益气养阴方配合左甲状腺素钠片对分化型甲状腺癌手术患者甲状腺功能的改善效果

Improvement effect of Yiqi Yangyin recipe combined with levothyroxine sodium tablets on thyroid function in patients undergoing differentiated thyroid cancer surgery

目的分析益气养阴方配合左甲状腺素钠片对分化型甲状腺癌手术患者甲状腺功能的改善效果。方法纳入2016年10月至2021年1月于我院诊治的120例分化型甲状腺癌手术患者为研究对象,按照红绿双色球法将其分为对照组(n=60,左甲状腺素钠片)与试验组(n=60,益气养阴方^(+)左甲状腺素钠片)。连续治疗8周后,比较两组患者治疗前、后的甲状腺功能指标、白细胞介素-6(IL-6)、β_(2)-微球蛋白(β_(2)-MG)、骨代谢指标、免疫功能指标水平及中医证候积分,统计并比较两组患者的不良反应发生情况。结果治疗后,两组的促甲状腺激素(TSH)、甲状腺球蛋白(TG)以及甲状旁腺激素(PTH)水平均降低,且试验组明显低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的中医证候积分及IL-6、β_(2)-MG水平均降低,且试验组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的碱性磷酸酶(ALP)、骨钙素(BGP)、β-胶原特殊序列(β-CTX)、Ⅰ型前胶原氨基端前肽(PⅠNP)水平均升高,但试验组低于对照组,差异具有统计学意义(P<0.05)。试验组的不良反应总发生率为6.67%,明显低于对照组的26.67%,差异具有统计学意义(P<0.05)。治疗后,两组的CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)均升高,CD8^(+)均降低,且试验组优于对照组,差异具有统计学意义(P<0.05)。结论益气养阴方^(+)左甲状腺素钠片用于分化型甲状腺癌术后患者中的治疗效果理想,对于甲状腺功能以及临床症状具有改善效果,有利于减轻患者的炎症反应,优化骨代谢指标水平与免疫功能,且不良反应少,临床可进一步推广应用。

Objective To analyze the improvement effect of Yiqi Yangyin recipe combined with levothyroxine sodium tablets on thyroid function in patients undergoing differentiated thyroid cancer surgery.Methods From October 2016 to January 2021,120 patients undergoing differentiated thyroid cancer surgery in our hospital were included in this study,and the patients were divided into control group(n=60,levothyroxine sodium tablets)and experimental group(n=60,Yiqi Yangyin recipe^(+)levothyroxine sodium tablets)by the red and green double-color ball method.After 8 weeks of continuous treatment,the levels of thyroid function indexes,interleukin-6(IL-6)and β_(2)-microglobulin(β_(2)-MG),bone metabolism indexes,immune function indexes and TCM syndrome score of the two groups before and after treatment were compared,and the occurrence of adverse reactions of the two groups were counted and compared.Results After treatment,the levels of thyroid stimulating hormone(TSH),thyroglobulin(TG)and parathyroid hormone(PTH)in the two groups decreased,those in the experimental group were significantly lower than the control group,and the differences were statistically significant(P<0.05).After treatment,TCM syndrome score and IL-6 and β_(2)-MG levels decreased in both groups,those in the experimental group were lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of alkaline phosphatase(ALP),osteocalcin(BGP)and β-crosslaps(β-CTX)and typeⅠprocollagen N-terminal propeptide(PⅠNP)increased in both groups,but those in the experimental group were lower than the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the experimental group was 6.67%,which was significantly lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups increased and CD8^(+)decreased,thosein the experimental group were better than the control group,and the differences were statistically significant(P<0.05).Conclusion The Yiqi Yangyin recipe^(+)levothyroxine sodium tablets has ideal therapeutic effect for patients undergoing differentiated thyroid cancer surgery.It can improve thyroid function and clinical symptoms,reduce patients'inflammatory reaction,and optimize bone metabolism indexes level and immune function,with few adverse reaction,which can be further popularized and applied in clinic.