 0
P值0.806 60.000 00.880 00.000 0
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海藻玉壶汤化裁治疗甲状腺肿的随机对照临床研究
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陈春燕 , 琚鹏磊 , 徐雨薇 , 余龙龙
中华中医药学刊 | 国家项目点击 2025,43(11): 51-54
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中华中医药学刊 |国家项目点击 2025 , 43 (11) : 51 -54
海藻玉壶汤化裁治疗甲状腺肿的随机对照临床研究
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陈春燕, 琚鹏磊, 徐雨薇, 余龙龙
作者信息
  • 衢州市中医医院,浙江 衢州 324002
通讯作者:
余龙龙(1963-),男,浙江衢州人,主任中医师,硕士,研究方向:肿瘤相关。E-mail:。
作者简介:

陈春燕(1984-),女,浙江衢州人,副主任医师,硕士,研究方向:乳甲疾病。

Randomized Controlled Clinical Study of Modified Haizao Yuhu Decoction(海藻玉壶汤)in Treatment of Goiter
Chunyan CHEN, Penglei JU, Yuwei XU, Longlong YU
Affiliations
  • Quzhou Hospital of Traditional Chinese Medicine,Quzhou 324002,Zhejiang,China
出版时间: 2025-11-10 doi: 10.13193/j.issn.1673-7717.2025.11.012
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目的

甲状腺肿患者采取海藻玉壶汤化裁治疗的随机对照研究分析。

方法

选取衢州市中医医院乳甲外科2021年5月—2024年5月收治的100例甲状腺肿患者作为研究对象,采取随机数字表法将患者分为两组,采取西药治疗的50例患者既定为对照组,采取海藻玉壶汤化裁治疗的50例患者既定为试验组,均治疗12周。治疗后,观察对比两组患者的临床效果。

结果

治疗后两组单项症状积分均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。治疗后两组游离三碘甲状腺原氨酸(Free Triiodothyronine,FT3)、游离甲状腺激素(Free Thyroxine,FT4)均升高,促甲状腺激素(Thyroid Stimulating Hormone,TSH)降低(P<0.05),且与对照组比较,试验组FT3、FT4更高,TSH更低(P<0.05)。治疗后两组甲状腺结节最大直径、体积均降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。治疗后两组甲状腺自身抗体甲状腺过氧化物酶抗体(Thyroid Peroxidase Antibody,TPOAb)、甲状腺球蛋白抗体(Thyroglobulin Antibody,TGAb)水平均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。

结论

甲状腺肿患者采取海藻玉壶汤化裁治疗后,可有效调节机体免疫,改善患者的临床症状,效果良好。

甲状腺肿  /  海藻玉壶汤  /  临床效果
Objective

To analyze a randomized controlled study on the treatment of goiter patients with Modified Haizao Yuhu Decoction(海藻玉壶汤).

Methods

A hundred goiter patients admitted to Quzhou Hospital of Traditional Chinese Medicine from May 2021 to May 2024 were selected as the study objects. The patients were divided into two groups by random number table method. Fifty patients treated with Western medicine were established as the control group,and the other fifty patients treated with Modified Haizao Yuhu Decoction were established as the experimental group,all of whom were treated for 12 weeks. After treatment,the clinical effects of the two groups were observed and compared.

Results

After treatment,the single symptom scores of both groups were decreased(P<0.05),and the score of the experimental group was more significantly decreased than that of the control group(P<0.05). After treatment,the levels of free triiodothyronine(FT3)and free thyroid hormone(FT4)were increased in both groups,and the level of thyroid stimulating hormone(TSH)was decreased(P<0.05). Compared with those in the control group,the levels of FT3 and FT4 were higher and the level of TSH was lower in the experimental group(P<0.05). After treatment,the maximum diameter and volume of thyroid nodules in both groups were decreased(P<0.05),and the decrease was more significant in the experimental group compared with that in the control group(P<0.05). After treatment,the levels of thyroid autoantibodies thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TGAb)were decreased in both groups(P<0.05),and the levels in the experimental group were more significantly decreased than those in the control group(P<0.05).

Conclusion

After the treatment of goiter patients with Modified Haizao Yuhu Decoction,it can effectively regulate the immunity and improve the clinical symptoms of patients with good results.

goiter  /  Haizao Yuhu Decoction(海藻玉壶汤)  /  clinical effect
陈春燕, 琚鹏磊, 徐雨薇, 余龙龙. 海藻玉壶汤化裁治疗甲状腺肿的随机对照临床研究. 中华中医药学刊, 2025 , 43 (11) : 51 -54 . DOI: 10.13193/j.issn.1673-7717.2025.11.012
Chunyan CHEN, Penglei JU, Yuwei XU, Longlong YU. Randomized Controlled Clinical Study of Modified Haizao Yuhu Decoction(海藻玉壶汤)in Treatment of Goiter[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (11) : 51 -54 . DOI: 10.13193/j.issn.1673-7717.2025.11.012
甲状腺疾病属于临床上常见的内分泌疾病,主要是环境因素、遗传因素、肠道菌群失常等导致甲状腺的形态、功能出现异常[1]。甲状腺肿属于临床常见的甲状腺疾病,具有较高的发病率,该病的主要表现为甲状腺出现弥漫性或多结节性的肿大,甲状腺的体积、直径逐渐增加,甲状腺激素紊乱等,严重影响患者的身体健康[2]。目前,临床治疗甲状腺肿可分为手术、药物治疗,有一定耐受性及复发率[3]。西药治疗以补充甲状腺激素为主,但长期使用会影响甲状腺的正常功能[4]。海藻玉壶汤属于传统中医的经典方剂之一[5]。该方剂最早在1742年清代吴谦所编纂的《医宗金鉴》中被记载,该书中比较详细记录了海藻玉壶汤的方药组成、主治和疗效作用,对治疗甲状腺肿具有较好的疗效[6-7]。海藻玉壶汤具有消瘿散结、化痰消肿的功效,采取海藻玉壶汤作为治疗基础方,四诊合参,根据患者的实际情况加减药材,对气滞、血瘀、痰凝导致的甲状腺肿具有较好疗效[8]。基于此,为探究海藻玉壶汤化裁治疗甲状腺肿的临床效果,该文选取100例甲状腺肿患者进行研究分析,对比其疗效。现报道如下。
选取衢州市中医医院乳甲外科2021年5月—2024年5月收治的100例甲状腺肿患者作为研究对象,采取计算机生成的随机数字将患者分为两组。对照组年龄18~38岁,病程10~50个月;试验组年龄18~39岁,病程12~51个月。两组患者一般资料比较,差异无统计学意义(P>0.05),可比性较好。该研究经患者知情同意并签署同意书,通过医学伦理委员会批准。见表1。
①符合《中国甲状腺疾病诊治指南》[9]中对该病的诊断标准;②患者感颈部不适、有憋气感,颈前区出现肿大,或有结节;查体可触及甲状腺肿大,质地软,边界比较清晰,无压痛;③影像学检查示甲状腺有结节;穿刺细胞学检查显示符合甲状腺肿的病理标准。
①符合《中药新药临床研究指导原则》[10]中对该病的诊断标准;②主症:颈前有肿块,随吞咽上下活动,颈部不适,呼吸不畅等;③次症:情绪不畅、烦躁易怒,失眠,汗多等;舌体胖大,齿状舌,舌苔薄白,脉弦数。
①患者年龄在18~65岁,且性别不限;②符合中西医诊断标准,中医临床诊断为甲状腺肿,且甲状腺功能正常或轻度异常;③体检和实验室检查未伴有严重心、肝、肾功能不全;④自愿参加研究,并签署知情同意书。
①严重心、肝、肾功能不全者;②对研究药物过敏者;③近期使用其他治疗甲状腺肿的中西药物者;④妊娠或哺乳期妇女;⑤合并其他严重慢性疾病或近期接受过放射治疗者。
给予化裁海藻玉壶汤,药用:海藻15 g,昆布15 g,海带15 g,胖大海15 g,陈皮10 g,半夏10 g,川贝母10 g,党参10 g,甘草6 g,青皮10 g,连翘15 g,夏枯草15 g,白芷6 g,醋香附6 g,生大黄6 g,吴茱萸15 g,冰片3 g,川芎10 g,苏叶6 g,小茴香6 g。兼有严重的咽喉肿痛(热象明显)的患者:加入黄连6 g,黄芩9 g;体质虚弱,容易疲倦乏力的患者:加入黄芪15 g,白术10 g;有明显的寒象,手脚冰冷的患者:加入桂枝6 g,附子9 g。1剂/d,水煎服,早晚各1次。治疗时间为12周。
给予左甲状腺素钠片(深圳市中联制药有限公司;国药准字H20010008)口服治疗,1次50μg,1次/d。治疗时间为12周。
两组患者均医嘱保持均衡饮食,适量摄入碘,避免高碘和有可能致甲状腺肿食物(如卷心菜、甘蓝、木薯、大豆等);避免过度劳累,保持良好作息;坚持适度运动,选择温和锻炼;戒烟限酒,保持身心健康。
评估症状颈部肿胀不适、胸胁胀闷以及情志不畅三项,分值为0~3分。分值越高,患者症状越严重。
治疗前以及治疗12周后,抽取患者清晨空腹静脉血,采取化学发光法检测游离三碘甲状腺原氨酸(Free Triiodothyronine,FT3)、游离甲状腺激素(Free Thyroxine,FT4)、促甲状腺激素(Thyroid Stimulating Hormone,TSH)水平。
治疗前以及治疗12周后,采取彩色多普勒超声检查仪(Mindray DC-8)检查患者甲状腺结节最大直径以及体积。
治疗前以及治疗12周后,抽取患者清晨空腹静脉血,免疫化学发光法检查甲状腺过氧化物酶抗体(Thyroid Peroxidase Antibody,TPOAb)、甲状腺球蛋白抗体(Thyroglobulin Antibody,TGAb)水平。
采用SPSS 25.0处理分析,数据资料均符合正态分布,计数资料用例(%)表示,采用χ2检验;单项症状积分、甲状腺相关指标、甲状腺情况、甲状腺自身抗体TPOAb、TGAb水平等指标用表示,用t检验。采用重复测量方差分析(Repeated Measures ANOVA)来评估两组患者单项症状积分、甲状腺相关指标、甲状腺情况、甲状腺自身抗体TPOAb、TGAb水平在不同治疗时段(治疗前、治疗12周后)的变化。
治疗前两组单项症状积分比较差异无统计学意义(P>0.05);治疗后两组单项症状积分均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。见表2。
治疗前两组TSH、FT3、FT4水平比较差异无统计学意义(P>0.05);治疗后两组FT3、FT4均升高,TSH 降低(P<0.05),且与对照组比较,试验组FT3、FT4更高,TSH更低(P<0.05)。见表3。
治疗前两组甲状腺结节最大直径、体积比较差异无统计学意义(P>0.05);治疗后两组甲状腺结节最大直径、体积均降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。见表4。
治疗前两组甲状腺自身抗体TPOAb、TGAb水平比较差异无统计学意义(P>0.05);治疗后两组甲状腺自身抗体TPOAb、TGAb水平均有所降低(P<0.05),且与对照组比较,试验组降低更显著(P<0.05)。见表5。
随着生活节奏的加快,工作、生活压力的增加,导致甲状腺疾病的发病率逐年增长。其中,比较常见的甲状腺疾病为甲状腺肿,且男性发病率高于女性[11]。目前,临床上治疗该病主要采取甲状腺素替代疗法,如口服左甲状腺素钠片,该药物可以利用下丘脑-垂体-甲状腺轴负反馈的作用,从而对血清中TSH水平产生抑制,缩小结节的直径、体积,降低新发结节出现的概率[12-13]。但是,长期使用左甲状腺素钠片可能导致诸多不良反应,如心房颤动、骨质疏松等,疗效不理想,因此,寻求更好的治疗方式是临床的重点。
甲状腺肿属于中医学“瘿瘤”范畴[14],认为瘿瘤(甲状腺肿)的病发主要与患者情志密切相关[15]。肝主疏泄,若是患者情志不畅,会导致肝气不舒,肝气郁结;而脾主运化,若是脾失健运,会导致内生痰浊[16-17];或由于肝郁化火,导致气滞痰凝在甲状腺,进而出现甲状腺肿[18]。因此,治疗甲状腺肿时主要以疏肝解郁、消瘿散结、化痰消肿为主。海藻玉壶汤是我国中医经典方剂,最早在《医宗金鉴》中被记载,对治疗甲状腺肿具有较好的疗效[19]。海藻玉壶汤中含有的海藻、昆布、海带属于海产藻类,含有丰富的碘[20]。海藻具有消痰、软坚的功效,昆布具有化痰消肿、利水、软坚散结的功效,上述两种药物为治疗甲状腺疾病的常用药对[21-22];夏枯草散结消肿、清热泻火,可助海藻、昆布消肿散结、清热,属于破癥散瘿之圣药[23];川贝母可以清热化痰、消肿散结;胖大海、生大黄清热;陈皮健脾理气、化痰燥湿;半夏燥湿化痰[24];党参补中益气、健脾;青皮、醋香附疏肝破气;连翘清热解毒、消肿散结;冰片散郁火;川芎、苏叶、小茴香行气止痛[25-26]。诸药合用,可达到疏肝解郁、消瘿散结、化痰消肿的目的。从现代药理学的角度看,海藻、昆布具有较好的抗肿瘤效果,且对于甲状腺疾病具有较好疗效[27];海带中含有的昆布多糖可以抑制肿瘤细胞的增殖,还能杀灭肿瘤细胞[28-29];夏枯草具有抗炎、抗肿瘤、调节免疫的效果;川贝母具有抗炎、抗肿瘤、抗氧化的效果;陈皮可抗炎、抗氧化[30-31]。因此,海藻玉壶汤可以调节机体免疫,减轻患者甲状腺的氧化应激,提高其氧化应激的防御功能,进而保护患者的甲状腺细胞[32-33]。同时,还不会加重由于碘缺乏导致的甲状腺损伤,消瘿效果显著。采取海藻玉壶汤治疗,再根据患者的实际情况辨证加减,可有效达到治疗目的。在本研究中,治疗后与对照组比较,试验组单项症状积分降低更显著。治疗后试验组甲状腺结节最大直径、体积均低于对照组。说明海藻玉壶汤化裁治疗甲状腺肿可有效减轻患者的临床症状,缩小甲状腺结节的体积、直径。甲状腺疾病极易导致患者甲状腺功能紊乱,导致甲状腺功能、形态出现改变。而FT3、FT4对检测甲状腺功能具有较高的灵敏度,具有生理活性,可有效反映出患者甲状腺的代谢情况[34]。TSH属于甲状腺功能筛查的特异性参数[35],而治疗后与对照组比较,试验组FT3、FT4更高,TSH更低,说明采取海藻玉壶汤化裁治疗可有效改善患者的甲状腺激素水平,改善患者的甲状腺功能。治疗后与对照组比较,试验组甲状腺自身抗体TPOAb、TGAb水平降低更显著,说明采取海藻玉壶汤化裁治疗可以对患者免疫紊乱情况进行有效调节,降低其甲状腺的抗体水平。但由于样本量小,没有进行远期随访观察,且不具备广泛的代表性。因此,还需要进一步加深和扩大研究的范围,并进行后续的跟踪报道。
综上所述,海藻玉壶汤化裁治疗甲状腺肿疗效确切,可有效减轻患者的临床症状,改善患者的甲状腺功能,调节机体免疫,临床治疗效果良好。
  • 国家中医药管理局全国名老中医药专家经验传承项目(国中医药发〔2008〕7号)
  • 浙江省中医药科技计划项目(2021ZB325)
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2025年第43卷第11期
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doi: 10.13193/j.issn.1673-7717.2025.11.012
  • 首发时间:2026-10-30
  • 出版时间:2025-11-10
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基金
国家中医药管理局全国名老中医药专家经验传承项目(国中医药发〔2008〕7号)
浙江省中医药科技计划项目(2021ZB325)
作者信息
    衢州市中医医院,浙江 衢州 324002

通讯作者:

余龙龙(1963-),男,浙江衢州人,主任中医师,硕士,研究方向:肿瘤相关。E-mail:。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.11.012
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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