二仙汤加芪海消瘿汤治疗慢性淋巴细胞性甲状腺炎伴甲状腺功能减退症的临床研究

Application of ER Xian Tang and QI Hai Xiao Ying Tang for the treatment of chronic lymphocytic thyroiditis complicated with hypothyroidism

目的观察二仙汤加芪海消瘿汤治疗慢性淋巴细胞性甲状腺炎(慢甲炎)伴甲状腺功能减退症的临床疗效。方法选择慢甲炎伴甲状腺功能减退症70例,皆用左旋甲状腺素片维持甲状腺激素正常,分为两组,治疗组在左旋甲状腺素基础上加二仙汤和芪海消瘿汤方,对照组单用左旋甲状腺素。治疗前后观察两组临床疗效,并检测两组血清总甲状腺素(T4)、血清总三碘甲腺原氨酸(T3)、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、血常规、肝肾功。结果治疗前两组T3、T4、TSH、FT3、FT4、TGAb、TPOAb、血常规比较差异无统计学意义(P>0.05),肝肾功能皆正常,具可比性。经治疗后治疗组有效率为91.4%,对照组为74.3%,两组比较差异有统计学意义(P<0.05)。治疗后两组T3、T4、FT3、FT4、TSH皆正常,治疗组TGAb、TPOAb降低,与治疗前相比差异有统计学意义(P<0.05),与对照组相比差异有统计学意义(P<0.05)。治疗组左旋甲状腺素用量明显减少,与治疗前相比差异有统计学意义(P<0.05)。治疗组肿大的甲状腺较治疗前缩小,相比差异有统计学意义(P<0.05);对照组治疗前、后甲状腺大小变化不大,与治疗组相比差异有统计学意义(P<0.05)。结论二仙汤加芪海消瘿汤能调节慢甲炎伴甲状腺功能减退患者免疫功能,降低抗体水平,减少左旋甲状腺素用量,缩小肿大的甲状腺。

Objective To explore the curative effects of ER Xian Tang and QI Hai Xiao Ying Tang for the treatment of chronic lymphocytic thyroiditis （CLT ） complicated with hypothyroidism .Methods A total of 70 pa-tients with CLT complicate with hypothyroidism were divided into treatment group ,given Er Xian Tang ,Qi Hai Xiao Ying Tang and levothyroxine sodium tablets ,and control group ,given evothyroxine sodium tablets .Curative effects , and serum levels of triiodothyronine （T3） ,thyroxine （T4） ,free triiodothyronine （FT3） ,free thyroxine （FT4） ,thyro-tropic-stimulating hormone （TSH） ,thyroglobulin antibody （TGAb） ,thyroid peroxidase antibody （TPOAb） and so on were compared between the two groups .Results Before treatment ,the differences of levels of T3 ,T4 ,TSH ,FT3 , FT4 ,TGAb ,TPOAb and indexes of routine blood test between the two groups were not significant （P＆gt;0 .05） ,and liver function of patients in the two groups were all without abnormality .After treatment ,the effective rate in treat-ment group was 91 .4% ,being significantly different with the 74 .3% in control group （P＆lt;0 .05） .After treatment , levels of T3 ,T4 ,FT3 ,FT4 and TSH in the two groups all return to normal range ,and levels of TGAb and TPOAb in treatment group were reduced ,being significantly different with levels detected before treatment and with levels of control group （P＆lt;0 .05） .In treatment group ,the dosage of levothyroxine reduced significantly （P＆lt;0 .05） .Thyroid volume reduced significantly only in treatment group （P＆lt;0 .05） .Conclusion Er Xian Tang and Qi Hai Xiao Ying Tang could effectively regulate immune function ,reduce levels of TGAb ,TPOAb and thyroid volume in patients with CLT complicated with hypothyroidism .