| Objective:Observe the clinical effect of Jiawei Tianwang Buxin Bolus in the treatment of hyperthyroidism,and explore its mechanism of action in the treatment of hyperthyroidism with heart liver yin deficiency syndrome.Methods:The research objects were 74 patients diagnosed as hyperthyroidism(heart and liver yin deficiency syndrome)in The Third People’s Hospital of Linyi from July 2018 to December 2019.With the consent of the medical ethics Association from the Hospital,74patients were randomly divided into experimental group and control group,and the two groups were treated with different methods.Patients in the control group(n=37)were treated with oral methimazole while the experimental group(n=37)with oral methimazole adding Jiawei Tianwang Buxin Bolus,patients in both groups were examined by blood and B-ultrasound,followed up and recorded the parameters.The main control indexes were the value of serum total thyroxine(TT4)and the rise and fall of thyroid stimulating hormone(TSH)before and after treatment;the changes of serum free triiodothyronine(FT3),serum total triiodothyronine(TT3),thyroid stimulating hormone receptor antibody(TRAb)and serum free thyroxine(FT4)were recorded;meanwhile,the body weight of patients were recorded and analyzed as well as changes in heart rate.Results:(1)There was no significant difference in age before treatment(t=-0.774,P=0.442),course of disease(t=1.737,P=0.087),duration of disease(t=1.737,P=0.087),gender(χ~2=1.138,P=0.286)and TCM syndrome score(P>0.05).(2)There were significant differences in improving TSH,TT4,TT3,FT4,FT3,TRAb and heart rate in the treatment group(P<0.01);There was significant difference in weight gain(P=0.011<0.05).There were significant differences in improving TSH,TT4,TT3,FT4,FT3,TRAb,heart rate and body weight in the control group(P<0.05).In the control group,TT4,TT3,FT4,FT3,TRAb were not reduced to the normal range after two courses of methimazole alone.In addition,Jiawei Tianwang Buxin Bolus combined with methimazole was better than the control group in increasing TSH.The results showed that the effect of Jiawei Tianwang Buxin Bolus combined with methimazole was more obvious than that of oral methimazole alone,and it was more effective to improve the clinical symptoms of hyperthyroidism.(3)After drug treatment,the scores of TCM syndromes such as restless palpitation,irritability,red face,gall swelling,insomnia and dreaminess,dizziness and pulse condition in the two groups decreased with statistical significance(P<0.05).The treatment group was better than the control group in improving TCM syndromes,except for tongue condition,there was no difference between the two groups(z=1.85,P=0.064).(4)After treatment,there are some quantitative differences in clinical efficacy between the treatment group and the control group.In the treatment group,the numbers of markedly effective,effective and ineffective patients were 13,23 and 1 respectively,accounting for 35.14%,62.16%and 2.70%respectively,the total effective rate of the treatment group was 97.30%.At the same time,the number of markedly effective,effective and ineffective patients in the control group were 2,22 and 13,respectively accounting for 5.41%,59.46%and 35.14%respectively,the total effective rate of the control group was 64.86%.The total effective rates of the treatment group and the control group were statistically analyzed,and the result was z=3.16,P=0.002,which means that there was significant difference between the two groups.Conclusions:Jiawei Tianwang Buxin Bolus combined with methimazole in the treatment of hyperthyroidism can significantly reduce the clinical symptoms(palpitations,irritability,etc.)and improve the TCM syndrome score,and the total effect is better than oral methimazole alone,without obvious side effects. |
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