健脾消瘿汤合优甲乐对脾气亏虚型桥本甲状腺炎患者甲状腺激素、甲状腺自身抗体和CD4+CD45RO+记忆性T细胞的影响

Effects of Jianpi Xiaoying Decoction Combined with Youjiale on Thyroid Hormone,Thyroid Autoantibody and CD4+CD45RO+Memory T Cells in Patients with Hashimoto’s Thyroiditis of Spleen Qi Deficiency Type

目的:探讨健脾消瘿汤联合优甲乐对脾气亏虚型桥本甲状腺炎(HT)患者甲状腺激素、甲状腺自身抗体和CD4+CD45RO+记忆性T细胞的影响。方法:选择2020年5月~2021年11月期间我院收治的HT患者60例,采用随机数字表法分为对照组(优甲乐治疗,30例)和研究组(健脾消瘿汤联合优甲乐治疗,30例),两组均治疗12周后观察临床疗效,并对比两组治疗前后中医证候积分、甲状腺激素、甲状腺自身抗体和CD4+CD45RO+记忆性T细胞的变化。结果:研究组临床总有效率较对照组高(P<0.05)。研究组治疗后促甲状腺激素(TSH)水平、中医证候总积分、CD4+CD45RO+记忆性T细胞在外周血单个核细胞(PBMC)中的百分比、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)均低于对照组(P<0.05),游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平高于对照组(P<0.05)。结论:脾气亏虚型HT患者采用健脾消瘿汤联合优甲乐治疗,可改善其甲状腺激素水平,调节甲状腺自身抗体水平和CD4+CD45RO+记忆性T细胞在PBMC中的百分比,进一步提高临床疗效。

Objective:To investigate the effects of Jianpi Xiaoying decoction combined with youjiale on thyroid hormone,thyroid autoantibody and CD4+CD45RO+memory T cells in patients with Hashimoto’s?thyroiditis(HT) of spleen qi deficiency type.Methods:60 patients with HT who were treated in our hospital from May 2020 to November 2021 were selected,and they were randomly divided into control group(received youjiale,30 cases) and study group(received Jianpi Xiaoying decoction combined with youjiale,30 cases)by random number table method.The clinical effects of the two groups were observed at 12 weeks after treatment,and the changes of TCM syndrome score,thyroid hormone,thyroid autoantibody and CD4+CD45RO+memory T cells were compared between the two groups before and after treatment.Results:The total clinical effective rate of the study group was higher than that of the control group(P<0.05).After treatment,thyroid stimulating hormone(TSH),total score of TCM syndromes,percentage of CD4+CD45RO+memory T cells in peripheral blood mononuclear cells(PBMC),thyroglobulin antibody(TGAb) and thyroid peroxidase antibody(TPOAb) of the study group were lower than those of the control group(P<0.05),and free triiodothyronine(FT3) and free thyroxine(FT4) were higher than those in the control group(P<0.05).Conclusion:The patients of HT of spleen qi deficiency type use Jianpi Xiaoying decoction combined with youjiale treatment can improve the level of thyroid hormone,regulate the level of thyroid autoantibody and the percentage of CD4+CD45RO+memory T cells in PBMC,and further improve the clinical efficacy.