Clinical Observation Of Modified Prunella Vulgaris Decoction Combined With Sanhuang Ointment In Treating Benign Thyroid Nodules With Qi Stagnation And Phlegm Obstruction

Objective: This study mainly observed the clinical effect of Xiakucao decoction combined with Sanhuang Ointment in the treatment of benign thyroid nodules of qi stagnation and phlegm stagnation type,and discussed the advantages of the two drugs in the treatment of benign thyroid nodules of qi stagnation and phlegm stagnation type,so as to provide more sufficient theoretical basis for the prevention and treatment of benign thyroid nodules with traditional Chinese medicine.Methods: 120 patients who met the inclusion and exclusion criteria from January 2019 to January 2021 were randomly divided into blank control group,Sanhuang Ointment group,traditional Chinese medicine group and combined group,30 cases in each group.The patients in the control group were not given any drug treatment.They were told to adjust their diet,relax their emotions,avoid fatigue and exercise,Sanhuang Ointment group was given external application of Sanhuang Ointment 1g / d,applied to thyroid nodules every night,and cleaned in the morning of the next day,The traditional Chinese medicine group was given Xiakucao Decoction 200 ml / time,twice a day,half an hour after breakfast and dinner,The combined group was given Xiakucao Decoction and Sanhuang Ointment(Xiakucao Decoction and Sanhuang Ointment were used in the same way as the traditional Chinese medicine group and Sanhuang Ointment group).After 3 courses of treatment,the changes of TCM symptom score,curative effect,thyroid function(TSH,TT3,TT4,FT3,FT4,TPOAb,TGAb),maximum transverse diameter of thyroid nodules in color Doppler ultrasound and curative effect of maximum transverse diameter of thyroid nodules in color Doppler ultrasound were compared.Spss25.0 software was used for data processing,P ≤ 0.05 was statistically significant.Results:(1)There was no significant difference in the general data of sex,age,course of disease,education,occupation and BMI between the four groups before treatment(P>0.05).(2)The improvement of TCM syndrome score in blank control group was not obvious(P>0.05),and the improvement of TCM syndrome score in Sanhuang ointment group,Chinese medicine group and combined group was significant(P<0.05).(3)After treatment,the curative effect of TCM syndromes in four groups was statistically significant(P<0.05).The total effective rate was 3.45% in blank control group,20.69% in Sanhuang ointment group,58.62% in traditional Chinese medicine group and 82.76% in combined group.After treatment,there was no significant difference in total effective rate between Sanhuang ointment group and blank control group(P>0.05),significant difference in total effective rate between traditional Chinese medicine group and combined group and Sanhuang ointment group(P<0.05).The combined group was superior to the traditional Chinese medicine group(P<0.01).(4)After treatment,except for the obvious improvement(P<0.01)of cervical nodule swelling in the single TCM syndrome score of Sanhuang ointment group,the change of the remaining single TCM syndrome score was not significant(P>0.05).Except for the improvement of stool viscosity in the single TCM syndrome score of traditional Chinese medicine group and combined group(P<0.05).Sanhuang ointment group,traditional Chinese medicine group and combined group after treatment,compared with Sanhuang ointment group,the traditional Chinese medicine group and the combined group improved significantly with mood fluctuation,neck sensation distention,chest and flank pain,good breath,chest tightness,phlegm in pharynx,pharynx obstruction,epigastric distention(P<0.05),the traditional Chinese medicine group and the Sanhuang ointment group improved significantly better than the Sanhuang ointment group(P>0.05),the combined group in improving the patients with cervical nodule swelling(P<0.01).The traditional Chinese medicine group and the combined group after treatment,in the improvement of Qi stagnation phlegm obstruction type benign thyroid nodule patients except the neck nodule swelling has the difference(P<0.05),the other single Chinese medicine syndrome aspect curative effect is quite(P>0.05).(5)There were no significant changes in thyroid function(TSH,TT3,TT4,FT3,FT4,TPOAb,Tg Ab)in all four groups after treatment(P>0.05).(6)The maximum transverse diameter of the nodules in the four groups was reduced in varying degrees(P<0.05)compared with that in the blank control group.Compared with the blank control group,the nodules in the Sanhuang ointment group,the traditional Chinese medicine group and the combined group were more significantly reduced(P<0.01).After treatment,the Sanhuang ointment group and the traditional Chinese medicine group had the same curative effect(P>0.05)in reducing the maximum transverse diameter of the nodules in the benign thyroid nodules with Qi stagnation and phlegm obstruction,combined group was better than Sanhuang ointment and traditional Chinese medicine group(P<0.01).(7)After treatment,the maximum transverse diameter of thyroid nodules in four groups was different(P<0.05).The overall effective rates of the four groups were 3.45% in blank control group,48.28% in Sanhuang ointment group,55.17% in traditional Chinese medicine group and 82.76% in combined group.The total effective rate of maximum transverse diameter of nodules was higher(P<0.05)in Sanhuang ointment group,traditional Chinese medicine group and combined group than in Sanhuang ointment group and traditional Chinese medicine group(P<0.05).Conclusion: Simple Xiakucao Decoction and external application of Sanhuang Ointment can effectively reduce the maximum transverse diameter of thyroid nodules in patients with benign thyroid nodules of qi stagnation and phlegm obstruction type,and improve the clinical symptoms of patients.The combined effect of the two is better,and the clinical application is safe.