王柔钧 朱燕

摘要： 目的 觀察引药入肺兼扶正自拟方治疗良性甲状腺结节的临床疗效。方法 选择良性甲状腺结节患者 80例，采用非随机对照研究，根据患者意愿按就诊次序分为观察组及对照组，每组各40例。对照组患者口服小剂量左甲状腺钠片治疗，观察组患者服用引药入肺兼扶正自拟方，12周为1个疗程，连服2个疗程随访。结果 观察组在经过治疗后，其临床总有效率为70%，显著高于对照组的20%，差异有统计学意义（P<0.05）;观察组治疗后，中医症状总积分较治疗前显著下降（P<0.05），对照组总积分改善不明显，差异无统计学意义（P>0.05），2组间比较，差异有统计学意义（P<0.05）;观察组治疗后最大结节直径较治疗前缩小（P<0.05），而对照组无明显变化（P>0.05），且观察组直径小于对照组（P<0.05）;2组治疗后肝肾功能、血常规均无异常，也未发生胃肠道等不良反应。结论 引药入肺兼扶正自拟方治疗良性甲状腺结节安全有效，值得临床推广。

关键词： 良性甲状腺结节;引药入肺兼扶正自拟方;临床研究

中图分类号：R581   文献标志码：B   文章编号：1007-2349（2021）08-0041-04

Clinical Observation on the Treatment of Thyroid Nodules by Introducing Medicine into the Lung with Self-made Prescription for Strengthening Body Resistance

WANG Rou-jun， ZHU Yan

（Traditional Chinese Medicine Hospital of Kunming City， Kunming 650011， China）

【Abstract】Objective： To observe the clinical effect of introducing medicine into the lung with self-made prescription for strengthening body resistance in treating benign thyroid nodules. Methods： 80 patients with benign thyroid nodules were selected and a non-randomized controlled study was adopted. According to the wishes of the patients， they were divided into an observation group and a control group， 40 cases per group. The patients in the control group were treated with low-dose left thyroid sodium tablets and the patients in the observation group were treated with the introduction of the medicine into the lung and the self-made prescription for strengthening body resistance. 12 weeks was a course of treatment and the patients were followed up 2 courses later. Results： After treatment， the total clinical effective rate of the observation group was 70%， which was significantly higher than 20% of the control group. The difference was statistically significant （P<0.05）. After treatment， the total score of TCM symptoms of the observation group decreased significantly than the prior treatment （P<0.05）， but the total score of the control group did not improve significantly， and the difference was not statistically significant （P>0.05）. The difference between the two groups was statistically significant （P<0.05）. The largest nodule in the observation group reduced after treatment and the diameter was smaller than the prior treatment （P<0.05）， while the control group had no significant change （P>0.05）. The observation group had a smaller diameter than the control group （P<0.05） and there was no abnormality in liver and kidney function and blood routine in the two groups after treatment and also no adverse reactions such as gastrointestinal tract. Conclusion： The introduction of the medicine into the lungs with the self-made prescription for strengthening body resistance is safe and effective for the treatment of benign thyroid nodules and worthy of clinical application.

【Key words】Benign Thyroid Nodules; Introducing Medicine into the Lung with Self-Made Prescription for Strengthening Body Resistance; Clinical Research

甲状腺结节，不管是单发还是多发，是临床常见的一种因甲状腺局部异常增生引起的散在性病变。在对正常人常规体格检查进行临床甲状腺触诊时，甲状腺结节的发现率约为5%，在对一般人群进行高分辨率甲状腺超声检查时，甲状腺结节的发现率约为60%[1-2]。虽然大多数结节是良性的不生长，但是有些结节逐渐变大并有症状。有些病人可能会感到脖子、下巴疼痛或者对耳朵和美容的不良影响，影响外表及其社交。如果不治疗，会有一些病人甚至可能出现呼吸、吞咽困难，声音沙哑等，使生活质量下降。患者及医生最关心的问题是如何尽可能快速、有效、经济地治疗治疗甲状腺结节，减少不必要的甲状腺手术。中医中药具有多成分，其具有多靶点的作用机制。近两年笔者采用引药入肺兼扶正自拟方治疗良性甲状腺结节，取得了较好的疗效。……