当归六黄汤辨证加减治疗对风热痰凝型或气滞痰凝型桥本甲状腺炎患者的疗效及安全性分析

The efficacy and safety of the Danggui Liuhuang decoction on Hashimoto thyroiditis of the Fengre Tanning type or the Qizhi Tanning type

目的:探讨当归六黄汤辨证加减治疗对风热痰凝型或气滞痰凝型桥本甲状腺炎患者的疗效及安全性分析。方法:以我院内分泌科2018年8月-2019年8月诊治的100例风热痰凝型或气滞痰凝型桥本甲状腺炎患者为研究对象,随机分为观察组(50例,给予当归六黄汤口服治疗)和对照组(50例,给予优甲乐口服治疗)。对比两组患者治疗效果、中医症状积分、甲状腺体积改变情况、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(Thyroid Stimulating Hormone,TSH)、免疫功能指标[甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、γ-干扰素(Interferon-γ,IFN-γ)、肿瘤坏死因子(Tumor Necrosis Factor,TNF-α)、白介素(Interleukin,IL)-6、IL-23、IL-17A]及药物安全性分析。结果:观察组临床证候积分、总有效率均优于对照组,组间比较差异有统计学意义(P均<0.05);治疗前,两组甲状腺体积、FT3、FT4、TSH、TPOAb、TgAb、IFN-γ、TNF-α、IL-6、IL-23、IL-17A比较,差异不显著(P>0.05);治疗后6个月,观察组甲状腺体积、FT3、FT4、TSH、TPOAb、TgAb、IFN-γ、TNF-α、IL-6、IL-23、IL-17A明显优于对照组,组间比较差异有统计学意义(P<0.05),且两组均无不良反应。结论:在风热痰凝型或气滞痰凝型桥本甲状腺炎患者中采用当归六黄汤辨证加减治疗治疗效果确切,可有效改善患者中医症状,可促使甲状腺体积恢复至正常,降低甲状腺自身免疫性抗体指标,且安全性高,值得临床推广使用。

Objective:To study the effect and safety of the Danggui Liuhuang decoction(当归六黄汤)on Hashimoto thyroiditis of the Fengre Tanning type(风热痰凝型)or the Qizhi Tanning type(气滞痰凝型).Methods:100 patients were randomly divided into the observation group(given the Danggui Liuhuang decoction)and control group(given oral euthyrox).Results:The clinical syndrome score and total efficiency in the observation group were better than those in the control group(P<0.05).After treatment,thyroid volume,FT3,FT4,TSH,TPOAb,Tg Ab,IFN-γ,TNF-α,IL-6,IL-23 and IL-17 A in the observation group were significantly better than those in the control group(P<0.05),and no adverse reactions was observed in the two groups.Conclusion:The Danggui Liuhuang decoction on Hashimoto thyroiditis of the Fengre Tanning type or the Qizhi Tanning type shows a definite therapeutic effect,can effectively improve the symptoms of TCM,promote the thyroid volume to return to normal,reduce the thyroid autoimmune antibody index,and is safe and worthy of clinical promotion.