【作者】 崔鹏；

【导师】 高天舒；

【作者基本信息】 辽宁中医药大学 ， 中西医结合临床， 2007， 硕士

【摘要】 目的测定常用软坚散结中药及复方的碘含量。方法从大量古今文献中筛选常用于治疗瘿病的软坚散结中药及复方，碱灰化法消化固体饮片，常规水煎中药及复方煎剂，采用中华人民共和国卫生部行业标准规定的方法：砷铈催化分光光度法。同一标本连续测定三次，取平均值。结果海藻饮片碘含量682.46 ug／kg，煎剂碘含量1951.75 ug／L；昆布饮片碘含量794.6ug／kg，煎剂碘含量1760.85 ug／L；黄药子饮片碘含量4.69 ug／kg，煎剂碘含量54.24 ug／L；海藻玉壶汤碘含量1951.75 ug／L；除去海藻、昆布、海带的海藻玉壶汤碘含量51.39 ug／L；消瘿瘤汤碘含量3829.50 ug／L。结论海藻、昆布为碘含量丰富的中药即富碘中药，海藻玉壶汤、消瘿瘤汤为富碘复方。目的观察富碘复方（海藻玉壶汤）和非富碘复方（调甲平）对瘿病大鼠甲状腺功能和形态的影响及比较研究。方法复制瘿病大鼠模型，设正常对照组、模型对照组、单纯碘过量组、海藻玉壶汤组、调甲平组。观察各组大鼠甲状腺相对重量、血清TT₃、TT₄、TSH、r-T₃、甲状腺中的TT₃、TT₄、甲状腺滤泡上皮细胞高度、滤泡腔面积以及光学显微镜、透射电镜下甲状腺形态的变化。结果予海藻玉壶汤28天，甲状腺相对重量、血清TT₄、TSH、r-T₃、甲状腺中TT₃与正常对照组无显著差异，血清TT₄、r-T₃、甲状腺中TT₃高于模型对照组水平，甲状腺相对重量、血清TSH低于模型对照组水平，与模型对照组有显著差异。血清TT₃、甲状腺中TT₄、甲状腺滤泡腔面积高于正常水平。甲状腺滤泡上皮细胞高度低于正常水平，血清TT₃、甲状腺中TT₄、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组和模型对照组均有显著差异。处理因素28天，调甲平组甲状腺相对重量、TSH、甲状腺滤泡上皮细胞高度、滤泡腔面积与正常对照组无显著差异，与模型对照组有显著差异。血清TT₄、r-T₃、甲状腺中TT₃、TT₄低于正常对照组水平，高于模型对照组水平，与正常对照组和模型对照组均有显著差异。血清TT₃与正常对照组有显著差异，与模型对照组无显著差异。（P＜0.05）结论治疗瘿病的疗效，海藻玉壶汤优于单纯碘过量组，调甲平使甲状腺肿恢复完全，甲状腺功能（除TSH外）恢复不完全，缺乏治疗更长治疗时间的比较。高天舒教授认为瘿病包括阳瘿和阴瘿，阳瘿分为肝气郁结型，气滞血瘀型，肝火旺盛型，心肝火盛、肝肾阴虚型，肝阳上亢型：阴瘿分为肝气郁结型，肝郁脾虚型，脾气虚弱型，脾肾阳虚型，阳虚水泛型。临床上从肝脾肾论治，能明显降低甲状腺自身免疫抗体水平，对患者甲状腺激素水平起到双向调节作用，疗效显著。高天舒教授指出“夫治瘿病者，上工治肝，中工治脾，下工治肾”。更多还原

【Abstract】 Objective: To mensurate the content of iodine in herbal medicine and compound prescription used in softening hard mass and disintegrating masses o Method: selected herbal medicine and compound prescription from masses of literature in all times, which were used in curing goiter, digestion fixed the herb of small pieces Alkali-ash method, decocted herbal medicine and compound prescription routinely, using People’ s Republic of China medicaldepartment’ professionstandard’ stipulation: Arseniccerium catalysis spectrophotometric method. The same sample was mensurated three times, we chose the average. Result: the content of iodine in algae (herb of small pieces)was 682.46 ug/kg, while the result in decoction was 1951.75 ug/L; the content of iodine in kunbu (herb of small pieces)was 794.69 ug/kg, while the result in decoction was 1760.85 ug/L; the content of iodine in huangyaozi (herb of small pieces)was 4.69 ug/kg, while the result in decoction was 54.24 ug/L; the content of iodine in the decoction of haizaoyuhu was 1951.75 ug/ kg;but the result in haizaoyuhu decoction was 51.39 ug/h with the exception of algae、kubu、haidai; the content of iodine in the decoction of xiaoyingliu was 3829.50ug/kg. Conclusion: Algae and Kubu were full of iodine in herbal medicine, as well as the decoction of haizaoyuhu and the decoction of xiaoyingliu in compound prescription.Key words: softening hard mass and disintegrating masses; herbal medicine; compound prescription; the content of iodine Objective: To study the effect of Tiaojiaping on thyroid function and morphology in goiter Wistar rats due to iodine deficiency.Methods: Replicated Iodine-deficient Wistar rats and divided into 4 groups: normal group, model group, iodine excess group, Haizaoyuhutang group, Tiaojiaping group. Observed various outcome in each group, including the relative thyroid weight, serum TT3、TT4、TSH、rT3, thyroid TT3、TT4, the height of thyrocytes, the areas of thyroid follicular cavities and the thyroid morphological changes under optical microscope. Results: Giving the processing factor 28 days later, therelative thyroid weight、TSH、the height of thyrocytes and the areas of thyroid follicular cavities had no discrepancies in both Tiaojiaping group and the normal group, but there was obviously discrepancies in Tiaojiaping group and the model group. serum TT4、r-T3 and thyroid TT3、TT4 values inTiaojiaping group were obviously lower than normal group, obviously higher than model group, serum TT3 had obviously discrepancies in both Tiaojiaping group and the normalgroup, but no discrepancies existed in Tiaojiaping group and the model group(P＜0.05). Conclusion: Tiaojiaping results in the goiter in iodine deficiency Wistar rats completely recover, but the thyroid function(except TSH) does not completely recover. It lacks comparison with long therapy. Objective: Professor Gao(Gaotianshu) think that goiter can be divide into two kinds Yang goiter and Yin goiter. The former one can be divide into Liver-Qi stagnation; Stagnation of Qi and blood; Liver-fire bloom; Excess-fire in the liver-heart; Deficiency-Ying in the liver-kidney; Hyperactivity of liver-Yangand the later one can be divided into Liver-Qi stagnation; Liver-Qi stagnation and spleen-Qi deficiency; Spleen-Qi deficiency; Deficiency-Yang in the Spleen-kidney: Flood due to deficiency-Yang. If Bianzheng Lunzhifrom liver, spleen and kidney is used in clinic, the level of self-immunity antibody in thyroid gland could be reduced obviously and there will be double-effect to the level of the patient’ s goiter hormone, and the curative is observably. Professor Gaopoint out: To treat goiter, the best doctor treat Liver;the better one treat spleen and the common one treat kidney.更多还原