目的 探讨丙硫氧嘧啶联合天王补心丹治疗甲状腺功能亢进患者的治疗效果。方法 选取2018年1月-2019年6月许昌市人民医院收治甲状腺功能亢进患者86例，随机分为对照组和治疗组，每组各43例。对照组患者口服丙硫氧嘧啶片，初始剂量为100 mg/次，3次/d，然后依据患者甲状腺激素水平改变剂量。治疗组在对照组基础上口服天王补心丹，1丸/次，3次/d。两组患者治疗30 d。观察两组患者临床疗效，同时比较治疗前后两组患者中医证候积分，三碘甲状腺原氨酸（FT3）、四碘甲状腺原氨酸（FT4）、促甲状腺激素（TSH）和促甲状腺素受体抗体（TRAb）指标水平，及随访结果情况。结果 治疗后，对照组临床有效率为79.07%，显著低于治疗组的95.35%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组中医证候积分均明显降低（P<0.05），且治疗组降幅明显大于对照组（P<0.05）。治疗后，两组患者FT3、FT4、TRAb的指标均明显下降（P<0.05），而TSH指标则明显上升（P<0.05），且治疗组明显好于对照组（P<0.05）。随访期间治疗组患者的症状控制时间、肝脏损伤时间、TSH指标恢复正常时间均显著短于对照组（P<0.05）。结论 丙硫氧嘧啶联合天王补心丹治疗甲状腺功能亢进患者疗效显著，并改善患者的甲状腺激素水平，同时安全性好。

Objective To investigate the therapeutic effect of Tiangwang BuxinPills combined with prothiouracil in treatment of hyperthyroidism. Methods Patients (86 cases) with hyperthyroidism in Xuchang People's Hospital from January 2018 to June 2019 were randomly divided into control and treatment groups, and each had 43 cases. Patients in the control group were po administered with Propylthiouracil Tablets, the initial dose was 100 mg/time, three time daily, then the dose was changed according to the thyroid hormone level. Patients in the treatment group were po administered with Tiangwang BuxinPills on the basis of the control group, 1 pill/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the TCM syndromes scores, the level of FT3, FT4, TRAb and TSH, and follow up results in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.07% and 95.35% respectively, and there were differences between two groups (P<0.05). After treatment, the TCM syndromes scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the level of FT3, FT4 and TRAb in two groups was significantly decreased (P<0.05), but the TSH level was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the time of liver injury, control symptom and TSH index returned to normal in the treatment group was significantly shorter than those in the control group (P<0.05). Conclusion Tiangwang BuxinPills combined with prothiouracil in treatment of hyperthyroidism has significant curative effect, can significantly improve the level of thyroid hormone with good safety.

R977

河南省科技研发专项项目（172102310044）