【作者】 林鸿国；

【导师】 黄学阳；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2005， 硕士

【摘要】 背景与目的: 结节性甲状腺疾病是常见的内分泌病,其发病率为4%-8%,一般而言,女性患病率高于男性,男女比例从1:1.2到1:4.3不等。甲状腺良性结节是多发病、常见病,并存在着一定的恶变率,故手术切除仍是治疗甲状腺结节的主要手段。但术后如何促进机体恢复、缩短住院时间的研究则几乎是空白,本研究通过回顾性总结,对广东省中医院外一科甲状腺良性结节病人围手术期中医辨证进行分析,探讨证候规律,以指导临床实践。 方法: 通过病历资料的收集,将符合纳入标准的102例患者于手术前、术后第一天、术后第三天对相关症状、体征、舌象、脉象、血常规、甲功、肝功进行记录,并及时进行电脑录入,以统计软件SPSS13.0进行聚类分析及相关统计,并咨询专家以总结甲状腺良性结节围手术期中医辨证规律。 结果: 1.通过聚类分型,术前分为两型,即气滞痰凝型(85例)、痰瘀互结型(17例);术后第一天分为两型,分别为风热夹湿型(52例)、风邪外侵夹瘀型(50例);术后第三天分为三型,即正常者(59例)、风热欲解犁(7例)、风邪外侵夹瘀型(36例)。 2.肉瘿的发病与年龄、性别、情志因素相关。 3.性别、诊断、病程、情志对证型的分布影响不大(各P>0.05) 4.术前及术后各分型的白细胞及中性粒比例、异常的甲功、异常的胆红素无明显差异(各P>0.05)。 结论: 术前分型以气滞痰瘀为主,术后分型以外感风热为主。中医治疗术前以理气化痰、活血化瘀为法,术后以解表利咽为法。更多还原

【Abstract】 BACKGROUD and OBJECTIVE:Tubercular thyroid disease is the common incretion disease. The incidence of disease is 4%~8%. The rate from B ultrasonic diagnosis is 40%~50%. Generally, the female incidence of disease is higher than male. The comparison between male and female is from 1:1.2 to 1:4.3.Thyroid positive tubercle is familiar. But it can become malignant possibly. The main therapy of thyroid tubercle is operation. After the operation, the study that how to promote the physical instauration and shorten the time of hospitalization is blank almost. It accumulated abundant experience of treating with syndrome differentiation of TCM on thyroid tubercle in the period of operation in No. 1 Surgery Department in Guangdong Province Hospital of TCM.METHODS:We reviewed 102 cases history of the patients who matched inclusion criteria and exclusion criteria. The data includes symptom, sign, tongue picture, pulse condition, blood regulations, thyroid function, liver function, kidney function. After the data inputted the computer, it would been done consistency analyse and related statistics with SPSS13. 0.RESULTS:1. After consistency analyse, there are 2 types of the treatment by syndrome differentiation before operation: sluggishness of qi and phlegm stagnancy, phlegm stagnancy complicated with blood stasis. There are 2 types of the treatment by syndrome differentiation in the first day after operation:wind-heat complicated with dampness, wind-evil encroachment complicated with blood stasis. There are 2 types of the treatment by syndrome differentiation in the third day after operation:normalcy, wind-heat dismissing, wind-evil encroachment complicated with blood stasis.更多还原