隔附子饼灸关元、命门为主对桥本甲状腺炎患者甲状腺功能的影响

Effect of aconite cake-separated moxibustion at Guanyuan(CV 4) and Mingmen(GV 4) on thyroid function in patients of Hashimoto's thyroiditis

目的:探讨隔附子饼艾灸对桥本甲状腺炎患者甲状腺功能的影响,为桥本病提供更优化的治疗方法。方法:85例患者随机分为灸药组(42例)和西药组(43例)。灸药组予隔附子饼灸,穴取①膻中、中脘、关元,②大椎、肾俞、命门,两组交替,轮流施灸,并口服优甲乐25μg,每天1次;西药组单纯口服优甲乐25μg,每天1次。观察两组患者治疗前后甲状腺功能指标变化并比较其临床疗效。结果:灸药组临床疗效和甲状腺功能改变总有效率分别为25.0%(10/40)、87.5%(35/40),优于西药组的7.5%(3/40)、57.5%(23/40),差异有统计学意义(均P<0.05)。灸药组治疗后血清游离甲状腺素(FT4)显著上升(P<0.01),血清超敏促甲状腺素(S-TSH)含量均值低于西药组,而FT4、血清游离三碘甲状腺原氨酸(FT3)含量均值均高于西药组,但差异没有统计学意义(均P>0.05)。结论:隔附子饼灸关元、命门为主结合口服优甲乐可有效改善桥本甲状腺炎患者临床症状和甲状腺功能,其疗效优于单纯口服优甲乐。

Objective To explore the effects on thyroid function in patients of Hashimoto＇s thyroiditis treated with aconite cake-separated moxibustion and option the better therapeutic program.Methods Eighty-five cases were randomly divided into a moxibustion group（42 cases） and a western medication group（43 cases）.The moxibustion group was treated by aconite cake-separated moxibustion therapy with acupoints of two groups [①Danzhong（CV 17）,Zhongwan（CV 12）,Guanyuan（CV 4）;②Dazhui（GV 14）,Shenshu（BL 23）,Mingmen（GV 4）] alternatively and oral administration of 25 μg Euthyrox everyday.The western medication group was oral administration of 25 μg Euthyrox everyday.Indices of thyroid function before and after treatment and clinical effect were compared between two groups.Results The clinical total effective rate and effective rate of thyroid function were 25.0%（10/40）,87.5%（35/40） in moxibustion group respectively,7.5%（3/40） and 57.5%（23/40） in western medication group,with significant differences between two groups（both P0.05）.Content of serum free thyroxine index（FT4） increased significantly in the moxibustion group after treatment（P0.01）;content of serum supersensitive thyrotropin（S-TSH） in the moxibustion group was lower than that of western medication group,and contents of serum FT4and free triiodothyronine（FT3） were higher than those of western medication group,but with no significant differences（all P0.05）.Conclusion Aconite cake-separated moxibustion at Guanyuan（CV 4） and Mingmen（GV 4） combined with oral administration of Euthyrox can improve clinical symptoms and thyroid function in patients of Hashimoto＇s thyroiditis,which is better than simple oral administration of Euthyrox.