益气化瘀方治疗甲状腺功能正常桥本甲状腺炎的临床研究

Clinical study of Yiqi Huayu Recipe in the treatment of Hashimoto thyroiditis with normal thyroid function

目的观察益气化瘀方对甲状腺功能正常的桥本甲状腺炎(HT)患者甲状腺自身抗体和甲状腺功能的影响。方法选取湖北省黄冈市中医医院甲状腺科2016年7月~2017年2月收治的甲状腺功能正常的HT患者112例,采用随机数字表法将其随机分为治疗组和对照组,各56例。治疗组给予益气化瘀中药复方制剂,对照组不服用任何药物治疗,仅要求低碘饮食。两组治疗6个月,测定治疗前后甲状腺自身抗体[甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(Tg Ab)]、甲状腺功能[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)]。结果治疗组治疗后TPOAb、Tg Ab水平均较治疗前下降,差异有统计学意义(P<0.05),并且明显低于对照组治疗后(P<0.05)。对照组治疗后TPOAb、Tg Ab较治疗前上升,差异有统计学意义(P<0.05)。对照组治疗后TSH水平较治疗前上升,且明显高于治疗组(P<0.05)。治疗组治疗前后TSH水平比较,差异无统计学意义(P>0.05)。两组治疗前后FT3、FT4水平比较,差异无统计学意义(P>0.05)。结论益气化瘀中药复方可以降低甲状腺功能正常的HT患者TPOAb、Tg Ab水平,但是对于甲状腺功能的影响不大;单纯低碘饮食不能控制HT患者TPOAb、Tg Ab及TSH水平的升高。

Objective To observe the effects of Yiqi Huayu Recipe on the thyroid autoantibodies and thyroid function in Hashimoto thyroiditis （HT） patients with normal thyroid function. Methods From July 2016 to February 2017, a total of 112 patients of HT with normal thyroid function in Department of Thyroid, Hubei Huanggang Hospital of Traditional Chinese Medicine, were recruited in this study. They were randomly classified into treatment group and control group, with 56 cases in each group. The treatment group was given Chinese medicine compound preparation of Yiqi Huayu Recipe, the control group did not take any medication, they were only taken iodine deficient diet. The two groups were treated for 6 months, The thyroid autoantibodies [thyroid peroxidase antibody （TPOAb）, thyroglobulin antibodies （TgAb）] and thyroid function [thyrotropic hormone （TSH）, free triiodothyronine （FT3）, free thyroxine （FT4）] were measured before and after treatment. Results The levels of TPOAb and TgAb in the treatment group were both lower than those before treatment, the differences were statistically significant （P 〈 0.05）, which were significantly lower than those of control group （P 〈 0.05）; the levels of TPOAb and TgAb in the control group were significantly higher than those before treatment, the differences were statistically significant （P 〈 0.05）. After treatment, the level of TSH in the control group was significantly higher than that before treatment, which was significantly higher than that of treatment group （P 〈 0.05）, there was no statistically significant difference of TSH in the treatment group before and after treatment （P 〉 0.05）. There were no statistically significant differences of FT3 and FT4 before and after treatment in the two groups （P 〉 0.05）. Conclusion Chinese medicine compound preparation of Yiqi Huayu Recipe can reduce the levels of TPOAb and TgAb in HT patients with normal thyroid function, but it has little effects on thyroid function; iodine deficient diet can not control the increase of TPOAb, TgAb and TSH in HT patients.