甲状腺癌术后患者使用左甲状腺素联合养阴散结汤的临床疗效评价

黎茂尧

[摘要]目的探討甲状腺癌术后患者使用左甲状腺素联合养阴散结汤的临床疗效。方法选取2018年4月至2019年6月化州市人民医院收治的86例接受甲状腺癌手术的患者作为研究对象，根据随机数字表法分为对照组与试验组，每组各43例，对照组接受左甲状腺素钠片治疗，试验组接受左甲状腺素钠片联合养阴散结汤治疗，比较两组治疗前及治疗3个月后的临床症状积分、血清促甲状腺激素（TSH）与甲状腺球蛋白（TG）含量、甲状腺结节最大直径、促甲状腺激素受体抗体（TRAb）、甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）水平的变化、临床治疗总有效率、临床症状改善起效时间、术后并发症总发生率情况。结果治疗前，两组患者的临床症状积分、TSH 与 TG 含量、甲状腺结节最大直径、TRAb、TgAb、TPOAb水平差异无统计学意义（ P >0.05）;治疗3个月后，试验组的临床症状积分、TSH 与 TG 含量、甲状腺结节最大直径、TRAb、TgAb、TPOAb水平均显著低于对照组，并且试验组的临床治疗总有效率明显高于对照组，临床症状改善起效时间明显短于对照组，术后并发症总发生率明显低于对照组，两组比较差异有统计学意义（ P <0.05）。结论甲状腺癌术后患者使用左甲状腺素联合养阴散结汤具有良好的效果，不仅能够降低临床症状积分、TSH 与 TG 含量、甲状腺结节最大直径、TRAb、TgAb、TPOAb水平、术后并发症总发生率，同时能够提升临床治疗总有效率、缩短临床症状改善起效时间。

[关键词]甲状腺癌;左甲状腺素;养阴散结汤;甲状腺结节最大直径

[中图分类号] R736.1  [文献标识码] A   [文章编号]2095-0616（2021）23-0222-05

Clinical evaluation of levothyroxine combined with YangyinSanjie Decoction in patients after thyroid cancer surgery

LI  Maoyao

Department of Endocrinology， Huazhou People's Hospital， Guangdong， Huazhou 525100， China

[Abstract] Objective To explore the clinical effect of levothyroxine combined with YangyinSanjie Decoction in patients with thyroid cancer after operation. Methods A total of 86 patients who underwent thyroid cancer surgery in Huazhou People's Hospital from April 2018 to June 2019 were selected as the research objects， and divided into the control group and the study group according to random number table method， with 43 cases in each group. The control group received levothyroxine sodium tablets and the study group received levothyroxine sodium tablets combined with YangyinSanjie Decoction. Clinical symptom score， serum TSH and TG content， maximum diameter of thyroid nodules， changes of TSH receptor antibody （TRAb）， thyroglobulin antibody （TgAb） and thyroid peroxidase antibody （TPOAb）， total effective rate of clinical treatment， effective time of improvement of clinical symptoms and total incidence of postoperative complications were compared between the two groups before and after 3 months of treatment. Results Before treatment， there were no significant differences in clinical symptom score， TSH and TG content， maximum diameter of thyroid nodule， TRAb， TgAb and TPOAb level between the two groups （P >0.05）. After 3 months of treatment， the clinical symptom score， TSH and TG contents， the maximum diameter of thyroid nodules， TRAb， TgAb and TPOAb levels in the study group were significantly lower than those in the control group， and the total effective rate of clinical treatment in the study group was significantly higher than that in the control group. The effective time of improvement of clinical symptoms was significantly shorter than that in the control group， and the total incidence of postoperative complications was significantly lower than that in the control group， with statistically significant differences between the two groups （P <0.05）. Conclusion Levothyroxine combined with YangyinSanjie Decoction has a good effect on postoperative patients with thyroid cancer， which can not only reduce the clinical symptom score， TSH and TG contents， the maximum diameter of thyroid nodules， TRAb， TgAb and TPOAb levels， total incidence of postoperative complications， but also improve the total effective rate of clinical treatment and shorten the effective time of the improvement of clinical symptoms.

[Key words] Thyroid cancer; Levothyroxine; YangyinSanjie Decoction; Maximum diameter of thyroid nodules

甲状腺癌是一种较为常见的恶性肿瘤疾病，研究显示，缺碘或高碘饮食、内分泌异常是导致甲状腺癌发生的重要因素[1]，对患者具有严重的不良影响，临床主要使用手术的方式进行治疗[2]，虽然能够对病灶进行切除，在一定程度上改善患者病情，但诸多患者在术后会产生一系列不良症状，不仅降低患者的舒适度，同时也会影响康复效果，并且还会增加患者复发的概率，需要采取积极有效的措施进行预防应对[3-4]。以往……