主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2014, Vol. 37 ›› Issue (7): 467-471.doi: 10.3969/j.issn.1006-2157.2014.07.007

• 临床研究 • 上一篇    下一篇

结节性甲状腺肿中医证候及证候要素的调查研究

吕萌1, 邓卫芳2, 朱赫1, 夏仲元3   

  1. 1 北京中医药大学 北京 100029;
    2 山西中医学院中医外科;
    3 中日友好医院中医外科
  • 收稿日期:2014-03-12 出版日期:2014-07-30 发布日期:2014-07-30
  • 通讯作者: 夏仲元,女,博士,副主任医师,硕士生导师,主要研究方向:甲状腺病、乳腺病的中西医结合临床与研究,E-mail:hongf1111@sohu.com
  • 作者简介:吕萌,女,在读硕士生
  • 基金资助:
    国家中医药管理局中医药标准化项目(No.ZYYS-2009)

TCM syndromes and syndrome factors of nodular goiter

LV Meng1, DENG Wei-fang2, ZHU He1, XIA Zhong-yuan3   

  1. 1 School of Preclinical Medicine, Beijing University of Chinese Medicine, Beijing 100029;
    2 Department of Chinese Surgery, Shanxi University of Traditional Chinese Medicine;
    3 Department of Chinese Surgery, China-Japan Friendship Hospital
  • Received:2014-03-12 Online:2014-07-30 Published:2014-07-30

摘要: 目的 通过流行病学调查了解结节性甲状腺肿的中医证候规律。方法 采用流行病学横断面调查方法,对236 例符合纳入标准的结节性甲状腺肿患者进行病例调查,分析证候及证候要素的分布规律,并对中医证候与年龄、病程、甲状腺B超、甲状腺功能之间的相关性进行分析。结果 结节性甲状腺肿证候中肝郁气滞证比例最大,占40.3%,其次为痰瘀互结证和肝郁脾虚证,分别为27.5%和17.4%。病位主要涉及肝、脾、肾,病机以气滞、痰凝、血瘀为特征。不同的证候组间甲状腺最大结节直径大小差异无显著性(P>0.05)。甲状腺功能气阴两虚证组TSH水平较低,与其他证型比较,差异有统计学意义(P<0.05)。各证候组间年龄差异有统计学意义(P<0.05),肝郁肾虚组年龄最大,肝郁气滞组年龄较小。病程肝郁肾虚组较肝郁气滞、痰瘀互结组长,差异有统计学意义(P<0.05)。结论 结节性甲状腺肿以肝郁气滞、痰瘀互结和肝郁脾虚证最为常见,气滞、痰凝、血瘀为重要病机。

关键词: 结节性甲状腺肿, 中医证候, 证候要素, 临床流行病学

Abstract: Objective To study the laws of TCM syndromes of nodular goiter through epidemiological survey. Methods The cross-sectional method of epidemiological survey was applied for analyzing the distribution laws of TCM syndromes and syndrome factors in 236 patients with nodular goiter who were eligible to internalized standard. The correlation between syndrome types and age, course of disease, outcomes of thyroid ultrasound and thyroid function was studied. Results The syndrome of liver depression and qi stagnation had the highest percentage (40.3%) and second ones were syndrome of binding of phlegm and stasis (27.5%) and syndrome of liver depression and spleen deficiency (17.4%). The syndrome factors related to disease locations were mainly liver, spleen and kidney, and those related to pathogenesis were qi stagnation, phlegm coagulation and blood stasis. The difference in the diameter of the largest thyroid nodule had no significance among different groups (P<0.05). The index of thyroid function-TSH level was lower in group of dual deficiency of qi and yin compared with other syndrome types (P<0.05). The difference in age had statistical significance among different groups (P<0.05), and age of liver depression and kidney deficiency group was the eldest and that of liver depression and qi stagnation group was younger. The course of disease was longer in liver depression and kidney deficiency group than that in liver depression and qi stagnation group and binding of phlegm and stasis group (P<0.05). Conclusion The most common syndrome types of nodular goiter are syndromes of liver depression and qi stagnation, binding of phlegm and stasis and liver depression and spleen deficiency, and its important pathogeneses are qi stagnation, phlegm coagulation and blood stasis.

Key words: nodular goiter, TCM syndromes, syndrome factors, clinical epidemiology

中图分类号: 

  • R259.813