消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效研究

Study on clinical effect of Xiaoying prescription combined with microwave ablation on Hashimoto’thyroiditis with nodule

目的:探讨消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效。方法:将108例桥本甲状腺炎伴结节患者随机分为三组,中药组行消瘿方联合微波消融术治疗,西药组行微波消融术联合左甲状腺素钠片治疗,对照组行微波消融术治疗。治疗后,比较三组甲状腺功能、甲状腺体积、结节体积、缩瘤率、临床证候积分、临床疗效。结果:与治疗前比较,治疗后6个月中药组、西药组FT3、FT4水平比较,差异无统计学意义(均P>0.05),而TSH、TgAb、TPOAb降低,差异有统计学意义(均P<0.05)。治疗后6个月中药组、西药组TgAb、TPOAb水平低于对照组,且中药组低于西药组,差异有统计学意义(均P<0.05)。与治疗前比较,治疗后6个月中药组、西药组甲状腺体积均缩小、临床证候积分降低,差异有统计学意义(均P<0.05)。治疗后6个月对照组甲状腺体积、临床证候积分与治疗前比较,差异无统计学意义(均P>0.05)。与治疗前比较,治疗后6个月三组结节体积均缩小,差异有统计学意义(P<0.05)。治疗后6个月,中药组的缩瘤率、有效率均高于西药组、对照组,差异有统计学意义(均P<0.05)。结论:消瘿方联合微波消融术治疗桥本甲状腺炎伴结节疗效较好,可促进甲状腺结节消融灶吸收,改善患者临床症状及甲状腺功能,且安全性较好。

Objective:To investigate the effect of Xiaoying prescription combined with microwave ablation in the treatment of Hashimoto’thyroiditis with nodule.Methods:108 cases of Hashimoto’thyroiditis with nodule were randomly divided into three groups.The traditional Chinese medicine group were received Xiaoying prescription combined with microwave ablation,the western medicine group received microwave ablation combined with levothyroxine sodium tablet,and the control group received microwave ablation.After treatment,thyroid function,thyroid volume,nodule volume,tumor reduction rate,clinical symptom score and clinical efficacy of the three groups were compared.Results:Compared with before treatment,there were no significant difference in FT3 and FT4 levels between the traditional Chinese medicine group and the western medicine group after treatment(all P>0.05),while TSH,TgAb and TPOAb decreased,difference statistically significant(all P<0.05).After 6 months treatment,the levels of TgAb and TPOAb in the traditional Chinese medicine group and the western medicine group were lower than those in the control group,and the levels of TgAb and TPOAb in the traditional Chinese medicine group were lower than those in the western medicine group,difference statistically significant(all P<0.05).Compared with before treatment,thyroid volume and clinical symptom score of the traditional Chinese medicine group and western medicine group decreased 6 months after treatment(all P<0.05).Compared with before treatment,there were no significant differences in thyroid volume and clinical symptom score of the control group after 6 months treatment,difference not statistically significant(all P>0.05).Compared with before treatment,nodule volume in the three groups decreased after 6 months treatment,difference statistically significant(all P<0.05).After 6 months treatment,the tumor reduction rate and effective rate in the traditional Chinese medicine group were higher than those in the western medicine group and the control group,difference statistically significant(all P<0.05).Conclusion:Xiaoying prescription combined with microwave ablation has good efficacy in the treatment of Hashimoto'thyroiditis with nodules,which can promote the absorption of thyroid nodules ablation,improve clinical symptoms and thyroid function of patients with better safety.