九味散结胶囊结合左甲状腺素钠对桥本甲状腺炎IL-17和IL-23表达的影响

The effect ofJiuwei-Sanjie capsuls combined with levothyroxine sodium on IL-17 and IL-23 expression in the patients with Hashimoto’s thyroiditis

目的：探讨九味散结胶囊结合左甲状腺素钠对桥本甲状腺炎（Hashimoto＇s thyroiditis, HT）患者IL-17和IL-23表达的影响。方法将符合入选标准的76例HT患者采用随机数字表分为2组，每组38例。对照组口服左甲状腺素钠片，观察组在对照组基础上加服九味散结胶囊。2组均治疗3个月。采用化学发光法检测患者血清游离三碘甲状腺原氨酸（triiodothyronine, FT3）、游离甲状腺素（thyroxine, FT4）、血清促甲状腺素（thyrotropin, TSH）、甲状腺球蛋白抗体（thyroglobulin antibody, TGAb）、甲状腺过氧化物酶抗体（thyroid peroxidase antibody, TPOAb），采用ELISA法检测患者血清IL-17、IL-23，评价临床疗效。结果观察组总有效率为94.7%（36/38）、对照组为81.6%（31/38），2组比较差异有统计学意义（χ2＝2.316， P＝0.042）。治疗后，观察组 IL-17[（22.32±4.25）ng/ml 比（31.55±6.84）ng/ml ， t＝2.416]、IL-23[（14.72±3.42）ng/ml 比（23.27±5.26）ng/ml ， t＝2.512]水平低于对照组（P＜0.05）；观察组TSH[（3.04±0.82）IU/ml 比（4.83±1.22）IU/ml，t＝2.355]、TGAb[（152.71±38.02）IU/ml 比（238.48±54.18）IU/ml，t＝2.406]和TPOAb[（121.31±26.23）IU/ml 比（184.19±42.53）IU/ml，t＝2.423]水平低于对照组（P＜0.05）。结论九味散结胶囊结合左甲状腺素钠可降低HT患者IL-17和IL-23水平，改善甲状腺功能。

Objective To observe the effect ofJiuwei-Sanjie capsuls combined with levothyroxine sodium on IL-17 and IL-23 expression in the patients with Hashimoto’s thyroiditis （HT）. Methods A total of 76 HT patients were randomly divided into the control group （n=38） and observation group （n=38）. The control group was treated with Levothyroxine Sodium, and the observation group was treated with Levothyroxine Sodium andJiuwei-Sanjie capsuls. The expression of FT3, FT4, TSH, TGAb, and TPOAb were detected by chemiluminescent immunoassay. The expression of IL-17 and IL-23 were detected by ELISA analysis. The clinical effect were compared.ResultsThe clinical effect was 94.7% （36/38） in observation group, which was better than that of 81.6% （31/38） in control group （χ2=2.316,P=0.042） . After treatment, the expression of IL-17 （22.32 ± 4.25 ng/mlvs. 31.55 ± 6.84 ng/ml,t=2.416） and IL-23 （14.72 ± 3.42 ng/mlvs. 23.27 ± 5.26 ng/ml, t=2.512） in observation group was lower than that in control group （P〈0.05）. The expression of TSH （3.04 ± 0.82 IU/mlvs. 4.83 ± 1.22 IU/ml,t=2.355）, TGAb （152.71 ± 38.02 IU/mlvs. 238.48 ± 54.18 IU/ml,t=2.406）, and TPOAb （121.31 ± 26.23 IU/mlvs. 184.19 ± 42.53 IU/ml,t=2.423） in observation group was lower than that in control group after treatment （P〈0.05）.ConclusionsJiuwei-Sanjie capsuls can decrease IL-17 and IL-23 〈br〉 expression in patients with Hashimoto＇s thyroiditis, and improve thyroid function.