瘿瘤停治疗桥本氏甲状腺炎并发甲状腺功能减退临床研究
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摘要
目的:观察瘿瘤停治疗桥本氏甲状腺炎并发甲状腺功能减退的临床疗效。方法:将60例桥本氏甲状腺炎伴甲状腺功能减退患者随机分为2组,每组30例;对照组予左甲状腺素钠片口服,实验组予中药瘿瘤停汤剂口服,2组均连续治疗3月;观察2组患者治疗前后中医证候疗效、甲状腺功能、甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)情况,以及在治疗中的不良反应。结果:治疗后总有效率实验组为96.7%,对照组为73.3%,2组比较,差异有统计学意义(P <0.05)。治疗2、3月,对照组中医证候积分较治疗前明显改善(P <0.05)。治疗1、2、3月,实验组中医证候积分均较治疗前明显改善(P <0.05);且于治疗3月,实验组中医证候积分改善明显优于对照组(P <0.05)。治疗1、2、3月,对照组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平均较治疗前改善(P <0.05);实验组患者FT3水平于治疗3月较治疗前改善(P <0.05),FT4、TSH水平于治疗2、3月时较治疗前改善(P <0.05)。治疗3月,对照组患者FT3、FT4、TSH水平改善较实验组更显著(P <0.05)。治疗1、2、3月,对照组TPO-Ab、TG-Ab水平较治疗前变化不明显(P> 0.05)。治疗1、2月,实验组TPO-Ab、TG-Ab水平较治疗前有下降趋势,但差异无统计学意义(P> 0.05);治疗3月,实验组TPO-Ab、TG-Ab水平较治疗前明显降低(P <0.05)。结论:瘿瘤停可改善桥本氏甲状腺炎并发甲减的临床症状、甲状腺功能和抗体水平。
Objective: To observe the clinical effect of Yingliuting for Hashimoto's thyroiditis complicated with hypothyroidism.Methods: Divided 60 cases of patients with Hashimoto's thyroiditis complicated with hypothyroidism into two groups randomly, 30 cases in each group. The control group was treated with oral administration of levothyroxine sodium tablets,while the experiment group was treated with Yingliuting Chinese herbal prescription. The two groups received continuous treatment for three months. Observed the curative effect of Chinese medicine syndromes, thyroid function, thyroid globulin antibody(TG-Ab), thyroid peroxidase antibody(TPO-Ab) and adverse reactions in the two groups before and after treatment. Results: After treatment, the total effective rate was96.7% in the experiment group and 73.3% in the control group,the difference being significant(P < 0.05). After two and three months of treatment, the score of Chinese medicine syndrome in the control group was significantly improved when compared with that before treatment(P < 0.05). After one,two and three months of treatment,the score of Chinese medicine syndrome in the experiment group was significantly improved when compared with that before treatment(P < 0.05). After three months of treatment,the score of Chinese medicine syndrome in the experiment group was significantly better than that in the control group(P < 0.05). After one,two and three months of treatment,levels of FT3,FT4 and TSH in the control group were improved when compared with those before treatment(P <0.05). After three months of treatment,the FT3 level in the experiment group was improved when compared with that before treatment(P< 0.05),and levels of FT4 and TSH were improved after two and three months of treatment(P < 0.05). After three months of treatment,levels of FT3,FT4 and TSH in the control group were improved more significantly than those in the experiment group(P < 0.05). After one,two and three months of treatment,the changes of levels of TPO-Ab and TG-Ab in the control group were not so obvious(P >0.05). After one and two months of treatment,levels of TPO-Ab and TG-Ab in the experiment group had the tendency to decreased,but the difference was not significant(P > 0.05). After three months of treatment,levels of TPO-Ab and TG-Ab in the experiment group were decreased significantly when compared with those before treatment(P < 0.05). Conclusion:Yingliuting can improve thyroid function and antibody level and the clinical symptoms caused by Hashimoto's thyroiditis complicated with hypothyroidism.
Objective: To observe the clinical effect of Yingliuting for Hashimoto's thyroiditis complicated with hypothyroidism.Methods: Divided 60 cases of patients with Hashimoto's thyroiditis complicated with hypothyroidism into two groups randomly, 30 cases in each group. The control group was treated with oral administration of levothyroxine sodium tablets,while the experiment group was treated with Yingliuting Chinese herbal prescription. The two groups received continuous treatment for three months. Observed the curative effect of Chinese medicine syndromes, thyroid function, thyroid globulin antibody(TG-Ab), thyroid peroxidase antibody(TPO-Ab) and adverse reactions in the two groups before and after treatment. Results: After treatment, the total effective rate was96.7% in the experiment group and 73.3% in the control group,the difference being significant(P < 0.05). After two and three months of treatment, the score of Chinese medicine syndrome in the control group was significantly improved when compared with that before treatment(P < 0.05). After one,two and three months of treatment,the score of Chinese medicine syndrome in the experiment group was significantly improved when compared with that before treatment(P < 0.05). After three months of treatment,the score of Chinese medicine syndrome in the experiment group was significantly better than that in the control group(P < 0.05). After one,two and three months of treatment,levels of FT3,FT4 and TSH in the control group were improved when compared with those before treatment(P <0.05). After three months of treatment,the FT3 level in the experiment group was improved when compared with that before treatment(P< 0.05),and levels of FT4 and TSH were improved after two and three months of treatment(P < 0.05). After three months of treatment,levels of FT3,FT4 and TSH in the control group were improved more significantly than those in the experiment group(P < 0.05). After one,two and three months of treatment,the changes of levels of TPO-Ab and TG-Ab in the control group were not so obvious(P >0.05). After one and two months of treatment,levels of TPO-Ab and TG-Ab in the experiment group had the tendency to decreased,but the difference was not significant(P > 0.05). After three months of treatment,levels of TPO-Ab and TG-Ab in the experiment group were decreased significantly when compared with those before treatment(P < 0.05). Conclusion:Yingliuting can improve thyroid function and antibody level and the clinical symptoms caused by Hashimoto's thyroiditis complicated with hypothyroidism.
引文
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[9]赵华.李中南治疗甲状腺结节经验[J].河南中医,2012, 32(4):504-505.
[10]李钦,胡继宏,高博,等.黄芪多糖在免疫调节方面的最新研究进展[J].中国实验方剂学杂志,2017,23(2):199-206.
[11]汪文玉.夏枯草化学成分及生物活性对免疫调节及抗炎抑菌的研究概况[J].世界最新医学信息文摘,2015,15(12):68-70.
[12]许惠玉,运晨霞,王雅贤.桃仁总蛋白对荷瘤鼠T淋巴细胞亚群及细胞凋亡的影响[J].齐齐哈尔医学院学报,2004,25(5):487.
[2] Ohye H, Sugawara M.Dual oxidase, hydrogen peroxide and thyroid diseases[J].Exp Biol Med, 2010, 235:424.
[3] Adamson LA, Fowler LJ, Clare-Salzler MJ, et al.Parvovirus B19 infection in Hashimoto's thyroiditis, papil lary thyroid carcinoma, and anaplastic thyroid carcinoma[J].Thyroid,2011,21(4):411.
[4] Kidd P.Th1/Th2 balance:the hypothesis, its limitations,andimplicationsforhealthanddisease[J].Alternative Medicine Review,2003,8(3):223-246.
[5]中华医学会内分泌学分会中国甲状腺疾病诊治指南编写组.中国甲状腺疾病诊治指南[J].中华内科杂志,2007,46(9):784-787.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:226-233.
[7]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:315-320.
[8]吴少杰.全身辐射后免疫器官、肾脏和甲状腺损伤规律及PET/CT可对其损伤进行快速评估[D].广州:南方医科大学,2012.
[9]赵华.李中南治疗甲状腺结节经验[J].河南中医,2012, 32(4):504-505.
[10]李钦,胡继宏,高博,等.黄芪多糖在免疫调节方面的最新研究进展[J].中国实验方剂学杂志,2017,23(2):199-206.
[11]汪文玉.夏枯草化学成分及生物活性对免疫调节及抗炎抑菌的研究概况[J].世界最新医学信息文摘,2015,15(12):68-70.
[12]许惠玉,运晨霞,王雅贤.桃仁总蛋白对荷瘤鼠T淋巴细胞亚群及细胞凋亡的影响[J].齐齐哈尔医学院学报,2004,25(5):487.