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Article(id=1322926694654419819, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.09.039, 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=1793339902794, onlineDateStr=2026-10-30, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339902794, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339902794, creator=13701087609, updateTime=1793339902794, updator=13701087609, issue=Issue{id=1322926492627378659, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='9', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1757433600000', pubDateStr='2025-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339854628, creator='13701087609', updateTime=1793340762858, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930302095590169, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930302095590170, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926492627378659, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=210, endPage=213, ext={EN=ArticleExt(id=1322926694897689452, articleId=1322926694654419819, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Xiagu Xiaoying Prescription（夏菇消瘿方）Combined with Chinese Medicine on Benign Simple Thyroid Nodules, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effect of Xiagu Xiaoying Prescription（夏菇消瘿方）combined with Chinese medicine on benign simple thyroid nodules.

Methods

A total of102 patientswith benign simple thyroid nodules admitted from January 2022 to June 2023 were included and divided into control group and traditional Chinese medicine group by random number table method，with 51 cases in each group. The patients in the control group were treated orally with levothyroxine sodium tablets，and those in the traditional Chinese medicine（TCM）group were treated with Xiagu Xiaoying Prescription and external application of Chinese medicine for 8 weeks on the basis of medication in the control group. During the treatment，4 cases fell off in control group and 3 cases fell off in TCM group. The data of each group was observed，including the clinical therapeutic effect，TCM symptom integral（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression）before and after treatment，thyroid volume and thyroid nodule diameter change before and after treatment，the levels of thyroid stimulating hormones［thyroid stimulating hormone（TSH），free thyroxine（FT4），free triiodothyronine（FT3）］and other thyroid function indexes and adverse reactions.

Results

The total effective rate of the TCM group（95.83%）was obvious higher than that of the control group（82.98%）（P<0.05）. Before treatment，TCM syndrome scores（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression），thyroid volume and maximum diameter of thyroid nodule were not significant between two groups（P<0.05）. After treatment，TCM syndrome scores（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression）of patients in tow groups decreased significantly，and thyroid volume and maximum diameter indexes of thyroid nodule decreased significantly. These indicators in the TCM group were all lower than those of the control（P<0.05）. There were no significant differences in thyroid function indexes（TSH，FT4 and FT3）among two groups after treatment（P>0.05）. The total adverse reaction rate of the TCM group（2.08%）was lower than that of the control group（14.89%）（P<0.05）.

Conclusion

Xiagu Xiaoying Prescription combined with Chinese medicine external application in the treatment of benign simple thyroid nodules can significantly relieve the symptoms，significantly reduce the nodules，the recovery is good，and the treatment of adverse reactions are less. The treatment method is safe and reliable，worthy of application.

, authors=Ying TANG, Huan YAO, Qing HE, Jing XU, Yuanyuan WU, Suying HU, authorsList=Ying TANG, Huan YAO, Qing HE, Jing XU, Yuanyuan WU, Suying HU, authorCompany=null, correspAuthors=Suying HU, 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=1322926697930171253, articleId=1322926694654419819, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=夏菇消瘿方结合中药外敷治疗良性单纯性甲状腺结节效果观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果。

方法

共计纳入102例甲状腺结节（良性单纯性）患者（2022年1月—2023年6月收治）以随机数字表法分为对照组、中医组，各组51例，对照组患者口服左甲状腺素钠片进行治疗，中医组患者在对照组用药基础上结合夏菇消瘿方、中药外敷治疗，治疗8周，治疗过程中中医组脱落3例，对照组脱落4例，观察各组数据情况：临床治疗效果、治疗前后中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）变化、治疗前后患者甲状腺体积以及最大的甲状腺结节直径改变、游离甲状腺素（FreeThyroxine，FT4）、促甲状腺激素（thyroidstimulatinghormone，TSH）以及游离三碘甲状腺原氨酸（Free Trnodothyronine，FT3）等甲状腺功能相关指标改变、治疗不良反应。

结果

中医组患者治疗总有效率（95.83%）显著高于对照组患者治疗总有效率（82.98%），P<0.05；治疗前各组患者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）、甲状腺体积以及甲状腺结节最大直径指标比较，P>0.05，治疗后各组患者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）显著下降，甲状腺体积以及甲状腺结节最大直径指标明显缩小，中医组患者治疗后者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）、甲状腺的具体体积以及最大甲状腺结节的直径指标均小于对照组患者，P<0.05；各组患者治疗后的甲状腺功能指标（TSH、FT4以及FT3）差异无显著统计学意义，P>0.05；中医组患者治疗总不良反应率（2.08%）比对照组患者（14.89%）更低，P<0.05。

结论

夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果甚佳，患者治疗后症状明显缓解，患者结节明显缩小，恢复较好，且治疗不良反应少，治疗方法安全可靠，值得应用。

, authors=唐莹, 姚欢, 何青, 许婧, 吴袁元, 胡素颖, authorsList=唐莹, 姚欢, 何青, 许婧, 吴袁元, 胡素颖, authorCompany=null, correspAuthors=胡素颖, authorNote=

唐莹（1983-），女，安徽岳西人，副主任医师，学士，研究方向：内分泌学。

, correspAuthorsNote=
胡素颖（1973-），女，安徽芜湖人，副主任医师，硕士研究生导师，学士，研究方向：内分泌学。E-mail：。
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唐莹（1983-），女，安徽岳西人，副主任医师，学士，研究方向：内分泌学。

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唐莹（1983-），女，安徽岳西人，副主任医师，学士，研究方向：内分泌学。

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articleTitle=基于文献挖掘探讨针刺治疗甲状腺结节的用穴特点及核心组合, refAbstract=null), Reference(id=1322926707463824331, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=3, pageStart=206, pageEnd=209, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=王昭, 彭书旺, 王永恒, journalName=中医药导报, refType=null, unstructuredReference=王昭，彭书旺，王永恒. 彭坚基于“痰瘀互结”理论治疗甲状腺结节经验［J］. 中医药导报，2023，29（3）：206-209., articleTitle=彭坚基于“痰瘀互结”理论治疗甲状腺结节经验, refAbstract=null), Reference(id=1322926707535127500, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2023, volume=42, issue=11, pageStart=1160, pageEnd=1166, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=董又滋, 路中艳, 侯广建, journalName=山东中医杂志, refType=null, unstructuredReference=董又滋，路中艳，侯广建，等. 赵泉霖基于“清”“消”“补”三法治疗甲状腺结节用药规律探析［J］. 山东中医杂志，2023，42（11）：1160-1166., articleTitle=赵泉霖基于“清”“消”“补”三法治疗甲状腺结节用药规律探析, refAbstract=null), Reference(id=1322926707606430669, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2023, volume=25, issue=3, pageStart=57, pageEnd=60, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=左艳敏, 韩娟, 张立文, journalName=湖北中医药大学学报, refType=null, unstructuredReference=左艳敏，韩娟，张立文，等. 疏肝解郁、软坚散结法治疗肝郁痰凝血瘀型甲状腺结节疗效研究［J］. 湖北中医药大学学报，2023，25（3）：57-60., articleTitle=疏肝解郁、软坚散结法治疗肝郁痰凝血瘀型甲状腺结节疗效研究, refAbstract=null), Reference(id=1322926707774202830, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2022, volume=29, issue=3, pageStart=17, pageEnd=25, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=刘洋靖, 马朝群, 朱太阳, journalName=中国中医药信息杂志, refType=null, unstructuredReference=刘洋靖，马朝群，朱太阳，等. 桂枝茯苓丸“异病同治”甲状腺结节、乳腺结节及子宫肌瘤网络药理学机制研究［J］. 中国中医药信息杂志，2022，29（3）：17-25., articleTitle=桂枝茯苓丸“异病同治”甲状腺结节、乳腺结节及子宫肌瘤网络药理学机制研究, refAbstract=null), Reference(id=1322926707849700303, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2022, volume=44, issue=1, pageStart=270, pageEnd=276, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=张莹莹, 凌霄, 李春晓, journalName=中成药, refType=null, unstructuredReference=张莹莹，凌霄，李春晓，等. 治疗甲状腺结节、乳腺增生、子宫肌瘤中药复方的用药共性规律［J］. 中成药，2022，44（1）：270-276., articleTitle=治疗甲状腺结节、乳腺增生、子宫肌瘤中药复方的用药共性规律, refAbstract=null), Reference(id=1322926707908420560, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2022, volume=19, issue=36, pageStart=148, pageEnd=152, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=郑修月, 邵迎新, journalName=中国医药导报, refType=null, unstructuredReference=郑修月，邵迎新. 邵迎新教授从气虚辨治甲状腺结节的经验［J］. 中国医药导报，2022，19（36）：148-152., articleTitle=邵迎新教授从气虚辨治甲状腺结节的经验, refAbstract=null), Reference(id=1322926707979723729, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2021, volume=41, issue=10, pageStart=1393, pageEnd=1396, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=解相蕊, 刘春雪, 张童, journalName=吉林中医药, refType=null, unstructuredReference=解相蕊，刘春雪，张童，等. 中医外治法治疗甲状腺结节研究进展［J］. 吉林中医药，2021，41（10）：1393-1396., articleTitle=中医外治法治疗甲状腺结节研究进展, refAbstract=null), Reference(id=1322926708046832594, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, doi=null, pmid=null, pmcid=null, year=2023, volume=64, issue=2, pageStart=193, pageEnd=197, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=阙慈嫺, 姜欣, 陈瑞鸥, journalName=中医杂志, refType=null, unstructuredReference=阙慈嫺，姜欣，陈瑞鸥，等. 从“火毒”辨治甲状腺结节热消融术后声音嘶哑［J］. 中医杂志，2023，64（2）：193-197., articleTitle=从“火毒”辨治甲状腺结节热消融术后声音嘶哑, refAbstract=null)], funds=[Fund(id=1322926705245037490, 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departmentName=null, remark=芜湖市中医医院，安徽 芜湖 241002)])], figs=[ArticleFig(id=1322926703965774760, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
对照组477248839（82.98）
中医组4815247246（95.83）
χ2值-----4.166 4
P值-----0.041 2
), ArticleFig(id=1322926704041272233, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=CN, label=表1, caption=

两组良性单纯性甲状腺结节患者临床治疗方面的效果对比

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
对照组477248839（82.98）
中医组4815247246（95.83）
χ2值-----4.166 4
P值-----0.041 2
), ArticleFig(id=1322926704116769706, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间颈前可触及肿块颈部不适感呼吸不畅咽部异物感肿块质软不痛情绪抑郁
对照组47治疗前2.33±0.162.18±0.231.95±0.251.89±0.201.85±0.232.00±0.34
治疗后0.65±0.10*0.61±0.13*0.48±0.06*0.50±0.07*0.48±0.05*0.43±0.04*
中医组48治疗前2.28±0.202.21±0.191.90±0.311.91±0.181.79±0.311.99±0.29
治疗后0.28±0.07*#0.24±0.05*#0.15±0.03*#0.16±0.04*#0.13±0.02*#0.14±0.04*#
), ArticleFig(id=1322926704385205163, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=CN, label=表2, caption=

两组良性单纯性甲状腺结节患者治疗前后中医证候积分比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间颈前可触及肿块颈部不适感呼吸不畅咽部异物感肿块质软不痛情绪抑郁
对照组47治疗前2.33±0.162.18±0.231.95±0.251.89±0.201.85±0.232.00±0.34
治疗后0.65±0.10*0.61±0.13*0.48±0.06*0.50±0.07*0.48±0.05*0.43±0.04*
中医组48治疗前2.28±0.202.21±0.191.90±0.311.91±0.181.79±0.311.99±0.29
治疗后0.28±0.07*#0.24±0.05*#0.15±0.03*#0.16±0.04*#0.13±0.02*#0.14±0.04*#
), ArticleFig(id=1322926704494257068, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间甲状腺体积/（cm3）甲状腺结节最大直径/（cm）
对照组47治疗前1.55±0.160.99±0.08
治疗后0.79±0.10*0.79±0.06*
中医组48治疗前1.58±0.200.97±0.06
治疗后0.51±0.08*#0.61±0.05*#
), ArticleFig(id=1322926704594920365, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=CN, label=表3, caption=

两组良性单纯性甲状腺结节患者的甲状腺具体体积以及最大甲状腺结节的直径指标对比（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间甲状腺体积/（cm3）甲状腺结节最大直径/（cm）
对照组47治疗前1.55±0.160.99±0.08
治疗后0.79±0.10*0.79±0.06*
中医组48治疗前1.58±0.200.97±0.06
治疗后0.51±0.08*#0.61±0.05*#
), ArticleFig(id=1322926704712360878, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间TSH（mIU/L）FT4（ng/dL）FT3（pg/mL）
对照组47治疗前3.41±0.654.69±0.622.39±0.37
治疗后3.77±0.734.75±0.452.43±0.29
中医组48治疗前3.38±0.704.74±0.592.42±0.40
治疗后3.69±0.68*4.69±0.63*2.46±0.32*
), ArticleFig(id=1322926704783664047, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=CN, label=表4, caption=

两组良性单纯性甲状腺结节患者治疗前后甲状腺功能指标（TSH、FT4以及FT3）对比（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间TSH（mIU/L）FT4（ng/dL）FT3（pg/mL）
对照组47治疗前3.41±0.654.69±0.622.39±0.37
治疗后3.77±0.734.75±0.452.43±0.29
中医组48治疗前3.38±0.704.74±0.592.42±0.40
治疗后3.69±0.68*4.69±0.63*2.46±0.32*
), ArticleFig(id=1322926704863355824, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐头痛总不良反应
对照组474217（14.89）
中医组481001（2.08）
χ2值----5.053 3
P值----0.024 6
), ArticleFig(id=1322926704943047601, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926694654419819, language=CN, label=表5, caption=

两组良性单纯性甲状腺结节患者治疗不良反应比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐头痛总不良反应
对照组474217（14.89）
中医组481001（2.08）
χ2值----5.053 3
P值----0.024 6
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夏菇消瘿方结合中药外敷治疗良性单纯性甲状腺结节效果观察
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唐莹 , 姚欢 , 何青 , 许婧 , 吴袁元 , 胡素颖
中华中医药学刊 | 省级项目平台 2025,43(9): 210-213
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中华中医药学刊 |省级项目平台 2025 , 43 (9) : 210 -213
夏菇消瘿方结合中药外敷治疗良性单纯性甲状腺结节效果观察
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唐莹, 姚欢, 何青, 许婧, 吴袁元, 胡素颖
作者信息
  • 芜湖市中医医院，安徽 芜湖 241002
通讯作者:
胡素颖（1973-），女，安徽芜湖人，副主任医师，硕士研究生导师，学士，研究方向：内分泌学。E-mail：。
作者简介:

唐莹（1983-），女，安徽岳西人，副主任医师，学士，研究方向：内分泌学。

Effect of Xiagu Xiaoying Prescription（夏菇消瘿方）Combined with Chinese Medicine on Benign Simple Thyroid Nodules
Ying TANG, Huan YAO, Qing HE, Jing XU, Yuanyuan WU, Suying HU
Affiliations
  • Department of Endocrinology，Wuhu Traditional Chinese Medicine Hospital，Wuhu 241002，Anhui，China
出版时间: 2025-09-10 doi: 10.13193/j.issn.1673-7717.2025.09.039
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摘要
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目的

探讨夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果。

方法

共计纳入102例甲状腺结节（良性单纯性）患者（2022年1月—2023年6月收治）以随机数字表法分为对照组、中医组，各组51例，对照组患者口服左甲状腺素钠片进行治疗，中医组患者在对照组用药基础上结合夏菇消瘿方、中药外敷治疗，治疗8周，治疗过程中中医组脱落3例，对照组脱落4例，观察各组数据情况：临床治疗效果、治疗前后中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）变化、治疗前后患者甲状腺体积以及最大的甲状腺结节直径改变、游离甲状腺素（FreeThyroxine，FT4）、促甲状腺激素（thyroidstimulatinghormone，TSH）以及游离三碘甲状腺原氨酸（Free Trnodothyronine，FT3）等甲状腺功能相关指标改变、治疗不良反应。

结果

中医组患者治疗总有效率（95.83%）显著高于对照组患者治疗总有效率（82.98%），P<0.05；治疗前各组患者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）、甲状腺体积以及甲状腺结节最大直径指标比较，P>0.05，治疗后各组患者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）显著下降，甲状腺体积以及甲状腺结节最大直径指标明显缩小，中医组患者治疗后者中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）、甲状腺的具体体积以及最大甲状腺结节的直径指标均小于对照组患者，P<0.05；各组患者治疗后的甲状腺功能指标（TSH、FT4以及FT3）差异无显著统计学意义，P>0.05；中医组患者治疗总不良反应率（2.08%）比对照组患者（14.89%）更低，P<0.05。

结论

夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果甚佳，患者治疗后症状明显缓解，患者结节明显缩小，恢复较好，且治疗不良反应少，治疗方法安全可靠，值得应用。

良性单纯性甲状腺结节  /  中药外敷  /  夏菇消瘿方  /  临床治疗效果  /  中医证候积分  /  甲状腺功能指标  /  甲状腺体积  /  不良反应
Objective

To explore the effect of Xiagu Xiaoying Prescription（夏菇消瘿方）combined with Chinese medicine on benign simple thyroid nodules.

Methods

A total of102 patientswith benign simple thyroid nodules admitted from January 2022 to June 2023 were included and divided into control group and traditional Chinese medicine group by random number table method，with 51 cases in each group. The patients in the control group were treated orally with levothyroxine sodium tablets，and those in the traditional Chinese medicine（TCM）group were treated with Xiagu Xiaoying Prescription and external application of Chinese medicine for 8 weeks on the basis of medication in the control group. During the treatment，4 cases fell off in control group and 3 cases fell off in TCM group. The data of each group was observed，including the clinical therapeutic effect，TCM symptom integral（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression）before and after treatment，thyroid volume and thyroid nodule diameter change before and after treatment，the levels of thyroid stimulating hormones［thyroid stimulating hormone（TSH），free thyroxine（FT4），free triiodothyronine（FT3）］and other thyroid function indexes and adverse reactions.

Results

The total effective rate of the TCM group（95.83%）was obvious higher than that of the control group（82.98%）（P<0.05）. Before treatment，TCM syndrome scores（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression），thyroid volume and maximum diameter of thyroid nodule were not significant between two groups（P<0.05）. After treatment，TCM syndrome scores（palpable lump in front of the neck，discomfort in the neck，difficulty breathing，foreign body sensation in the throat，soft and painless mass，emotional depression）of patients in tow groups decreased significantly，and thyroid volume and maximum diameter indexes of thyroid nodule decreased significantly. These indicators in the TCM group were all lower than those of the control（P<0.05）. There were no significant differences in thyroid function indexes（TSH，FT4 and FT3）among two groups after treatment（P>0.05）. The total adverse reaction rate of the TCM group（2.08%）was lower than that of the control group（14.89%）（P<0.05）.

Conclusion

Xiagu Xiaoying Prescription combined with Chinese medicine external application in the treatment of benign simple thyroid nodules can significantly relieve the symptoms，significantly reduce the nodules，the recovery is good，and the treatment of adverse reactions are less. The treatment method is safe and reliable，worthy of application.

benign simple thyroid nodules  /  external application of Chinese medicine  /  Xiagu Xiaoying Prescription（夏菇消瘿方）  /  clinical treatment effect  /  TCM syndrome score  /  thyroid function index  /  thyroid volume  /  adverse reaction
唐莹, 姚欢, 何青, 许婧, 吴袁元, 胡素颖. 夏菇消瘿方结合中药外敷治疗良性单纯性甲状腺结节效果观察. 中华中医药学刊, 2025 , 43 (9) : 210 -213 . DOI: 10.13193/j.issn.1673-7717.2025.09.039
Ying TANG, Huan YAO, Qing HE, Jing XU, Yuanyuan WU, Suying HU. Effect of Xiagu Xiaoying Prescription（夏菇消瘿方）Combined with Chinese Medicine on Benign Simple Thyroid Nodules[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (9) : 210 -213 . DOI: 10.13193/j.issn.1673-7717.2025.09.039
正文
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良性单纯性甲状腺结节作为临床容易出现的一类疾病，指各种因素造成甲状腺里面有非肿瘤、非炎性组织结构异常团块出现，近年疾病发病率显著上升，危害严重[1-3]。良性单纯性甲状腺结节病程较长，多无明显症状，可经触诊、超声确诊[3-4]。西医治疗良性单纯性甲状腺结节疾病多采取药物治疗、手术治疗，而药物治疗多以左甲状腺素钠片治疗，取得较好效果，但患者长期应用左甲状腺素钠片存在较多不良反应，且疾病容易复发，故而需积极探讨患者新的有效的治疗方法[5-7]。中医对甲状腺结节认识较深，记载较多，将其纳入“瘿病”“瘿瘤”等范畴，临床发现，肝郁脾虚证较为多见，可采取疏肝健脾、活血化瘀及祛痰之法治疗，故而给予患者夏菇消瘿方结合中药外敷治疗，取得较好临床效果，值得重视[8-9]。故而此次纳入甲状腺结节（良性单纯性）患者102例予以分组，探讨中药外敷结合夏菇消瘿方治疗方面的效果，如下报道。
1　资料与方法
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1.1　一般资料
共计纳入102例良性单纯性甲状腺结节患者（2022年1月—2023年6月收治）以随机数字表法分为对照组、中医组，各组51例。治疗过程中中医组脱落3例，对照组脱落4例。中医组：48例，女32例，男16例，年龄29～67岁（48.62±4.31）岁，病程1～7年（3.95±0.45）年，单个结节40例，多个结节8例。对照组：47例，女32例，男15例，年龄27～69岁（48.58±4.37）岁，病程1～7年（4.02±0.38）年，单个结节39例，多个结节8例。比较中医组与对照组患者资料，P>0.05。
1.2　诊断方面的标准
西医诊断甲状腺结节（良性单纯性）参照《甲状腺结节和分化型甲状腺癌诊治指南》[10]：患者的结节能够随着吞咽上下活动，结节没有出现红肿热痛，结节较大的患者可发生难以呼吸以及颈部憋胀感相关的症状，经甲状腺彩超确诊。中医诊断甲状腺结节（良性单纯性）（肝郁脾虚证）参照《中药新药临床研究指导原则（试行）》[11]：主症-颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛；次症-失眠多汗、烦躁易怒、倦怠乏力、情绪抑郁等；舌脉-舌肥大、苔薄白、脉弦。
1.3　纳入排除剔除标准
纳入标准：患者符合甲状腺结节（良性单纯性）诊断，中医辨证为肝郁脾虚、痰瘀互结证；患者自愿加入研究；患者可接受左甲状腺素钠片、夏菇消瘿方、中药外敷治疗；伦理批准研究进行（编号：YW2024-015）。排除标准：符合手术指征，需手术患者；参与其他研究患者；合并肿瘤疾病患者；肝肾功能损伤患者；药物过敏患者；哺乳期、妊娠女性患者；依从性差，无法配合本次研究患者；精神疾病、心理疾病患者等。脱落标准：自愿退出研究患者；治疗过程中发生意外患者；严重药物过敏反应患者等。
1.4　治疗方法
对照组：患者予以左甲状腺素钠片（默克制药公司，国药准字是J20160065）口服治疗。早餐前30 min，口服，每次剂量为12.5～50 μg，治疗8周。中医组：在对照组用药基础上结合中医方案治疗。口服夏菇消瘿方，组方如下：生牡蛎30 g，茯苓15 g，当归15 g，白芍15 g，柴胡15 g，炒白术15 g，黄芩10 g，夏枯草10 g，鬼箭羽10 g，山慈菇8 g，甘草6 g。每日1剂，水煎煮，取汁450 mL，分早中晚服药，每次150 mL，治疗8周。中药外敷治疗：制马钱子100 g、大戟及甘遂各85 g，以10 mL醋兑入中药粉末中，炼蜜为膏，加入15 mL二甲基亚砜，调为糊状，取3 g外敷于患者患处，时间4～5 h，每日1次，治疗8周。
1.5　观察指标
①对比中医组与对照组患者临床治疗效果[12]。痊愈-患者治疗后超声检查显示甲状腺结节全部消失；显效-患者治疗后超声检查可见甲状腺结节缩小2/3以上；有效-患者治疗后超声检查可见甲状腺结节缩小范围1/3～2/3；无效-患者治疗后超声检查可见甲状腺结节缩小不足1/3。总有效率＝痊愈率+显效率+有效率。②比较中医组与对照组患者治疗前后颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等中医证候相关的积分，各项积分满分是3分，分值和患者的证候情况成正比[13]。③比较中医组与对照组患者治疗前后甲状腺体积以及最大的甲状腺结节直径改变。采取超声测定甲状腺结节的长径a（cm）以及横径b（cm）、宽径c（cm）。结节体积＝π/6×a（cm）×b（cm）×c（cm）。注：多个结节患者取最大结节。④比较各组患者治疗前后甲状腺功能指标。主要测定游离甲状腺素（FreeThyroxine，FT4）、促甲状腺激素（thyroidstimulatinghormone，TSH）以及游离三碘甲状腺原氨酸（Free Trnodothyronine，FT3）等指标，采取放射免疫法、免疫化学测定法进行测定。⑤比较中医组与对照组患者治疗不良反应情况。
1.6　统计学方法
中医组与对照组患者的临床数据均录入SPSS 27.0软件，分析及处理各组数据，计量资料（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等中医证候积分、甲状腺体积以及甲状腺结节最大直径、甲状腺功能指标等）以形式表示、计数资料（临床治疗效果以及治疗不良反应等）以%形式表示，分别实施t/χ2检验，当P<a（α＝0.05）时，说明数据比较存在显著统计学差异。
2　结果
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2.1　两组患者临床治疗方面的效果对比
表1可见，总有效率方面，治疗后中医组患者（95.83%）较对照组患者高（82.98%），P<0.05。
2.2　两组患者治疗前后中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）比较
表2显示，各组患者治疗前的中医证候积分（颈前可触及肿块、颈部不适感、呼吸不畅、咽部异物感、肿块质软不痛、情绪抑郁等）比较，P>0.05，治疗后各组患者的中医证候积分均显著下降，而中医组患者治疗后的中医证候积分低于对照组，P<0.05。
2.3　治疗前后两组患者的甲状腺具体体积以及最大甲状腺结节的直径指标对比
表3显示，甲状腺具体体积以及最大甲状腺结节的直径方面，各组患者治疗前对比并无差异，P>0.05，治疗后各组患者上述指标均出现了下降情况，而中医组患者这两项指标治疗后全部较对照组小，P<0.05。
2.4　两组患者治疗前后甲状腺功能指标（TSH、FT4以及FT3）对比
表4显示，各组患者治疗前甲状腺功能方面的指标（TSH、FT4以及FT3）比较，P>0.05，中医组患者治疗后甲状腺功能方面的指标与对照组相当，无统计学差异，P>0.05。
2.5　两组患者治疗不良反应比较
表5可见，中医组患者治疗总不良反应率（2.08%）比对照组患者（14.89%）更低，P<0.05。
3　讨论
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中医把甲状腺结节（良性单纯性）这一疾病归属于“瘿瘤”“瘿病”“肉瘿”等范畴[13-17]。中医对这一疾病的记载较多。《集验方》[18]里面就有相应的记载：“瘿病者，始作与瘿核相似，其瘿病喜当颈下。”其病机较为复杂。《诸病源候论》[19]里面亦有相应的记载，“瘿者，由忧恚气结所生。”甲状腺结节发病与患者情志失常、饮食不节有关，此外长期忧郁，肝气郁结，脾失健运，气滞痰凝，日久结于颈前，故而引起疾病[20-23]。甲状腺结节（良性单纯性）需积极治疗，分析其病机，给予患者有效方法治疗乃患者康复的关键[24-26]。临床发现，甲状腺结节（良性单纯性）临床辨证多为肝郁脾虚证，其主要病机为肝郁气结、脾虚痰凝，针对患者病机给予患者夏菇消瘿方治疗，取得较好效果[27-28]。夏菇消瘿方是由逍遥散加减而来，逍遥散记载于《太平惠民和剂局方.治妇人诸疾》里面，该方在和营健脾及解郁疏肝方面的功效较好，治疗肝郁血虚脾弱证效果良好。夏菇消瘿方由生牡蛎、茯苓、当归、白芍、柴胡及炒白术、黄芩、夏枯草、鬼箭羽、山慈菇、甘草等中药组成，方中夏枯草为君药，具有夏枯草具有清肝泻火及散结消肿等功效。茯苓、当归、白芍、柴胡及炒白术、黄芩为臣药，其中茯苓具有利水渗湿、健脾以及宁心安神等功效；当归具有补血活血、调经止痛等功效；白芍具有养血调经、柔肝止痛等功效；柴胡具有疏散退热以及疏肝解郁、升举阳气等功效；炒白术具有补气健脾以及燥湿利水等功效；黄芩具有清热燥湿、泻火解毒等功效。山慈菇、生牡蛎、鬼箭羽为佐药，其中山慈菇具有清热解毒、化痰散结等功效；生牡蛎具有平肝潜阳、软坚散结、镇惊安神等功效；鬼箭羽具有破血通经、解毒消肿等功效；甘草为使药，具有益气补中、解毒、缓急止痛等功效。诸药配伍具有较好活血化瘀、健脾益气、软坚散结等功效。现代药理指出，生牡蛎可镇静，调节体内阴阳平衡以及软化体内物质，较好分散结节；茯苓可抗炎及调节免疫；当归可抗氧化及增强身体免疫功能；白芍可抗炎及调节免疫功能；柴胡具有抗肝损伤以及免疫调节作用；炒白术可增加机体免疫功能；黄芩可抗炎镇痛及抑菌；夏枯草可抗炎及抑菌，还可抗肿瘤；甘草可抗炎及增加机体免疫功能[29-30]。中药外敷甲状腺结节（良性单纯性）效果良好，而中药主要取制马钱子、大戟及甘遂，其中制马钱子具有通经活血、抗菌消炎、止痛等作用；大戟具有通利二便、消肿散结等作用；甘遂具有泻水逐饮、消肿散结等功效[31-32]。该中药具有较好通经活血及散结等功效，以外敷方式治疗，较为安全可靠，有利于甲状腺结节（良性单纯性）患者康复，结合夏菇消瘿方内服可较好提升甲状腺结节（良性单纯性）患者治疗效果，值得应用。
本次数据提示，中医组患者治疗总有效率（95.83%）显著高于对照组患者治疗总有效率（82.98%），且患者中医证候积分下降低于对照组，P<0.05，提示夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果良好，患者病症显著改善，分析其原因为，夏菇消瘿方结合中药外敷治疗具有较好疏肝健脾、益气、软坚散结功效，还可抗炎，调节免疫功能作用，而肝郁脾虚证甲状腺结节（良性单纯性）患者主要病机为脾虚、肝郁，故而本次治疗效果显著。甲状腺结节（良性单纯性）患者甲状腺结节体积较大，而治疗该病根本在于缩小甲状腺结节，夏菇消瘿方结合中药外敷具有较好软坚散结作用，利于结节缩小，故而本次治疗后患者的甲状腺体积以及甲状腺结节最大直径均缩小。西药治疗甲状腺结节（良性单纯性）具有一定效果，但存在一定不良反应，而中医药用药安全，不良反应少，且夏菇消瘿方具有一定解毒、清肝泻火等作用，故而可一定程度改善西药不良反应，提升治疗安全。
综上所述，夏菇消瘿方结合中药外敷治疗甲状腺结节（良性单纯性）效果良好，患者症状改善，结节缩小，恢复较好，且治疗不良反应少，安全可靠。
基金
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  • 安徽省高等学校省级质量工程项目(2022jyxm901)
文献
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2025年第43卷第9期
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doi: 10.13193/j.issn.1673-7717.2025.09.039
  • 首发时间：2026-10-30
  • 出版时间：2025-09-10
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安徽省高等学校省级质量工程项目(2022jyxm901)
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    芜湖市中医医院，安徽 芜湖 241002

通讯作者:

胡素颖（1973-），女，安徽芜湖人，副主任医师，硕士研究生导师，学士，研究方向：内分泌学。E-mail：。
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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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