二仙消瘿汤联合左旋甲状腺素钠治疗桥本甲状腺炎继发甲状腺功能减退30例

Erxian Xiaoying Decoction combined with levothyroxine sodium in the treatment of hypothyroidism secondary to Hashimoto's thyroiditis: 30 cases report

目的观察二仙消瘿汤联合左旋甲状腺素钠治疗桥本甲状腺炎继发甲状腺功能减退(桥本甲减)的临床疗效。方法将60例桥本甲减患者随机分成治疗组和对照组,每组30例。对照组予左旋甲状腺素钠(优甲乐)治疗,治疗组在对照组治疗措施的基础上加用二仙消瘿汤。4周为1个疗程,两组均治疗3个疗程,观察临床疗效,比较优甲乐用量、甲状腺功能[总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]及相关抗体[抗甲状腺球蛋白抗体(TGAb)、抗甲状腺微粒体抗体(TMAb)]水平的变化情况。结果 (1)治疗组、对照组总有效率分别为93.3%、66.7%;治疗组临床疗效优于对照组(P<0.05)。(2)治疗前后组内比较,两组TT3、TT4、FT3、FT4水平均较治疗前升高(P<0.05),TSH较治疗前降低(P<0.05);组间治疗后比较,甲状腺功能各项指标差异均有统计学意义(P<0.05)。(3)治疗前后组内比较,两组TGAb、TMAb水平及优甲乐用量均较治疗前减少(P<0.05);组间治疗后比较,治疗组TGAb、TMAb水平、优甲乐用量均低于对照组(P<0.05)。结论二仙消瘿汤联合优甲乐治疗桥本甲减疗效满意,可明显改善患者的临床症状及甲状腺功能,降低相关抗体水平。

Objective To observe the clinical efficacy of Erxian Xiaoying Decoction combined with levothyroxine sodium in the treatment of hypothyroidism secondary to Hashimoto＇ s thyroidifis （Hashimoto＇ s hypothyroidism）. Methods 60 patients with Hashimoto＇ s hypothyroidism were randomly divided into the treatment group and control group, 30 cases in each group. The control group was treated with levothyroxine sodium（ Euthyrox）, and the treatment group was treated with Erxian Xiaoying Decoction based on the treatment for the control group. 4 weeks were taken as a course, and both groups were treated for 3 courses. The clinical efficacy was observed, the changes on the dosage of Euthyrox, thyroid function indexes including total triiodothyronine （ TT3 ）, total thyroxine （ TT4 ）, thyroid- stimulating hormone （TSH）, free triiodothyronine （FT3）, free thyroxine （FT4）, and related antibodies including anti-thyroid globulin antibody （TGAb） and anti- thyroid microsomal antibody （TMAb） were compared. Results ①The total effective rates were 93.3% in the treatment group and 66.7% in the control group, and the clinical efficacy of the treatment group was better than that of the control group （ P〈0.05 ）. ②Compared with treatment before, the levels of Tl＇3, TT4, FT3 and FT4 were increased in both groups after treatment （P〈0.05） , while the TSH level was decreased after treatment （P〈0.05）. After treatment, there were statistically significant differences on the levels of all thyroid function indexes between the two groups （P〈0.05）. ③Compared with treatment before, the levels of TGAb and TMAb and the dosage of Euthyrox were decreased in both groups after treatment （P〈0.05）. After treatment, the levels of TGAb and TMAb and the dosage of Euthyrox in the treatment group were lower than those in the control group （P〈0.05）. Conclusion Erxian Xiaoying Decoction combined with levothyroxine sodium shows satisfactory efficacy in the treatment of Hashimoto＇ s hypothyroidism, which can obviously improve the clinical symptoms and thyroid function of patients, and reduce the levels of related antibodies.