消瘿散结方治疗桥本氏甲状腺炎临床观察

Clinical Observation of Xiaoying Sanjie Prescription in Treating HT

目的:观察消瘿散结方治疗甲状腺功能正常及亚临床甲状腺功能减退桥本氏甲状腺炎(HT)的临床疗效及对患者血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)及白细胞介素-2(IL-2)、白细胞介素-6(IL-6)的影响。方法:将56例HT患者随机分为治疗组和对照组,每组28例。2组均进行基础治疗,对照组在此基础上加用金水宝胶囊,治疗组在对照组用药基础上加服消瘿散结方。治疗后评估临床疗效,比较2组治疗前后中医证候积分及血清TPOAb、TGAb、IL-2、IL-6水平的变化。结果:治疗组总有效率92.9%,对照组总有效率71.4%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),治疗组的中医证候积分比对照组下降更明显(P<0.05)。治疗后,2组血清TPOAb、TGAb、IL-2及IL-6水平均较治疗前下降(P<0.05),治疗组的TPOAb、TGAb、IL-2及IL-6水平均较对照组下降更明显(P<0.05)。结论:消瘿散结方治疗甲状腺功能正常及亚临床甲状腺功能减退HT,能明显改善患者的临床症状,降低甲状腺自身抗体水平,其作用机制可能与降低IL-2和IL-6表达,调节Th1/Th2失衡有关。

Objective.. To observe the clinical effect of Xiaoying Sanjie prescription in treating euthyroid or subclinical hypothyroidism Hashimoto＇s thyroiditis （HT） and its effect on thyroid peroxidase antibody （TPOAb）, thyroglobulin antibody （TGAb）, interleukin-2（IL-2） and interleukin-6（IL-6）. Methods.. Selected 56 patients, and divided them into the trearment group and the control group, 28 cases in each. The two groups both received basic treatment, while the control group was given Jinshuibao capsule, and the treatment group was given Xiaoying Sanjie prescription based on the treatment of the control group. After treatment, evaluated climical effect and compared the change of Chinese medicine syndrome score and level of serum TPOAb, TGAb, IL-2 and IL-6. Results. The total effective rate was 92.9% in the treatment group and was 71.4% in the control group, the difference being significant（P〈 0.05）. After treatment, Chinese medicine syndrome scores of the two groups were lower than those before treatment（P〈 0.05）, and the decline of the treatment group was more obvious than that of the control group（P〈 0.05）. After treatment, levels of serum TPOAb, TGAb, IL-2 and IL-6 of both groups were all lower than those before treatment （P 〈O.05）and the decline of the treatment group was more obvious than that of the control group（P〈 0.05）. Conclusion- Xiaoying Sanjie prescription can effectively improve clinical symptoms, reduce levels of thyroid autoantibody in treating euthyroid or subclinical hypothyroidism HT. Its mechanism may be related to reduction of expression of IL-2 and IL-6 which helps regualte imbalance of Thl/Th2.