Mr Leung Hoi-wing says that the overall efficacy rate of Chinese medicine treatment of hyperthyroidism is over 80%


梁浩榮講師指中醫藥治療甲亢總有效率逾八成

Traditional Chinese medicine for the treatment of hyperthyroidism


常用於治療甲亢的中藥

Date: 15 Nov 2017 (Wednesday)

Archive

HKBU clinical study finds Chinese medicine treatment of hyperthyroidism to be over 80% effective

浸大臨床觀察顯示中醫藥治療甲亢總有效率逾八成

The School of Chinese Medicine (SCM) recently conducted a clinical study on Chinese medicine treatment of hyperthyroidism. The results indicated that Chinese medicine is effective in improving the symptoms of patients with hyperthyroidism and enhancing their quality of life in general. With its comparative advantage in regulating the immune system, the overall efficacy rate of such treatment is 88.7%.

Hyperthyroidism is a common endocrine disease in which the thyroid gland is overactive and makes more thyroid hormones than the body needs. The excess secretion of the hormone thyroxine speeds up the body’s metabolism, causing many of the body’s functions to speed up, such as the nervous, circulation and digestive systems. Hyperthyroidism symptoms are complex and as the condition is difficult to cure, treatment can be a long process and there is a high recurrence rate.

Hyperthyroidism falls under “goiter” in Chinese medicine. Major symptoms include neck swelling, excessive appetite, emaciation, restlessness, palpitations, intolerance to heat, hyperhidrosis, hand tremors and protruding eyes. From the perspective of Chinese medicine, the pathogenic factors of hyperthyroidism are mainly related to emotion, diet, constitution and inheritance. The pathogenesis of such disease is stagnation of qi which will generate fire, causing consumption of yin and qi, and asthenic yin excessive pyrexia.

Mr Leung Ho-wing, Lecturer I of the SCM Clinical Division at HKBU, conducted a clinical observation of 115 patients who attended HKBU’s Chinese medicine clinics for treatment of hyperthyroidism from May 2013 to April 2017. The study aimed at exploring the incidence of hyperthyroidism in Hong Kong and to assess the curative effect of Chinese medicine treatment on such illness. The 19 male and 96 female patients, with ages ranging from 13 to 66, have been suffering from the disease for periods ranging from a week to 28 years.

According to the principle of syndrome differentiation and treatment in traditional Chinese medicine, Mr Leung classified the patients into six groups, namely deficiency of qi and yin; hepatic stagnation and stagnation of qi; hepatic and renal yin deficiency; asthenic yin excessive pyrexia; excessive hepatopyretic; and stagnation of phlegm and stasis. The findings showed that deficiency of qi and yin, and hepatic stagnation and stagnation of qi were the two major syndromes of hyperthyroidism with a total of 60 clinical cases (52.2%).

Mr Leung explained that according to the different stages (acute phase, remission, recovery period) and constitution of the patients, Chinese medicine prescriptions with the function of eliminating pathogen and supporting vital qi were provided for patients. The course of treatment ranged from one month to 12 months with the key focus of replenishing yin, strengthening qi, alleviating burden on the liver and regulating qi. In general, the observation indicated that the overall efficacy rate of the treatment for hyperthyroidism was 88.7%; 15 patients made a full recovery (13%), 34 patients showed obvious improvement (29.6%), 53 exhibited general improvement (46.1%) while 13 showed no progress (11.3%). The curative rate of the treatment was 42.6%.

According to the observation, 78.3% of the patients were between the ages of 21 and 50. The disorder is more common in women especially those aged between 30 and 40. The results also indicated that family inheritance and emotional disorder are the two major causes of hyperthyroidism. Of the 115 cases, 47 patients had a family history of hyperthyroidism (40.9%); and 72 patients (62.6%) developed hyperthyroidism for the first time or it recurred due to emotional problems or pressure.

Mr Leung explained that the study revealed that the male to female prevalence ratio is one to five. This may be related to tendencies being inherited from the female side of the family and also females being more prone to emotional stress than males. He reminded ladies to pay more attention to their thyroid health, in particular those with a family history and have never developed hyperthyroidism. He added that more and more young people are diagnosed with hyperthyroidism and this trend should not be overlooked.
 
Mr Leung pointed out that hyperthyroidism can be treated with Chinese medicine in a variety of ways, such as in the form of herbs, soups, food, tea, and acupuncture. All these treatments also work well in strengthening a patient’s immunity to fight against the disease as well as enhancing the curative rate and reducing the chance of recurrence. He suggested patients to maintain a positive attitude and get enough rest to avoid over-exertion. A healthy diet and regular exercises such as tai chi, eight brocade breathing exercise, walking and swimming are also highly recommended.

中醫藥學院完成了一項中醫藥治療甲狀腺功能亢進症的臨床觀察,結果顯示中醫藥對治療甲亢有良好療效,總有效率達88.7%,能助患者改善臨床症狀,並提高他們的整體生活質量,以及調節免疫功能。

甲狀腺功能亢進症簡稱「甲亢」,是多種原因導致甲狀腺激素分泌過多,從而引發以神經、循環、消化等系統興奮性增高和代謝亢進為主要表現的臨床綜合症,亦是一種常見的內分泌疾病。甲亢特點一般為症狀複雜、治療期長、遷移難癒和復發率高。

甲亢屬於中醫學「癭氣」的範疇,患者一般會出現頸前腫大、易饑消瘦、急躁心悸、畏熱多汗、手顫、眼突等症狀。中醫認為,甲亢的病因多與情志、飲食、體質、遺傳等因素有關;病機主要為氣機鬱滯,日久鬱而化火,傷陰耗氣,陰虛火旺。

負責該臨床觀察的浸大中醫藥學院臨床部一級講師梁浩榮分析了115名於2013年5月至2017年4月期間,前往浸大中醫藥診所求診的甲亢患者病例,以了解本港甲亢的發病情況,並評估中醫治療甲亢的療效。在115個觀察病例當中,男女分別佔19和96例,年齡介乎13至66歲,患病期由一星期至28年不等。

按照中醫辨證論治原則,梁講師將觀察病例歸納為六個中醫證型:氣陰兩虛證、肝鬱氣滯證、肝腎陰虛證、陰虛火旺證、肝火亢盛證和痰瘀互結證,結果顯示氣陰兩虛證和肝鬱氣滯證為兩個主要甲亢證型,合共佔60例 (52.2%)。梁講師表示,根據患者的發病階段 (急性期、緩解期、恢復期) 和體質,為他們配以袪邪或扶正的中藥內服,療程由一個月至12個月不等,主要以養陰益氣、疏肝理氣為治療重點。整體而言,臨床痊癒15例 (13%)、顯效34例 (29.6%)、有效53例 (46.1%),另外13例 (11.3%) 為無效,總有效率為88.7%,治癒顯效率為42.6%。

綜合臨床觀察所得,甲亢的發病年齡多介乎21至50歲,佔總例數78.3%,其中女性患者較男性多,以30至40歲處於生育年齡的職業女性發病率為高。另外,觀察結果顯示家族遺傳與情志失調是甲亢發病的兩大主要因素,其中47名患者的家屬曾患甲亢,佔40.9%;首次發病或病情復發前曾有情緒刺激或受到壓力影響的佔72例 (62.6%)。

梁講師解釋,結果發現男女患病比例為1:5,這與女性的家族遺傳傾向性,以及女性較男性更易受情緒困擾有關。他提醒女士應多注意甲狀腺健康,特別是有甲狀腺病家族史而又未患過甲亢的女士,因為觀察反映女性患者的家族遺傳性較男性為明顯。另外他亦發現青少年的甲亢發病率近年有上升趨勢,認為青少年甲亢問題不容忽視。

梁講師指出,中醫治療甲亢的方法較為多元化,除了中藥內服,還可配合湯水、食療、茶療、穴位按摩等方法,均具有臨床治療與保健調理相結合的效用,有助增強患者的抵抗力,同時提高治癒率和減少復發率。他建議患者應保持心境愉快、避免過度疲勞和確保充分休息,忌食或少食辛辣和生冷食物,以及作一些輕柔運動,如太極、八段錦、散步、游泳。