Clinical Observation Of "Jianjiaping" Cream For Treating Qi Stagnation And Blood Stasis Type Benign Non-toxic Thyroid Nodules

[Objectives]To evaluate the clinical therapeutic effect about the external application of"Jie jia ping" paste on the theory of promoting blood circulation and removing blood stasis in the treatment of stagnation of vital energy,blood stasis and phlegm coagulation type of benign nontoxic thyroid nodules.To obtain the effective traditional Chinese medicine external treatment of the disease,and guide the clinical treatment and medication.[Methods]1.From November 2013 to April 2017,selected 44 endocrine outpatients with stagnation of vital energy,blood stasis and phlegm coagulation type of benign nontoxic thyroid nodules in Dongzhimen Hospital of Beijing University of Chinese Medicine,according to the Diagnosis of traditional Chinese medicine and Western Medicine.2.The study was randomly divided into treatment group(n=22)and control group(n=22).Based on the primary treatment of the two groups,the treatment group was treated with "Jie jia ping" paste external application combined with TCM "Jie jia decoction"orally,and the control group was given TCM "Jie Jia decoction" orally.After treatment for 6 months,analyze the change of the scores of TCM symptoms and signs,the maximum diameter of largest nodules from the left and right lobes,the numbers of nodules and the malignant risk scores of the two groups before and after treatment.To compare the superior efficiency of combined internal and external treatment and internal treatment,and evaluate the clinical therapeutic effect about the external treatment of "Jie jia ping" paste.[Resultd]1.General data comparisonThere was no statistical difference between the two groups before treatment in general data(including gender,age,course of disease,family history of thyroid disease,the maximum diameter of largest nodules,the scores of TCM symptoms and signs,the malignant risk scores of nodules)(P>0.05).2.Analysis on the scores of TCM symptoms and signsThe scores of TCM symptoms and signs after treatment were significantly different compared with before treatment(P<0.01)in the treatment group and the control group.There was no statistical difference in the scores after treatment between the two groups(P>0.05),but statistical difference in the integral difference before and after treatment(P<0.05).3.Analysis on the maximum diameter of largest nodules and the numbers of nodulesThere was no statistical difference in the largest nodule diameter after treatment compared with before treatment(P>0.05)in the two groups.There was no statistical difference in the largest nodule diameter between the two groups after treatment(P>0.05).There was no statistical difference in the diameter difference of the largest nodules between the two groups before and after treatment(P>0.05).Also there was no statistical difference in the number of nodules between the two groups after treatment(P>0.05).4.Analysis on the malignant risk scoresThe malignant risk scores after treatment were significantly different compared with before treatment(P<0.01)in the treatment group.There was no statistical difference in the malignant risk scores after treatment compared with before treatment(P>0.05)in the control group.There was a statistical difference between the two groups in the malignant risk score after treatment(P<0.05).5.Analysis on curative effectAccording to the criterion of symptoms and signs,the total effective rate was 72.73%in the treatment group,clinical cure in 0 case,markedly effective in 0 case,effective in 16 cases,and ineffective in 6 cases.The total effective rate was 40.91%in the control group,clinical cure in 0 case,markedly effective in 0 case,effective in 9 cases,invalid in 13 cases.There was statistical difference in the total effective rate between the two groups(P<0.05).According to the criterion of thyroid ultrasonography,the total effective rate was 22.73%in the treatment group,clinical cure in 0 case,markedly effective in 4 cases,effective in 1 cases,and ineffective in 17cases.The total effective rate was 13.64%in the control group,clinical cure in 0 case,markedly effective in 1 case,effective in 2 cases,invalid in 19 cases.There was no statistical difference in the total effective rate between the two groups(P>0.05).6.Analysis on the safety indexThe thyroid function(FT3,TT3,TT4,TSH),liver function(ALT,AST)and renal function(Scr,BUN)after treatment were not statistical different(P>0.05)compared with before treatment in the treatment group and the control group.[Conclusions]In the treatment of stagnation of vital energy,blood stasis and phlegm coagulation type of benign nontoxic thyroid nodules,both two groups made great significant curative effect in the improvement of symptoms and signs.Compared with the internal treatment,the curative effect of internal and external therapies is better.The size of the nodules remained stable and no growth was observed after treatment for six months in two groups.The combination of internal and external treatment can reduce the risk of malignant nodules,and the internal treatment can not.On the whole,it makes certain clinical curative effect of external treatment of "Jie jia ping" paste in the improvement of symptoms and signs and reducing the risk of malignant nodules.And the treatment is safe and reliable,worthy of clinical promotion and in-depth study.