中药加小剂量甲状腺片治疗桥本氏甲状腺炎36例临床观察

Clinical Observation on 36 cases of Hashimoto's Thyroiditis Treated with Chinese Drugs Plus Small Dose of Jia Zhuang Xian Tablet

为了观察中西医结合疗法治疗桥本氏甲状腺炎(HT)的临床疗效及对免疫功能的影响,初步探讨可能的疗效机制。将68例患者随机分为两组,中西医结合治疗组(简称治疗组)36例,采用温补脾肾中药加小剂量甲状腺片治疗;西药对照组(简称对照组)32例,采用甲状腺片治疗。检测治疗前后患者血清抗甲状腺自身抗体(TGAb、TMAb)及辅助性T细胞(TH细胞)亚群的变化,用免疫学指标对疗效机制进行探讨。结果治疗组治愈率、显效率、有效率和总有效率分别为8.33％、13.89％、69.45％和91.67％;对照组分别为0、6.25％、65.63％和71.88％,两组比较差异有显著性(P<0.05)。免疫指标检测结果显示,治疗前HT患者抗甲状腺自身抗体水平明显高于正常,TH细胞亚群数量和比例异常;治疗后,治疗组HT患者抗甲状腺自身抗体水平下降,与对照组比较差异有显著性(P<0.05);TH细胞亚群间比例趋向平衡状态。提示中西医结合疗法治疗HT临床疗效优于单纯服用西药甲状腺片,其疗效机制可能是通过调节HT患者的细胞免疫和体液免疫紊乱,恢复机体免疫平衡状态来实现的。

In order to observe clinical therapeutic effect of combined treatment of Chinese medicine and western medicine on Hashimoto's thyroiditis and its effect on immunological function, and preliminarily approach to mechanisms of the therapeutic effect. 68 cases Hashimoto's thyroiditis (HT) were randomly divided into treatment group (36 cases) treated with drugs for warming and tonifying spleen and kidney plus small dose of Jia Zhuang Xian Tablet, and control group (32 cases) treated with Western medicine Jia Zhuang Xian Tablet. Serum anti -thyroid auto - antibody (TGAb, TMAb) and T helper lymphocyte (TH) subgroup were detected before and after treatment. Results indicated that the cured rate, markedly effective rate, effective rate and the total effective rate were 8. 33%, 13. 89%, 69. 45%, 91. 67% in the treatment group and 0, 6. 25%, 65. 63%, 71. 88% in the control group, with significant difference between the two groups (P<0. 05). Additionally, TGAb and TMAb levels before treatment in the patient of HT were higher than normal and number and ratio of TH were abnormal; after treatment the TGAb and TMAb levels decreased in the treatment group with significant difference as compared with the control group (P<0. 05) and ratio of TH subgroups tended to balance state.