隔姜灸联合中药对亚急性甲状腺炎患者血清25-(OH)D3、ghrelin及TgAb、TMAb表达的影响

Effect of Ginger Moxibustion plus Chinese Herbal Medicine on Serum Expressions of 25-(OH)D3,Ghrelin,TgAb and TMAb in Patients with Subacute Thyroiditis

目的观察隔姜灸联合中药对亚急性甲状腺炎(SAT)患者血清25羟维生素D[25-(OH)D3]、促生长素(ghrelin)及甲状腺球蛋白抗体(TgAb)、甲状腺微粒体抗体(TMAb)表达水平的影响。方法将130例SAT患者作为研究对象,随机分为观察组44例,对照A组43例,对照B组43例。3组均予口服甲泼尼龙片,于此基础上,对照A组予以清热消瘿汤口服,对照B组予以隔姜灸,观察组予以隔姜灸联合清热消瘿汤口服。观察3组临床疗效、不良反应发生率及治疗前后血清甲状腺生化指标[超敏促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)]、血沉(ESR)、25-(OH)D3、ghrelin及TgAb、TMAb水平。结果观察组治愈率高于对照A组、对照B组(P<0.05);观察组退热时间、甲状腺肿大及疼痛消退时间短于对照A组、对照B组(P<0.05)。治疗4周、8周后,观察组T3、T4、ESR、ghrelin水平及TgAb、TMAb表达水平低于对照A组、对照B组(P<0.05),TSH、25-(OH)D3水平高于对照A、B组(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论隔姜灸联合中药治疗SAT,可明显促进患者症状、体征恢复,改善甲状腺功能,调节机体免疫及炎性反应表达。

Objective To observe the effect of ginger moxibustion plus Chinese herbal medicine on serum expressions levels of 25-hydroxyvitamin D(25-(OH)D3),ghrelin,thyroglobulin antibody(TgAb)and thyroid microsomal antibody(TMAb)in patients with subacute thyroiditis(SAT).Method One hundred and thirty SAT patients were enrolled as subjects and randomized to an observation group(44 cases),a control A group(43 cases)and a control B group(43 cases).All the three groups were given oral administration of methylprednisolone tablets.In addition,the control A group was treated with oral administration of Qingre Xiaoying decoction;the control B group,with ginger moxibustion;the observation group,with oral administration of Qingre Xiaoying decoction plus ginger moxibustion.The clinical therapeutic effects were evaluated,the incidence of adverse reactions was observed and pre-treatment and post-treatment serum thyroid biochemical indicators hypersensitive thyroid stimulating hormone(TSH),triiodothyronine(T3)and thyroxine(T4),erythrocyte sedimentation rate(ESR),25-(OH)D3,ghrelin,TgAb and TMAb levels were measured in the three groups.Result The cure rate was higher in the observation group than in the control A group and B group(P<0.05).Time to reduce the fever and time to resolve thyroid enlargement and pain were shorter in the observation group than in the control A group and B group(P<0.05).After four week and eight week of treatment,T3,T4,ESR and ghrelin levels and TgAb and TMAb expression levels were lower(P<0.05)and TSH and 25-(OH)D3 levels were higher(P<0.05)in the observation group than in the control A group and B group.There was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Ginger moxibustion plus Chinese herbal medicine can markedly promote the relief of patients’symptoms and signs,improve thyroid function and regulate the expressions of bodily immunity and inflammatory reaction.