| Specialty:TCM of Clinical BaseAuthor:Suhui CHENTutor:Changsong LINObjectiveTo observe the clinical symptom,physical sign and laboratory index of DangGuiLiuHuangTang for treated Graves aiming to approaching the curative effect and safety by the clinical experiment which adopted the randomized controlled trial.MethodsCollected 70 cases that had diagnosed as Graves disease in the internal hormone special department of Taiwan university affiliated hospital diagnosed as syndrome of hyperactivity of fire due to deficiency of YIN in TCM, which treated in the MingShi clinic department of Taibei from January 2009 to November 2009. Randomly divided into treatment group and control group at 1: lratio. Each group was 35cases. Combination DangGuiLiuHuangTang and tapazol were treated for treatment group. Control group used tapazol. DangGuiLiuHuangTang was composed with angelica root 9g.,rehmannia root 15 g.,prepared rehmannia root 15 g.,baical skullcap root 9 g.,coptidis rhizome 9 g.,milkvetch root30 g. one doses a day, and one time in every morning and evening for PO. And the patient was used with tapazol, PO.10mg, once a time, and 3times a day. The course of the treatment was 60 days. When to the control group, the patient was only used with tapazol as the treatment group. After a course of the treatment, the clinical symptom,physical sign,laboratory index,curative effect and safety were observed.At the end of the clinical research, clinical data was collected, and database was set up with the software of Epi Data3.01. The statistical analysis was used with the software of SPSS17.0. The classification data was observed usingχ2 test and the ranked data by Wilcoxon rank-sum test. Independent t-test or Wilcoxon rank-sum test was applied for group comparison. Matched t-test or Wilcoxon matched-rank-sum test was applied for self-AP:PA comparison. All the statistical graph were drew by the software Grapad Prism4.03.Results1. The curative effect of graves disease:In the treatment group, the clinical control rate was 34.3%. The excellence rate was 37.1% and the effective rate was 20.0%. The total effective rate was 91.4%. While in the control group, the clinical control rate was 22.9%. The excellence rate was 37.1%and the effective rate was 22.9%. The total effective rate was 82.9%. The total effective rate of the treatment group was higher than that of in the control group. There was statistical significance between two groups (P<0.01)2. The curative effect on symptom:In the treatment group, the clinical recovery rate was 42.9%. The excellence rate was 37.1% and the effective rate was 17.1%. The total effective rate was 97.1%. While in the control group, the clinical recovery rate was 22.9%, the excellence rate was 31.4% and the effective rate was 25.7%. The total effective rate was 80.0%. The total effective rate of the treatment group was higher than that of in the control group. There was statistical significance between two groups (P<0.05).3. The extenuation situation of single symptom or physical sign:The treatment has better effect on relieving the cardiopalmus,fast resting pulse rate,restlessness,colliquative sweating,frequently stool,sleepless and more dream,weary,hypodynamia,dry mouth than the single used tapazol group (P<0.05). There was no significantly difference between two groups on relieving thyromegaly,exophthalmos,emaciation,chatter,polyphagia and amnesia.4. The situation of symptom scores changed:the treatment group and the control group both can effectively decrease clinical symptom scores (P<0.01), but the treatment group better than the control group, and there was significantly difference between two groups (P<0.05). It was concluded that DangGuiLiuHuangTang has the effect of nourishing qi to generate fluid,purging pathogenic fire,stopping sweat. Just because of aiming directly at improving pathogenic fire derived from stagnation of liver-QI and asthenic yin causing excessive pyrexia, there could have the better effect on advance the quality of the patients. 5. The improved situation of thyromegaly:By the self-AP:PA test, the treatment group and the control group both can effectively decrease thyromegaly scores (P<0.01), there was significantly difference between two groups (P<0.01).It was presented that combined with DangGuiLiuHuangTang and tapazol has more important effect on contracting the swell thyroid and recovering the physiological function of thyreoid.6. The improved situation of the Graves exophthalmos symptom:By the self-AP:PA test, the treatment group and the control group both can effectively decrease the Graves exophthalmos symptom score (P<0.01), there was significantly difference between two groups (P<0.01). It was presented that combined with DangGuiLiuHuangTang and tapazol has effect on improving the Graves exophthalmos symptom and preventing aggravation.7. The improved situation of the level of thyroid hormone:By the self-AP:PA test, the treatment group and the control group both can effectively decrease T3,T4,FT3,FT4 (P<0.05). But the treatment group better than the control group. It was presented that combined with DangGuiLiuHuangTang and tapazol has effect on improving the function of thyroid.8. There was one case had medicine rash in the treatment group. There was no case appeared adverse effect such as aleucocytosis and liver functional lesion and so on. While there was 5cases aleucocytosis,5 cases medicine rash and 6cases liver functional lesion in the control group. It was evidenced that the treatment group was better than the control group on decreasing the drug side effect. ConclusionIt was concluded that combined with DangGuiLiuHuangTang and tapazol has the certain curative effect for treating the Graves disease which belonged type of hyperactivity of fire caused by deficiency of YIN, for effectively controlling the clinical symptom and improving the function of thyroid. Combined with DangGuiLiuHuangTang and tapazol for treating the Graves disease has little side effect, which was worth for further development. Combined with DangGuiLiuHuangTang and tapazol for treating the Graves disease has better improving effect on the level of thyroid hormone than the western medicine used only. During the treatment, Combined with DangGuiLiuHuangTang and tapazol for treating the Graves disease has little effect on the blood routine test,liver-renal function, which was a safe way for taking medicine played the preponderance of integrated traditional and western medicine, was worth for the further development.
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