桥本方治疗桥本甲状腺炎临床观察

Clinical Observation of Qiaoben Formula(桥本方)in Treatment of Hashimoto′s Thyroditis

目的以西药富希康为对照,评估益气养阴、调节免疫力的自拟方桥本方治疗桥本甲状腺炎的临床疗效。方法选择甲状腺功能[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)]正常且中医证属气阴两虚的桥本甲状腺炎患者74例,年龄18~70岁,随机分为试验组与对照组,每组患者各37例,试验组治疗予中药汤剂桥本方口服,对照组予富希康口服。观察两组治疗前后中医症状改善以及相关实验室指标[FT3、FT4、TSH、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、干扰素-γ(IFN-γ)、肿瘤坏死因子(TNF-α)、白细胞介素2(IL-2)、白细胞介素10(IL-10)、白细胞介素6(IL-6)、白细胞介素8(IL-8)]的变化情况。结果(1)试验组治疗总有效率(71.43%,25/35)明显优于对照组(34.29%,12/35)(P<0.01)。(2)试验组可有效改善患者的各项中医证候。(3)试验组和对照组均可有效降低TGAb、TPOAb滴度,其中TGAb试验组优于对照组;TPOAb两组间比较,差异无统计学意义。(4)试验组和对照组均可降低IL-2水平,但两组间比较,差异无统计学意义;试验组可升高IL-8水平,降低IFN-γ、TNF-α水平,而对照组未见此变化,其中IL-8两组间比较差异有统计学意义,其余两组间比较,差异无统计学意义。结论益气养阴法可明显改善气阴两虚型桥本甲状腺炎患者的中医证候,显著降低TGAb、TPOAb滴度,值得临床进一步推广使用。

Objective To evaluate the clinical efficacy of Qiaoben Formula(桥本方)for supplementing Qi,nourishing Yin and regulating immunity in the treatment of Hashimoto′s thyroiditis compared with Selenious Yeast Capsules.Methods Seventy-four Hashimoto′s thyroiditis patients whose thyroid function[free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH)]was normal and TCM syndrome was deficiency of both Qi and Yin were selected.The age was 18-70 years old.The patients were randomly divided them into the experimental group which was treated with Qiaoben Formula and the control group which was treated with Selenious Yeast Capsules,with 37 cases in each group.Then the different changes of TCM syndrome and related laboratory indexes[FT3,FT4,TSH,anti-thyroglobulin antibodies(TGAb),thyroid peroxidase antibody(TPOAb),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-10(IL-10),interleukin-6(IL-6),interleukin-8(IL-8)]before and after treatment.Results(1)The effective rate of the experimental group(71.43%,25/35)was better than that of the control group(34.29%,12/35)(P<0.01).(2)The experimental group can effectively improve the patients′various TCM syndromes.(3)Both the experimental group and the control group effectively reduce the titer of TGAb and TPOAb,and the effect of the experimental group was better in reducing the titer of TGAb than the control group.But there was no statistical significance of the comparison between the two groups in reducing the titer of TPOAb.4.Both the experimental group and control group can reduce the level of IL-2 but there was no statistical significance of the comparison between the two groups.The experimental group can increase the level of IL-8 and reduce the levels of IFN-γand TNF-α,but the control group did not have this change.There was statistical significance of the comparison of IL-8 between the two groups but there was no statistical significance of the other comparison between the two groups.Conclusion Tonifying Qi and nourishing Yin can significantly decrease TCM syndrome integral of Hashimoto′s thyroiditis patients whose syndrome is deficiency of both Qi and Yin,and it can improve various TCM symptoms.Moreover,it can effectively reduce the titer of TGAb and TPOAb.In addition,its adverse reaction is very few.Therefore,Qiaoben Formula is worthy of spreading in the clinical treatments.