肾病综合征患儿甲状腺功能水平与中医证型相关性及左甲状腺素片疗效分析

The correlation between PNS with thyroid hormone level and the syndrome of TCM and the effects of levothyroxine

目的探讨肾病综合征(NS)患儿甲状腺功能(以下简称甲功)与中医证型相关性及左甲状腺素片疗效。方法根据患儿甲功及治疗方案分为四组。未服用甲状腺素片(B组)与服用甲状腺素片(A组)的患儿中进行1∶1配对分析。结果肺脾气虚兼血瘀、脾肾阳虚兼血瘀分别与气阴两虚兼血瘀在T3水平上存在显著性差异(P<0.01),余证型在甲功方面无差异(P>0.05);配对显示,治疗1周,两组D-d存在显著性差异(P<0.01),余指标在治疗后改善不明显,但CHO、TG这两项指标A1组较B组改善明显;服用左甲状腺素片患儿中,仅1例出现T4明显升高(77.1)。结论中医证型与甲功水平存在一定相关性;加用左甲状腺素片无改善疗效作用;甲功低下的NS患儿加左甲状腺素片是安全的。

Objective To expolre the relation between the levels of thyroid hormone with NS and the syndromes of TCM, the effects of the L - thyroxine and side effects. Methods The patients were divided into four groups according to the levels of the thyroid hormone and treatment. We investigated the L - thyroxine users and non - users based 1 ： 1 matched according to the degrees of disease. Results There was differences in the level of T3 between the lung - spleen qi deficiency with blood stasis, spleen - kid- ney yang deficiency with blood stasis and qi - yin depletion （ P 〈 0.01 ） , the remained syndromes of TCM bad no difference （ P 〉 0. 05 ） ; Compared in groups, the indexes of these two groups had no differences except D - d （ P 〈 0.05 ） at the first week, but there was evident improvement in A1 group than B group on CHO and TG ;81 children adding L -thyroxine, only 1 produce the index T4 higher. Conclusion There is some correlations between the syndromes of TCM and the levels of thyroid; added L - thyroxine will not improves its treatment; It is safe to add L - thyroxine to the NS with low - level of thyroid.