温肾补虚方联合西药对亚临床甲状腺功能减退症患者血脂及血清IL-2、IL-10水平的影响
|
摘要
目的观察温肾补虚方联合左甲状腺素钠治疗亚临床甲状腺功能减退症的临床疗效及对血脂、相关细胞因子水平的影响。方法将86例亚临床甲状腺功能减退症患者随机分为对照组与治疗组,每组43例。对照组采用左甲状腺素钠片治疗,治疗组在此治疗措施的基础上加用温肾补虚方。两组均治疗3个月,观察临床疗效,比较甲状腺功能[甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]、白介素-2(IL-2)、白介素-10(IL-10)、白介素-2受体(IL-2R)、血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平的变化情况。结果(1)治疗组、对照组总有效率分别为93.0%、74.4%;组间临床疗效比较,差异有统计学意义(P<0.05)。(2)治疗前后组内比较,两组TSH水平较治疗前降低(P<0.05),FT3、FT4水平较治疗前升高(P<0.05);组间治疗后比较,TSH、FT3、FT4水平差异有统计学意义(P<0.05)。(3)治疗前后组内比较,两组TG、TC、LDL-C水平较治疗前降低(P<0.05),HDL-C水平较治疗前升高(P<0.05);组间治疗后比较,TG、TC、LDL-C、HDL-C水平差异有统计学意义(P<0.05)。(4)治疗前后组内比较,两组IL-2、IL-2R水平较治疗前降低(P<0.05),IL-10水平较治疗前升高(P<0.05);组间治疗后比较,IL-2、IL-10、IL-2R水平差异有统计学意义(P<0.05)。结论温肾补虚方联合左甲状腺素钠片治疗亚临床甲状腺功能减退症疗效满意,与单纯使用左甲状腺素钠片相比,能更好地改善患者的甲状腺功能,调节血脂及相关细胞因子水平。
Objective To observe the clinical efficacy of Wenshen Buxu Decoction combined with levothyroxine sodium in the treatment of subclinical hypothyroidism( SCH) and its effect on blood lipids and related cytokine levels. Methods A total of 86 SCH patients were randomly divided into treatment group and control group,43 cases in each group. The control group was treated with levothyroxine sodium tablets,and the treatment group was treated with Wenshen Bushu Decoction based on the treatment of the control group. The two groups were treated for 3 months. The clinical efficacy was observed and the interleukin-2( IL-2),interleukin-10( IL-10),interleukin-2 receptor( IL-2 R) as well as the thyroid function related indicators including serum thyroid stimulating hormone( TSH),serum free triiodothyronine( FT3),serum free thyroxine( FT4),the blood lipids indexes including triglycerides( TG),total cholesterol( TC),high-density lipoprotein cholesterol( HDL-C),low-density lipoprotein cholesterol( LDL-C) ]in the two groups were compared.Results(1)The total effective rate of the treatment group had significantly statistical difference compared with that of the control group( 93.02% vs 74.42%,P<0.05);(2)After treatment,the TSH level was decreased( P<0.05),while the serum FT3 and FT4 levels were increased( P<0.05),with statistic difference between the two groups( P<0.05).(3)After treatment,the serum TG,TC and LDL-C levels were decreased( P<0.05),while the HDL-C level was increased( P<0.05),with statistic difference between the two groups( P<0.05).(4)After treatment,the serum IL-10 levels were increased( P< 0.05),and the IL-2 and IL-2 R levels were decreased( P< 0.05),with statistic difference between the two groups( P< 0.05).Conclusion Compared with the single application of levothyroxine sodium,Wenshen Buxu Decoction combined with levothyroxine sodium can ameliorate the thyroid function and regulate the levels of blood lipids and related cytokines for SCH patients.
Objective To observe the clinical efficacy of Wenshen Buxu Decoction combined with levothyroxine sodium in the treatment of subclinical hypothyroidism( SCH) and its effect on blood lipids and related cytokine levels. Methods A total of 86 SCH patients were randomly divided into treatment group and control group,43 cases in each group. The control group was treated with levothyroxine sodium tablets,and the treatment group was treated with Wenshen Bushu Decoction based on the treatment of the control group. The two groups were treated for 3 months. The clinical efficacy was observed and the interleukin-2( IL-2),interleukin-10( IL-10),interleukin-2 receptor( IL-2 R) as well as the thyroid function related indicators including serum thyroid stimulating hormone( TSH),serum free triiodothyronine( FT3),serum free thyroxine( FT4),the blood lipids indexes including triglycerides( TG),total cholesterol( TC),high-density lipoprotein cholesterol( HDL-C),low-density lipoprotein cholesterol( LDL-C) ]in the two groups were compared.Results(1)The total effective rate of the treatment group had significantly statistical difference compared with that of the control group( 93.02% vs 74.42%,P<0.05);(2)After treatment,the TSH level was decreased( P<0.05),while the serum FT3 and FT4 levels were increased( P<0.05),with statistic difference between the two groups( P<0.05).(3)After treatment,the serum TG,TC and LDL-C levels were decreased( P<0.05),while the HDL-C level was increased( P<0.05),with statistic difference between the two groups( P<0.05).(4)After treatment,the serum IL-10 levels were increased( P< 0.05),and the IL-2 and IL-2 R levels were decreased( P< 0.05),with statistic difference between the two groups( P< 0.05).Conclusion Compared with the single application of levothyroxine sodium,Wenshen Buxu Decoction combined with levothyroxine sodium can ameliorate the thyroid function and regulate the levels of blood lipids and related cytokines for SCH patients.
引文
[1]李治鹏,梁利波,李双庆.亚临床甲状腺功能减退症的研究进展[J].浙江医学,2016,38(9):667-670.
[2]李产权,黄华兰,贺勇,等.中国西部人群亚临床甲状腺功能减退症患病率及相关因素研究[J].实用医学杂志,2014,30(6):925-927.
[3]潘立文,王晓明,杨先振.中医学论治亚临床甲状腺功能减退症理论探讨[J].辽宁中医药大学学报,2016,18(11):116-118..
[4]王耀立,魏军平.亚临床甲状腺功能减退症中医研究进展[J].中国临床保健杂志,2016,19(3):334-336.
[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.甲状腺疾病诊治指南——甲状腺功能减退症[J].中华内科杂志,2007,46(11):967-971.
[6]国家药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:226-230.
[7]孙亚琴.左甲状腺素钠联合中药治疗SCH伴血脂异常的临床观察[J].世界中西医结合杂志,2016,11(5):707-709.
[8]蒋晓霞,冷静,陆纪元,等.左旋甲状腺素钠片结合真武汤加味治疗甲状腺功能减退性心脏病临床观察[J].湖北中医药大学学报,2016,18(4):61-63.
[9]陆源源,代君.健脾疏肝和络方对桥本甲状腺炎合并亚临床甲状腺功能减退症患者T细胞因子IL-10、IL-2、IL-2R的影响[J].中医学报,2017,32(6):1036-1039.
[10] SYAMSUNDER A N,PAL P,PAL G K,et al. Decreased baroreflex sensitivity is linked to the atherogenic index,retrograde inflammation,and oxidative stress in subclinical hypothyroidism[J]. Endocr Res,2017,42(1):49-58.
[11]梁利波,张玫,黄亨建,等.体检人群中亚临床甲状腺功能减退症患者血脂、血糖和血尿酸水平分析[J].四川大学学报(医学版),2013,44(6):954-956.
[12]刘映川,张梅.亚临床甲状腺功能减退症与心血管疾病相关性的研究进展[J].天津医药,2016,44(4):509-512.
[13]王旭东,李哲,贾永平.亚临床甲状腺功能减退症与冠心病的相关关系研究[J].中西医结合心脑血管病杂志,2016,14(1):55-57.
[14]陈刚,廖志良,刘笃秋,等.亚临床甲状腺功能减退症与冠状动脉粥样硬化性心脏病的相关性[J].海南医学,2017,28(3):372-373.
[15]肖斯婷,王璞,王亚旭,等.基于CNKI的中医治疗甲状腺功能减退症用药规律研究[J].中国中医药信息杂志,2015,22(4):44-46.
[16]熊秋韵,李梦婷,缪璐琳,等.附子不同炮制品抗炎、镇痛和提高免疫功能作用的比较研究[J].中药药理与临床,2017,33(1):123-127.
[17]王焕江,赵金娟,刘金贤,等.菟丝子的药理作用及其开发前景[J].中医药学报,2012,40(6):123-125.
[2]李产权,黄华兰,贺勇,等.中国西部人群亚临床甲状腺功能减退症患病率及相关因素研究[J].实用医学杂志,2014,30(6):925-927.
[3]潘立文,王晓明,杨先振.中医学论治亚临床甲状腺功能减退症理论探讨[J].辽宁中医药大学学报,2016,18(11):116-118..
[4]王耀立,魏军平.亚临床甲状腺功能减退症中医研究进展[J].中国临床保健杂志,2016,19(3):334-336.
[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.甲状腺疾病诊治指南——甲状腺功能减退症[J].中华内科杂志,2007,46(11):967-971.
[6]国家药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:226-230.
[7]孙亚琴.左甲状腺素钠联合中药治疗SCH伴血脂异常的临床观察[J].世界中西医结合杂志,2016,11(5):707-709.
[8]蒋晓霞,冷静,陆纪元,等.左旋甲状腺素钠片结合真武汤加味治疗甲状腺功能减退性心脏病临床观察[J].湖北中医药大学学报,2016,18(4):61-63.
[9]陆源源,代君.健脾疏肝和络方对桥本甲状腺炎合并亚临床甲状腺功能减退症患者T细胞因子IL-10、IL-2、IL-2R的影响[J].中医学报,2017,32(6):1036-1039.
[10] SYAMSUNDER A N,PAL P,PAL G K,et al. Decreased baroreflex sensitivity is linked to the atherogenic index,retrograde inflammation,and oxidative stress in subclinical hypothyroidism[J]. Endocr Res,2017,42(1):49-58.
[11]梁利波,张玫,黄亨建,等.体检人群中亚临床甲状腺功能减退症患者血脂、血糖和血尿酸水平分析[J].四川大学学报(医学版),2013,44(6):954-956.
[12]刘映川,张梅.亚临床甲状腺功能减退症与心血管疾病相关性的研究进展[J].天津医药,2016,44(4):509-512.
[13]王旭东,李哲,贾永平.亚临床甲状腺功能减退症与冠心病的相关关系研究[J].中西医结合心脑血管病杂志,2016,14(1):55-57.
[14]陈刚,廖志良,刘笃秋,等.亚临床甲状腺功能减退症与冠状动脉粥样硬化性心脏病的相关性[J].海南医学,2017,28(3):372-373.
[15]肖斯婷,王璞,王亚旭,等.基于CNKI的中医治疗甲状腺功能减退症用药规律研究[J].中国中医药信息杂志,2015,22(4):44-46.
[16]熊秋韵,李梦婷,缪璐琳,等.附子不同炮制品抗炎、镇痛和提高免疫功能作用的比较研究[J].中药药理与临床,2017,33(1):123-127.
[17]王焕江,赵金娟,刘金贤,等.菟丝子的药理作用及其开发前景[J].中医药学报,2012,40(6):123-125.