金匮肾气丸联合左甲状腺素钠片治疗桥本甲状腺炎伴甲状腺功能减退的临床研究

Clinical study of Jingui Shenqi Pill combined with levothyroxine sodium tablets on Hashimoto's thyroiditis with hypothyroidism

目的观察金匮肾气丸联合左甲状腺素钠片治疗桥本甲状腺炎(HT)伴甲状腺功能减退的临床疗效。方法将60例HT伴甲状腺功能减退患者随机分为2组。对照组30例予口服左甲状腺素钠片治疗;治疗组30例在对照组基础上加用金匮肾气丸。连续治疗24周后,比较2组治疗前后甲状腺功能相关指标[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(Tg Ab)]及血脂[胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平变化,并统计疗效。结果 2组治疗后FT3、FT4、TSH水平均较治疗前改善(P<0.05),治疗后2组组间比较差异无统计学意义(P>0.05)。治疗组治疗后TPOAb、Tg Ab水平均较本组治疗前下降(P<0.05),对照组TPOAb、Tg Ab水平较本组治疗前无明显变化(P>0.05);治疗后治疗组TPOAb、Tg Ab水平均低于对照组(P<0.05)。2组治疗后TG、TC、LDL-C均降低(P<0.05),HDL-C无改善(P>0.05);治疗后治疗组TC低于对照组(P<0.05),2组治疗后TG、LDL-C、HDL-C比较差异无统计学意义(P>0.05)。治疗组总有效率90.00%,对照组总有效率73.33%,治疗组疗效优于对照组(P<0.05)。结论金匮肾气丸联合左甲状腺素钠片治疗HT伴甲状腺功能减退可更有效地调节甲状腺功能,降低血脂,改善免疫状态,减轻临床症状。

Objective To observe the clinical effects of Jingui Shenqi Pill combined with levothyroxine sodium tablets on Hashimoto's thyroiditis(HT)with hypothyroidism.Methods 60 cases with HT with hypothyroidism were randomly divided into two groups.30 cases in control group were treated by levothyroxine sodium tablets,and treatment group were treated by Jingui Shenqi Pill on the basis of control group treatment.After 24 weeks of continuous treatment,the changes of the thyroid function related indexes including thyroid stimulating hormone(TSH),free three iodine thyroprosine(FT3),free four iodine thyroprosine(FT4),anti thyroid peroxidase antibody(TPOAb),anti thyroglobulin antibody(TGAb)were observed,and the changes of blood lipids including cholesterol(TC),glycerin three fat(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were observed,and the curative effect was statistically analyzed.Results After treatment,the levels of FT3,FT4,and TSH in two groups were improved(P<0.05),and there was no significant difference between the two groups after treatment(P>0.05).The TPOAb and TGAb levels in treatment group were decreased after treatment(P<0.05).The TPOAb and TGA levels in control group did not change significantly before treatment(P>0.05).The TPOAb and TGAb levels in treatment group were lower than those in control group after treatment(P<0.05).After treatment,TG,TC and LDL-C in both groups were decreased(P<0.05),and HDL-C was not improved(P>0.05).After treatment,TC was lower in treatment group than in control group(P<0.05),and there was no significant difference in TG,LDL-C and HDL-C between the two groups(P>0.05).The total effective rate of kidney-yang deficiency in the treatment group was 90%and 73.33%in the control group,and the curative effect in the treatment group was better than that in the control group(P<0.05).Conclusion Jingni shenqiPill combined with levothyroxine sodium in the treatment of HT with hypothyroidism can effectily regulate the thyroid function,reduce serum lipids,improve immune status and reduce clinical symptoms.