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平目汤联合针刺治疗非活动期甲状腺相关眼病的前瞻性随机对照临床试验。

A prospective randomized controlled clinical trial of Pingmu Decoction combined with acupuncture in the treatment of non-active thyroid-related ophthalmopathy.

机构信息

Department of Endocrinology, Longhua Hospital, Shanghai University of Chinese Medicine, Shanghai.

Department of Internal Medicine, 949 Hospital of PLA Army, Altay.

出版信息

Medicine (Baltimore). 2020 Dec 18;99(51):e23734. doi: 10.1097/MD.0000000000023734.

Abstract

BACKGROUND

Thyroid eye disease of orbital disease first, it is main and clinical expression with exophthalmos, visual impairment, serious influence patient's quality of life and beautiful, especially for the non-active Graves' ophthalmopathy, there is no effective treatment methods at home and abroad, for the non-active thyroid eye disease only recommended surgery, but the procedure pain, poor curative effect, postoperative recurrence, most patients are difficult to accept. Pingmu Decoction can effectively reduce the degree of exophthalmus and TCM syndrome integral, and The combination therapy with acupuncture and moxibustion on the basis of Pingmu Decoction has achieved remarkable clinical effect, but the lack of rigorous evidence of evidence-based medicine (ebm). The test is designed to further evaluate flat mesh in active soup combined with acupuncture treatment of thyroid related ophthalmopathy card belongs to the yang qi-deficiency, phlegm and blood stasis block syndrome in patients with clinical efficacy and safety.

METHODS/DESIGN: A prospective, randomized controlled clinical trial will be conducted to evaluate the efficacy and safety of Pingmu Decoction combined with acupuncture in the treatment of non-active thyroid-related eye disease in patients with Yang qi deficiency and phlegm-blood stasis syndrome. A total of 120 patients with non-active thyroid-related eye disease, namely deficiency of Yang qi and blockage of phlegm and blood stasis, are randomly divided into 3 groups and treated for 12 weeks. All three groups will maintain basic western medicine treatment. The primary outcomes are to observe the degree of prominence of eyes, and the TCM syndrome scores. The secondary result is clinical efficacy. Free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), and thyroid stimulating hormone receptor antibody (TRAb)will be used as the observation indicators in this study. In addition, adverse reactions will be observed and recorded as safety indicators.

DISCUSSION

The results of this trial will provide convincing evidence for the efficacy and safety of Pingmu Decoction combined with acupuncture in the treatment of patients with non-active thyroid-associated eye disease with deficiency of Yang qi and phlegm and blood stasis block, and it will expand the treatment options for patients with non-active thyroid-related eye disease.

TRIAL REGISTRATION

Clinical Trials.gov ID: ChiCTR2000039626. Registered on 3 November 2020.

摘要

背景

甲状腺眼病是眼眶疾病的首要疾病,其主要和临床表现为突眼、视力受损,严重影响患者的生活质量和美观,特别是对于非活动期 Graves 眼病,国内外尚无有效的治疗方法,对于非活动期甲状腺眼病仅推荐手术,但手术痛苦、疗效差、术后复发,大多数患者难以接受。平目汤可有效降低突眼度和中医证候积分,在平目汤基础上结合针灸治疗,取得了显著的临床疗效,但缺乏严格的循证医学(EBM)证据。本试验旨在进一步评价平目汤联合针灸治疗甲状腺相关眼病属阳气亏虚、痰瘀阻滞证患者的临床疗效和安全性。

方法/设计:采用前瞻性、随机对照临床试验,评价平目汤联合针灸治疗阳气亏虚、痰瘀阻滞证甲状腺相关眼病非活动期患者的疗效和安全性。共纳入 120 例甲状腺相关眼病非活动期患者,即阳气亏虚、痰瘀阻滞证患者,随机分为 3 组,治疗 12 周。三组均维持基础西药治疗。主要结局观察眼球突出度和中医证候积分。次要结果是临床疗效。游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和促甲状腺激素受体抗体(TRAb)将作为本研究的观察指标。此外,还将观察并记录不良反应作为安全性指标。

讨论

该试验结果将为平目汤联合针灸治疗阳气亏虚、痰瘀阻滞证甲状腺相关眼病非活动期患者的疗效和安全性提供令人信服的证据,并为非活动期甲状腺相关眼病患者的治疗提供更多选择。

试验注册

ClinicalTrials.gov 标识符:ChiCTR2000039626。注册于 2020 年 11 月 3 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00ab/7748212/798bbcfa0820/medi-99-e23734-g001.jpg

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