| Objective:To observe the clinical effects in the treatment of Hashimoto’s thyroiditis with thyroid nodule using the combinat ion of the Qi and eliminate gall piece or Selfheal capsule and assess its clinical promotional value;to probe the Etiology and pathogenesis of thyroid nodule and Hashimoto’s thyroiditis;to analyze the internal relations of Hashimoto’s thyroiditis and t hyroid nodule.Methods:In the cases of thyroid specialized subject hospital in Hubei province,they divided 60 patients who were diagnosed o f Hashimoto’s thyroiditis associated with thyroid benign nodule s(phlegm and blood stasis type)into two groups according to the single blind random control method.The treatment group(30 case s):oral elimination gall pieces, each time 4,3 times a day;Self heal capsule,2 pieces at a time,two times a day;Control group(30 cases):oral Euthyrox pieces,each time 25μg-50μg,1 times a d ay;12 weeks for one period of treatment,continuous observation of two course of treatment.12 weeks and 24 weeks before and aft er the test,using the methods of statistical symptoms scale scores and B ultrasonic examination to have a clinical observation,analyzing the clinical symptoms of the two groups of patients b efore and after the treatment and the improving situation of th yroid size and goiter,the changes of thyroid function and thyro id antibody,and observing the relationship between the nodule s ize and treatment efficacy.Results:1.Efficacy comparison in treatment group and contro l group:In the clinical curative effect comparison,after treatm ent for 24 weeks(two courses),the total effective rate of treat ment group was 93.33%,the control group was 66.66%,compared the two,the difference was statistically significant(p<0.05),treat ment group was superior to control group;TCM symptoms curative effect comparison:Before the treatment of the treatment group a nd control group,there was no statistically significant differe nce in TCM symptoms(p>0.05),it was comparable,and after 12 week s of treatment,the treatment group compared with before treatme nt,oppressed feeling and anterior portion, stay two symptoms im proved significantly(p<0.05),there was no statistically signifi cant difference residual symptoms(p>0.05),the control group com pared with before treatment,the anterior portion oppressed feel ing the symptoms improved significantly(p<0.05),did not see mor e symptoms improved significantly,there was no statistically si gnificant difference(p>0.05),24 weeks after the treatment,the t reatment group and control group compared with before treatment,the difference was statistically significant(p<0.05),all sympto ms comparison between groups,the difference was statistically s ignificant(p<0.05). 2.Before and after treatment of thyroid volume,maximum diameterof the nodule comparison:There was no statistical significance(p>0.05)about the difference in the size of thyroid volume and nodule before the treatment of the two groups;after 12 weeks’ treatment,in the two groups all have different degrees of shrin k on thyroid volume and the size of the thyroid nodule,compared with before treatment,the difference was statistically signifi cant(p<0.05),compared with control group,there was no statistic ally significant difference(p>0.05);after 24 weeks’ treatment,the treatment group compared with before treatment have obvious difference(p<0.01),the control group compared with before trea tment,there were statistically significant differences on thyro id volume(p<0.05).Compared with 12 weeks’ treatment effect,the re was no statistically significant difference(p>0.05),in terms of thyroid nodule size,there was no statistically.significant difference(p>0.05). 3.The comparison before and after the treatment of thyroid func tion and thyroid antibodies(TGAb TPOAb):there was no statistic al significant(p>0.05)horizontal differentiation on thyroid fun ction and thyroid antibodies(TGAb TPOAb) before the treatment o f the two groups,comparable to the two groups after treatment,c ompared with before treatment,no obvious changes in thyroid fun ction,there was no statistically significant difference(p>0.05),after 24 weeks’ treatment,the treatment group compared with th e thyroid antibody levels before treatment,there was statistica lly significant difference(p<0.05),the control group compared w ith before treatment,there was no statistically significant dif ference(p>0.05). 4.Relationships of the Nodule size and the curative effect:after 24 weeks’ treatment,effective rate of nodal diameter<1cm gro up in the treatment group and control group were 88.89% and 62.5% respectively,nodules treatment effective rate of the diamete r between 1-2 in the treatment group and the control group were72.7% and 53.8% respectively,the curative effect of the diamet er of > 2cm nodule in the treatment group and control group wer e 30.0% and 11.1% respectively. 5.The treatment group has no obvious adverse drug reactions,the re was no any abnormality on blood analysis,liver and kidney fu nction and thyroid function.In the control group,there were 2 c ases occurring the symptoms(optimal a music group)of alpitation s and discomfort,the discomfort relieved after adjusting the do sage of drugs.So it is proofed that the combination of the gall elimination piece and Selfheal capsule in the treatment of Has himoto’s thyroiditis with nodules is safe and reliable, no bad reaction.Conclusion:the curative effect by the combination of the ga ll elimination piece and Selfheal capsule in the treatment of H ashimoto’s thyroiditis with benign nodules is exactly sure,it c an significantly improve the clinical symptoms,shrink thyroid v olume and the associated nodules,and reduce antibody titer,has no obvious side effects, and both of them are Chinese patent me dicine,taking convenient,worth clinical promotion. |
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