祛痰软坚法治疗多囊卵巢综合征合并自身免疫性甲状腺疾病的临床研究

Clinical study on Qutan Ruanjian in the treatment of polycystic ovary syndrome combined with autoimmune thyroid disease

目的观察祛痰软坚中药对多囊卵巢综合征(PCOS)合并自身免疫性甲状腺疾病(AITD)的临床疗效。方法收集2016年10月~2018年5月门诊就诊的PCOS(痰湿证)伴随AITD的64例患者,按随机数字表法分为观察组和对照组各32例,分别予祛痰软坚中药及达英-35治疗并随访各3个月。评价两组临床疗效,比较两组患者治疗前、后及随访时血清IL-6、TNF-α、性激素、HOMR-IR、TGAb、TPoAb及卵巢体积。结果观察组和对照组临床总有效率分别为96.88%和59.38%,差异有统计学意义(P<0.05)。随访时观察组血清LH、IL-6、TNF-α、TGAb、TPOAb、HOMA-IR及卵巢体积值均较对照组下降明显,两组差异有统计学意义(P<0.05),而FSH差异无统计学意义(P>0.05)。结论祛痰软坚中药治疗PCOS合并AITD具有较好的临床疗效,可能通过降低血清IL-6和TNF-α水平,一定程度调节患者的低度炎症及免疫失衡状态,从而改善患者的疾病状态。

Objective To observe the clinical efficacy of Qutan Ruanjian Chinese medicine in the treatment of polycystic ovary syndrome(PCOS)with autoimmune thyroid disease(AITD).Methods From October 2016 to May 2018,64 PCOS combined with AITD patients with phlegm-dampness syndrome who were admitted to the gynaecology clinic of Hospital of Traditional Chinese Medicine were divided into the observation group(n=32)and the control group(n=32)according to random number table method,and were treated with Qutan Ruanjian and diane-35 treatment and follow-up for 3 months.The clinical efficacy of the two groups was evaluated.Serum IL-6,TNF-α,sex hormone,HOMR-IR,TGAb,TPOAb and ovarian volume were compared before,after and at the time of treatment.Results The total clinical effective rate of observation group and control group were 96.88%and 59.38%,respectively,and the difference was statistically significant(P<0.05).The serum LH,IL-6,TNF-α,TGAb,TPOAb,HOMA-IR and ovarian volume values in the observation group decreased significantly compared with those in the control group during follow-up,and the difference between the two groups was statistically significant(P<0.05).There was no statistically significant difference in FSH between two groups(P>0.05).Conclusion The treatment of PCOS with AITD by Qutan Ruanjian has a good clinical effect.It may improve the patient’s disease state by reducing the levels of serum IL-6 and TNF-αand regulating the low-grade inflammation and immune imbalance,thus improving the disease of patients.