芪郁益气舒肝方对气虚肝郁型桥本甲状腺炎患者自身抗体水平的近远期疗效评价

Short-Term and Long-Term Effect of Qiyu Yiqi Shugan Recipe(芪郁益气舒肝方)on Autoantibody Level in Patients with Hashimoto Thyroiditis with Syndrome of Qi Deficiency and Liver Depression

目的通过观察芪郁益气舒肝方对桥本甲状腺炎自身抗体水平的近远期疗效,探索中医药治疗桥本甲状腺炎的优势。方法将符合纳入标准的339例气虚肝郁型桥本甲状腺炎患者,按实际用药情况分为中药组(140例)、硒酵母组(110例)及中药+硒酵母组(89例)。疗程2~42个月。(1)短期疗效观察:用药2个月,观察各组治疗前后抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平变化;(2)长期疗效观察:观察中药组、中药+硒酵母组长期随访患者自身抗体水平的变化趋势。对芪郁益气舒肝方的近远期疗效进行分析及评价。结果治疗2个月后中药组及中药+硒酵母组TPOAb、TGAb抗体水平均降低(P<0.05),疗效优于硒酵母组。长期随访过程中TPOAb、TGAb呈上下波动趋势,但最终稳定在较低水平。结论芪郁益气舒肝方短期内可明显降低甲状腺自身抗体滴度,从长远来看,也可使TPOAb、TGAb维持在较低水平。

Objective By observing the short-term and long-term effects of Qiyu Yiqi Shugan Recipe(芪郁益气舒肝方)on the level of autoantibodies in Hashimoto′s thyroiditis,we explored the advantages of traditional Chinese medicine in the treatment of Hashimoto′s thyroiditis.Methods A total of 339 patients with Hashimoto′s thyroiditis of Qi deficiency and liver depression were divided into traditional Chinese medicine group(140 cases),selenium yeast group(110 cases)and traditional Chinese medicine+selenium yeast group(89 cases).The course of treatment ranged from 2 months to 42 months.(1)Short-term efficacy observation:2 months after treatment,the changes of anti-thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TGAb)were observed before and after treatment in each group.(2)Longterm curative effect observation:We observed the change trend of autoantibody level of patients in traditional Chinese medicine group and traditional Chinese medicine+selenium yeast group after long-term follow-up.The short-term and longterm efficacy of Qiyu Yiqi Shugan Recipe was analyzed and evaluated.Results After 2 months of treatment,the levels of TPOAb and TGAb antibodies in traditional Chinese medicine group and traditional Chinese medicine+selenium yeast group decreased(P<0.05).The curative effect was superior to that of the selenium yeast group.During the long-term follow-up,TPOAb and TGAb fluctuated upward and downward,but eventually stabilized at a low level.Conclusion Qiyu Yiqi Shugan Recipe can significantly reduce the thyroid autoantibody titer in the short term,and in the long run,it also can keep TPOAb and TGAb at a low level.