柴葛解肌汤联合非甾体类抗炎药治疗亚急性甲状腺炎临床研究

Clinical Research on Chaige Jieji Decoction Combined with Non-steroid Anti-inflammatory Drug Treatment of Patients with Subacute Thyroiditis

目的:观察柴葛解肌汤联合非甾体类抗炎药治疗亚急性甲状腺炎(subacute thyroiditis,SAT)患者的临床疗效及其对患者血清学指标的影响。方法:100例SAT患者随机分为对照组48例和观察组52例。两组患者均给予布洛芬缓释胶囊口服,观察组在此基础上给予柴葛解肌汤治疗。治疗3个月后比较两组患者临床疗效及临床症状改善情况,检测两组患者治疗前后血清C-反应蛋白(C reaction protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)、游离三碘甲状腺原氨酸(free triiodothyronine,FT_3)、血清游离甲状腺素(free thyroxine,FT_4)及促甲状腺激素(thyrotropic hormone,TSH)水平变化,比较两组患者不良反应发生率。结果:治疗后,观察组有效率为92.31%,高于对照组81.25%,差异具有统计学意义(P<0.05);观察组发热、甲状腺肿大、疼痛、肢体震颤、咽痛、多汗、乏力及纳差等临床不适症状改善较对照组显著(P<0.05);血清学指标检测中,观察组CRP、ESR、FT_3、FT_4水平较对照组降低(P<0.05),TSH水平较对照组升高(P<0.05);两组患者不良反应未见差异(P>0.05)。结论:柴葛解肌汤与非甾体类抗炎药物联用治疗SAT能显著提高临床疗效,缓解临床症状,可通过改善炎性状态、改善受损甲状腺功能而发挥治疗作用。

Objective： To observe the influence of Chaige Jieji decoction combined with NSAID in clinical symptoms and serum index for patients with subacute thyroiditis. Methods： 100 patients hospitalized in our own hospital were diagnosed as subacute thyroiditis and were randomly divided into the treatment group and the control group,with 48 patients in control group and 52 patients in treatment group. All the patients were treated with Ibuprofen（ 0. 3 g,bid） on the foundation of regular treatment,patients in treatment group were treated with Chaige Jieji decoction. Both treatment courses continued 12 weeks. The level of CRP,ESR,FT3,FT4 and TSH were detected and recorded during the begin and last of the study. The clinical effects were detected also. During all the course,the adverse reactions during treatment were recorded. Results： The effective rate of the treatment group was 92. 31%and higher than the 81. 25% in control group（ P〈0. 05）. After treatment,the symptoms of fever,thyromegaly and pain,tremble,angina,hidrosis,weak and inappetence were improved distinctly（ P〈0. 05）,the level of CRP,ESR,FT3 and FT4were decreased（ P〈0. 05）,and the level of TSH were increased obviously（ P〈0. 05）. The adverse reactions rate in two groups were undifferentiated between them（ P〉0. 05）. Conclusion： Chaige Jieji decoction combined with NSAID has a better therapeutic effect on subacute thyroiditis,and this protect effect might related to the decrease of inflammatory response and the improve in thyroid function.