亚急性甲状腺炎超声特征与中医证型相关性评价
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R581.4

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Evaluation ofthe Correlation between UltrasonicCharacteristicsAnd Chinese Medicine Syndromes in Patients with Sub-acute Thyroiditis
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    摘要:

    目的:探讨亚急性甲状腺炎超声特征与中医证型的相关性。方法:将甲状腺穿刺活检确诊为亚急性甲状腺炎的65例患者纳入研究,对患者实施中医辨证和超声(超声弹性成像)检查,观察不同中医证型患者的超声表现,并对患者的超声检查图像进行分级,比较不同超声分级患者的中医证型。结果:中医证型以风热痰凝证为主,风热痰凝证与肝郁气虚证比较,差异有统计学意义(χ2=4.680,P=0.031)。风热痰凝证与气阴两虚兼痰凝证比较,差异有统计学意义(χ2=8.613,P=0.003)。患者主要超声表现包括甲状腺肿大、片状低回声区、低回声区周围有丰富血流信号、甲状腺上动脉峰值流速>40 cm/s。风热痰凝证各超声表现与气阴两虚兼痰凝证比较,差异有统计学意义(P<0.05);风热痰凝证甲状腺肿大、片状低回声区与肝郁气虚证比较,差异有统计学意义(P<0.05)。风热痰凝证各超声表现(除甲状腺肿大外)与气阴两虚兼痰凝证比较,差异有统计学意义(P<0.05)。超声弹性成像分级Ⅱ级构成比与0级比较,差异有统计学意义(χ2=15.577,P=0.000);Ⅱ级构成比与Ⅰ级比较,差异有统计学意义(χ2=5.969,P=0.015);Ⅱ级构成比与Ⅲ级比较,差异无统计学意义(χ2=1.851,P=0.174);Ⅱ级构成比与Ⅳ级比较,差异无统计学意义(χ2=2.459,P=0.117)。不同超声弹性成像分级中医证型分布情况比较,0级:风热痰凝证与肝郁气虚证比较,差异有统计学意义(χ2=4.800,P=0.028);Ⅱ级:风热痰凝证与肝郁气虚证、气阴两虚兼痰凝证比较,差异有统计学意义(χ2=7.765,6.017,P=0.005,0.014);Ⅳ级:风热痰凝证与肝郁气虚证、气阴两虚兼痰凝证比较,差异有统计学意义(χ2=7.337,5.250,P=0.007,0.022);其他证型两两比较,差异无统计学意义(P>0.05)。结论:亚急性甲状腺炎患者的超声特征与中医证型存在密切联系,不同中医证型患者的超声表现存在明显差异,不同超声弹性成像分级患者的中医证型分布也存在明显差异,而超声弹性成像分级更高。

    Abstract:

    Objective:To discuss the correlation between ultrasonic characteristics and Chinese medicine syndromes in patients with sub-acute thyroiditis.Methods:A total of 65 patients with sub-acute thyroiditis diagnosed by thyroid biopsy were included in the study,and were examined by Chinese medicine syndrome differentiation and ultrasound(ultrasound elastography).The ultrasonic manifestations of patients with different Chinese medicine syndromes were observed and the ultrasonic examination images of them were graded and at last the Chinese medicine syndromes of patients at different grades of ultrasound were compared.Results:The Chinese medicine syndrome were mainly the syndrome of wind-heat and phlegm coagulation;there was significant difference in the comparison between the syndrome of wind-heat and phlegm coagulation and the syndrome of liver depression and qi deficiency(χ2=4.680,P=0.031).There was significant difference in the comparison between the syndrome of wind-heat and phlegm coagulation and the syndrome of deficiency of both qi and yin combined with phlegm coagulation(χ2=8.613, P=0.003).The main ultrasonic manifestations of the patients included goiter,lamellar hypoechoic area,abundant blood flow signals around the hypoechoic area,and the peak flow rate of the superior thyroid artery over 40 cm/s.There was significant difference in the comparison of each ultrasonic manifestation between patients with the syndrome of wind-heat and phlegm coagulation and those with syndrome of deficiency of both qi and yin combined with phlegm coagulation(P<0.05).There was significant difference in the comparison of goiter and lamellar hypoechoic area between patients with the syndrome of wind-heat and phlegm coagulation and those with syndrome of liver depression and qi deficiency(P<0.05).There was significant difference in the comparison of each ultrasonic manifestation(except for goiter)between patients with the syndrome of wind-heat and phlegm coagulation and those with syndrome of deficiency of both qi and yin combined with phlegm coagulation(P<0.05).There was significant difference in the comparison between proportion of ultrasound elastography of grade and the grade 0(χ2=15.577, P=0.000).There was significant difference in the comparison between proportion of grade and the grade (χ2=5.969,P=0.015).There was no significant difference in the comparison between proportion of grade and the grade (χ2=1.851,P=0.174).There was no significant difference in the comparison between proportion of grade and the grade (χ2=2.459,P=0.117).In terms of the comparison of the distribution of Chinese medicine syndromes with different ultrasound elastography grades,at grade 0,there was significant difference between syndrome of wind-heat and phlegm coagulation and syndrome of liver depression and qi deficiency(χ2=4.800,P=0.028);at grade ,there was significant difference between syndrome of wind-heat and phlegm coagulation and syndrome of liver depression and qi deficiency as well as syndrome of deficiency of both qi and yin combined with phlegm coagulation(χ2=7.765, 6.017, P=0.005, 0.014); at grade , there was significant difference between syndrome of wind-heat and phlegm coagulation and syndrome of liver depression and qi deficiency as well as syndrome of deficiency of both qi and yin combined with phlegm coagulation(χ2=7.337,5.250,P=0.007,0.022).Pairwise comparison of other syndrome types showed no statistical significance(P>0.05).Conclusion:The ultrasonic characteristics are closely related to Chinese medicine syndromes in patients with sub-acute thyroiditis.The ultrasonic manifestations of patients with different Chinese medicine syndromes are significantly different,and the distribution of Chinese medicine syndromes of patients with different ultrasound elastography grades is also significantly different,while the ultrasound elastography grading is higher.

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林红霞,周微霞.亚急性甲状腺炎超声特征与中医证型相关性评价[J].新中医,2020,52(1):56-59

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  • 在线发布日期: 2020-01-06
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