穿山龙对甲状腺功能减退的桥本甲状腺炎患者影响的研究

A Study of the Impact of Dioscorea Nipponica on the Level of Serum TSH,TGAb and TPO-Ab of Hashimoto's Thyroiditis Patient

目的探讨穿山龙对甲状腺功能减退的桥本甲状腺炎(HT)患者促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)及甲状腺过氧化物酶抗体(TPO-Ab)的影响。方法选取2009年2月—2012年1月我院门诊治疗的TSH>5.5 mU/L,TPO-Ab>100 U/ml的HT患者48例,用随机数字表法将患者随机分为对照组和治疗组,每组24例。对照组口服左甲状腺素片(LT4)50～200μg/d,平均125μg/d。治疗组在对照组基础上加用穿山龙,早晚各1次,10 g/次,沸水冲服,2次/d。两组于治疗前及治疗后3个月时分别测定血常规、肝肾功能、血糖、血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH、TGAb、TPO-Ab水平。结果两组治疗前各指标比较,差异均无统计学意义(P>0.05)。治疗3个月后,两组白细胞计数(WBC)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血肌酐(Scr)、空腹血糖(FBG)、餐后血糖(PBG)、FT3、FT4水平比较,差异均无统计学意义(P>0.05);治疗组TSH、TGAb以及TPO-Ab水平低于对照组,差异均有统计学意义(P<0.05)。治疗3个月后对照组所用的LT4平均剂量为(82±30)μg/d,高于治疗组的(36±25)μg/d,差异有统计学意义(t=5.77,P<0.05)。结论穿山龙能明显降低血清TGAb和TPO-Ab水平,改善TSH水平,通过降低血清TGAb、TPO-Ab水平阻止或减轻HT患者甲状腺的病理损害,从而减缓甲状腺功能减退进程和减少甲状腺激素替代治疗剂量。

Objective To investigate the impact of Dioscorea nipponica on the level of serum TSH,TGAb and TPO-Ab of Hashimoto＇s thyroiditis patients.Methods A total of 48 patients with HT of TSH 5.5 mU / L,TPO-Ab 100 U / ml,were randomly assigned to control group and treatment group,24 cases in each group.The control group cases were treated with levothyroxine only and the treatment group cases were treated with both levothyroxine and Dioscorea nipponica.The levels of FT3,FT4,TSH,TGAb and TPO-Ab before the treatment and 3 months after the treatment were measured and compared between two groups.Results There were no significant differences in all indexes between the two groups before treatment（P《0.05）.After three months of treatment,there were no significant differences in WBC,ALT,AST,Scr,FBG,PBG,FT3 and FT4 between the two groups（P《0.05）,the level of serum TSH,TGAb and TPO-Ab in the treatment group cases were significantly lower than those in the control group cases（P《0.05）.The average dose of LT4 in control group and in treatment group was（82 ± 30） μg / d and（36 ± 25） μg / d,respectively,with a significant difference between two groups（t = 5.77,P《0.05）.Conclusion Dioscorea nipponica can significantly reduce serum TGAb and TPO-Ab level,improve the TSH level,which may help to slow down disease progression and reduce the dose of thyroid hormone replacement therapy.