段姗姗 王永恒 熊武 彭书旺

摘要 目的：观察加味当归建中汤对分化型甲状腺癌（DTC）患者甲状腺切除术后的临床疗效。方法：选取2017年1月至2019年12月湖南中医药大学第一附属医院收治的分化型甲状腺癌进行甲状腺切除术后患者92例作为研究对象，按照随机数字表法分为对照组和观察组，每组46例。对照组术后给予优甲乐治疗，观察组在对照组治疗基础上给予加味当归建中汤，2组患者均连续治疗3个月;治疗后，比较2组患者临床症状积分、卡氏评分、临床有效率、甲状腺功能、免疫功能、不良反应发生率及复发情况。结果：观察组临床症状积分高于对照组（P<0.05）;观察组卡氏评分、改善率、甲状腺评价指标均高于对照组（P<0.05）治疗后IgG含量差异有统计学意义（P<0.05）;观察组不良反应发生率为19.57%，低于对照组的6.52%（P<0.05）;患者复发率的差异无统计学意义。结论：加味当归建中汤联合优甲乐可有效改善分化型甲状腺癌患者甲状腺切除术后临床症状，提升临床有效率，增强患者机体免疫功能，安全性较高。

关键词 加味当归建中汤;优甲乐;分化型甲状腺癌;临床观察

Clinical Observation of Jiawei Danggui Jianzhong Decoction Combined with Youjiale on Differentiated Thyroid Carcinoma

DUAN Shanshan，WANG Yongheng，XIONG Wu，PENG Shuwang

（The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine，Changsha 410007，China）

Abstract Objective：To observe the clinical effect of modified Danggui Jianzhong Decoction on patients with differentiated thyroid cancer（DTC）after thyroidectomy.Methods：According to the random number table method，a total of 92 patients with DTC undergoing thyroidectomy were divided into a control group and an observation group，with 46 cases in each group; the control group was treated with Youjiale after the operation，and the observation group was treated with Jiawei Danggui Jianzhong Decoction on the basis of the control group.Both groups were treated continuously for 3 months; after treatment，the 2 groups were compared in terms of clinical symptom score，Karnofsky score，clinical effective rate，thyroid function，immune function，incidence of adverse reactions and recurrence.Results：The clinical symptom score of the observation group was higher than that of the control group（P<0.05）; the Karnofsky score，improvement rate，and thyroid evaluation index of the observation group were higher than those of the control group（P<0.05）.There were significant differences in IgG content after treatment（P<0.05）; the incidence of adverse reactions in the observation group was 19.57%，which was lower than 6.52% in the control group（P<0.05）; there was no significant difference in the recurrence rate of patients.Conclusion：Modified Danggui Jianzhong Decoction combined with Youjiale can effectively improve the clinical symptoms of patients with DTC after thyroidectomy，improve clinical efficiency，enhance the patient′s immune function，and have high safety.

Keywords Jiawei Danggui Jianzhong Decoction; Youjiale; Differentiated thyroid cancer; Clinical observation

中圖分类号：R273文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.24.020

分化型甲状腺癌（Differentiated Thyroid Cancer，DTC）是甲状腺癌的组织亚型，是内分泌系统多发恶性肿瘤之一，发病率较高[1]，临床诊断与治疗不及时，容易发生淋巴结转移、骨转移等，累及周围器官[2]。近年来，甲状腺癌的发病率增长速度持续稳定，并且在全球多个国家均观察到了相同的趋势，年龄为35～64岁女性的发病率更加明显，导致以年龄为横坐标的发病率曲线逐渐向倒U形转化[3]。甲状腺癌的治疗方案受患者发病年龄的影响，不同年龄段存在各自的疾病特异性，老年人接受手术治疗后生存率较中青年低[4]，这无疑增加了甲状腺癌的治愈难度，因此持续探索更适合的治疗方案以缩小这种治疗差异，减少预后不良[5]，同时增加甲状腺癌治愈率是现阶段甲状腺癌治疗领域，甚至于其他肿瘤治疗中亟待解决的关键问题。……