亚甲方治疗亚急性甲状腺炎(热毒壅盛、血热夹瘀证)的临床疗效及对免疫功能的影响

The Clinical effect of Yajia Decoction on Hyperacute Thyroiditis with Heat-toxic Congestion and Blood-heat Stagnation Type and Its Influence on Immune Function

目的通过观察亚甲方对亚急性甲状腺炎(热毒壅盛、血热夹瘀证)的临床疗效,探讨中医药治疗亚急性甲状腺炎的机制。方法患者62例采用随机、对照试验设计方法,分为观察组及对照组各31例,观察组予亚甲方口服,对照组予西医常规治疗。两组均治疗4周,观察中医证候评分、临床有效率及相关实验室指标(血沉、甲状腺功能、IgG、IgA、IgM、补体C3、C4、B因子)情况。结果 1)观察组能有效改善患者甲状腺肿、乏力、多汗、震颤、肢体酸痛、食欲不振,疗效优于对照组(P <0.05),在改善发热、甲状腺痛、咽痛方面两组比较差别无统计学意义(P> 0.05)。2)用药4周后观察组临床总有效率93.55%,优于对照组的87.10%(P <0.01)。3)观察组和对照组均可有效降低患者的ESR、FT3、FT4、TGAb、补体C3、C4、B因子的水平,升高TSH水平,组间比较,差异均无统计学意义(P> 0.05)。4)观察组可有效降低TG水平,结果优于对照组(P <0.05)。5)观察组可有效降低TPOAb、IgG、IgA、IgM的水平,而对照组无此效果。结论亚甲方可有效治疗亚急性甲状腺炎(热毒壅盛、血热夹瘀证),有效改善患者症状及体征;降低患者ESR、FT3、FT4、TGAb等水平,升高TSH水平,疗效与激素相当,更可有效降低TG、TPOAb、IgG、IgA、IgM的水平,疗效优于激素。

Objective:To explore the advantages of traditional Chinese medicine in the treatment of subacute thyroiditis by observing the clinical effect of Yajia Decoction on subacute thyroiditis of heat-toxic congestion and blood-heat stagnation type and its influence on immune function. Methods:62 cases were divided into experimental group and control group,each group was treated for 4 weeks. TCM Syndrome Scoring,Clinical efficiency,and the changes of laboratory indexes(erythrocyte sedimentation rate,thyroid function,IgG,IgA,IgM,complement C3,C4,B factor)before and after treatment were observed. Result:1)The experimental group could effectively improve goiter,fatigue,hyperhidrosis,tremor,limb ache and loss of appetite. The curative effect of the experimental group was better than that of the control group(P < 0.05). There is no significant difference in fever,thyroid pain and pharyngalgia between the two groups(P > 0.05). 2)The total effective rate of the experimental group was93.55%,which was better than 87.10% of the control group(P < 0.01). 3)The levels of ESR,FT3,FT4,TGAb,complement C3,C4 and B in SAT patients were reduced and TSH levels were increased in both groups,but there was no significant difference between the two groups(P > 0.05). 4)The experimental group can effectively reduce the level of TG,the results are better than the control group(P < 0.05). 5)The levels of TpoAb,IgG,IgA and IgM in the experimental group were significantly lower than those in the control group. Conclusions:Yajia Decoction can effectively treat subacute thyroiditis with heat-toxic congestion and blood-heat stagnation syndrome,effective improvement of symptoms and signs of patients;effectively reduce ESR,FT3,FT4,TGAb and so on,and increase TSH level. Its curative effect is similar to that of hormone. It can also effectively reduce the levels of TG,TpoAb,IgG,IgA and IgM,which is better than hormone.