二仙汤联合左甲状腺素钠片治疗甲状腺功能减退临床研究

Clinical Study of Erxian Decoction Combined with Levothyroxine Sodium Tablets in the Treatment of Hypothyroidism

目的:观察二仙汤联合左甲状腺素钠片治疗甲状腺功能减退的临床疗效。方法:选取2017年1月至2018年7月本院收治的甲状腺功能减退患者96例,按照随机数字表法分为对照组和观察组各48例。对照组采用左甲状腺素钠片治疗,观察组在对照组治疗的基础上采用二仙汤治疗。比较两组患者临床疗效、中医症状改善情况、治疗前后甲状腺功能与抗体指标[血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、促甲状腺激素(thyroid stimulating hormone,TSH)、游离甲状腺素(free thyroxine,FT4)、甲状腺过氧化物酶抗体(thyroid peroxidases antibody,TPOAb)、甲状腺球蛋白抗体(anti-thyroglobulin antibodies,TGAb)]、血清T细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+、CD16^+)及不良反应发生情况。结果:对照组有效率为77.08%,观察组有效率为95.83%,两组有效率比较,差异有统计学意义(P<0.05);观察组治疗后畏寒肢冷、身倦乏力、颜面肢体肿胀、腰膝酸软、记忆力减退症状积分均较对照组降低,差异有统计学意义(P<0.05);观察组治疗2个疗程后血清FT3、FT4较对照组高(P<0.05),TSH、TPOAb、TGAb较对照组低(P<0.05);治疗后观察组血清CD4^+、CD4^+/CD8^+较对照组高(P<0.05),CD8+、CD16+较对照组低(P<0.05);对照组不良反应发生率为18.75%,观察组不良反应发生率为8.33%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:二仙汤联合左甲状腺素钠片治疗甲状腺功能减退,可明显减轻患者临床症状,提高甲状腺功能,降低抗体水平,改善免疫功能,且不良反应较少。

Objective: To observe the clinical curative effect of Erxian Decoction combined with Levothyroxine Sodium Tablets on hypothyroidism. Methods: Ninety-six patients with hypothyroidism in our hospital were selected and divided into the control group and the observation group according to random number table method, with 48 cases in each group. The control group was treated with Levothyroxine Sodium Tablets, while the observation group was additionally treated with EXD on the basis of the control group. The clinical efficacies, improvement of TCM symptoms, thyroid function and antibody indexes before and after the treatment, including free triiodothyronine(FT3),thyroid stimulating hormone(TSH),free thyroxine(FT4),thyroid peroxidases antibody(TPOAb), and anti-thyroglobulin antibodies(TGAb), and Serum T cell subsets(CD4^+, CD8^+, CD4^+/CD8^+, CD16^+) and adverse reactions occurred were compared between the two groups. Results: The effective rate was 77.08% in the control group and 95.83% in the observation group. There was a significant difference between the two groups(P<0.05). After the treatment, the scores of symptoms of chills, fatigue, facial swelling, weakness of waist and knee, and memory impairment in the observation group were all lower than those in the control group, and all the differences were statistically significant(P<0.05). After two courses of treatment, the serum FT3 and FT4 in the observation group were higher than those in the control group(P<0.05), while TSH, TPOAb and TGAb were lower than those in the control group(P<0.05). After the treatment, the serum levels of CD4^+, CD4^+/CD8^+ in the observation group were higher than those in the control group(P<0.05), while the levels of CD8^+, CD16^+ in the observation group were lower than those in the control group(P<0.05). The incidence of adverse reactions was 18.75% in the control group and 8.33% in the observation group. There was no significant difference between the two groups(P>0.05). Conclusion: EXD combined with Levothyroxine Sodium Tablets has a remarkable efficacy on hypothyroidism, can obviously alleviate clinical symptoms, improve thyroid function, reduce antibody level and improve immune function, and has fewer adverse reactions.