针刺联合左甲状腺素钠治疗结节性甲状腺肿的疗效及对血清TGF-α、IFN-γ的影响

Therapeutic Efficacy of Acupuncture Combined with Levothyroxine Sodium for Nodular Goiter and Its Effects on Serum TGF-α and IFN-γ

目的观察针刺联合左甲状腺素钠治疗结节性甲状腺肿的临床疗效及对血清TGF-α、IFN-γ的影响。方法将70例结节性甲状腺肿患者随机分为对照组和观察组,每组35例。对照组予口服左甲状腺素钠,观察组予针刺联合口服左甲状腺素钠治疗。观察两组治疗前后最大结节直径、结节数量、结节动脉血流参数、甲状腺功能指标及血清转化生长因子(TGF-α)、干扰素(IFN-γ)水平。比较两组临床疗效。结果观察组总有效率高于对照组,两组差异具有统计学意义(P<0.05)。治疗后,两组最大结节直径、结节数量均较治疗前减少(P<0.05),且观察组最大结节直径、结节数量均小于对照组(P<0.05)。对照组治疗后收缩期峰值流速(PSV)、阻力指数(RI)与治疗前比较,差异无统计学意义(P>0.05);观察组治疗后PSV、RI值较治疗前明显降低(P<0.05),且低于对照组(P<0.05)。对照组治疗后血清促甲状腺激素(TSH)水平较治疗前降低(P<0.05),且与观察组比较,差异具有统计学意义(P<0.05);观察组治疗后血清TSH水平与治疗前比较无明显变化(P>0.05)。观察组治疗后血清TGF-α水平较治疗前降低(P<0.05),血清IFN-γ水平较治疗前升高(P<0.05),与对照组比较差异具有统计学意义(P<0.05);对照组治疗后血清TGF-α、IFN-γ水平与治疗前比较无明显变化(P>0.05)。结论针刺联合左甲状腺素钠治疗结节性甲状腺肿能缩小、消除甲状腺结节,调节结节动脉血流,稳定甲状腺功能,改善血清TGF-α、IFN-γ水平。

Objective To observe the therapeutic efficacy of acupuncture plus Levothyroxine sodium in treating nodular goiter and its effects on serum transforming growth factor(TGF)-α and interferon(IFN)-γ. Method Seventy patients with nodular goiter were randomly divided into a control group and an observation group, with 35 cases in each group. The control group was given oral administration of Levothyroxine sodium and the observation group was treated with acupuncture plus oral administration of Levothyroxine sodium. The maximum nodule diameter, number of nodules,intranodal arterial blood flow parameters, thyroid function indexes, and serum levels of TGF-α and IFN-γ were observed before and after treatment in the two groups. Clinical efficacy was also compared. Result The total effective rate was higher in the observation group than in the control group, and the difference was statistically significant(P<0.05). After treatment, the maximum nodule diameter and number of nodules decreased in both groups(P<0.05), and were smaller in the observation group than in the control group(P<0.05). The peak systolic velocity(PSV) and resistance index(RI) didn’t show significant changes after intervention in the control group(P>0.05). The PSV and RI declined significantly after treatment in the observation group(P<0.05), and were lower than in the control group(P<0.05). The serum level of thyroid stimulating hormone(TSH) dropped after treatment in the control group(P<0.05),and was significantly different from that in the observation group(P<0.05);the serum level of TSH didn’t show significant change in the observation group after treatment(P>0.05). After treatment, the level of serum TGF-αdeclined(P<0.05) and the level of serum IFN-γ increased(P<0.05) in the observation group, and were significantly different from those in the control group(P<0.05);there were no significant changes in the levels of TGF-α and IFN-γin the control group after treatment(P>0.05). Conclusion Acupuncture plus Levothyroxine sodium can reduce or even eliminate thyroid nodules, regulate the intranodal arterial blood flow, stabilize thyroid function and improve the levels of serum TGF-α and IFN-γ in treating nodular goiter.