基于中医经典理论探究古方新用——小柴胡汤合当归芍药散治疗桥本氏甲状腺炎

Exploring the new application of ancient prescriptions based on TCM classic theory——Treating Hashimoto’s thyroiditis with the Xiaochaihu decoction plus Danggui Shaoyao San

目的:利用科研验证临床的办法,探究中医古方治疗现代疾病的疗效和安全性,从而为拓展古方新用,为新病找到新法,验证中医经方“小柴胡汤合当归芍药散”治疗桥本氏甲状腺炎的临床疗效。方法:181例桥本氏甲状腺炎患者随机分为对照组(90例)与试验组(91例)。对照组单独采用甲状腺素片口服,试验组予甲状腺素片加小柴胡汤合当归芍药散原方治疗。观察两组桥本氏甲状腺炎患者治疗前后甲状腺功能指标游离三碘甲状腺原氨酸(Free Triiodothyronine,FT3)、游离甲状腺素(Free Thyroxine,FT4)、促甲状腺激素(Thyroid Stimulating Hormone,TSH),免疫学指标血清甲状腺球蛋白抗体(Thyroglobulin Antibody,TgAb)、甲状腺过氧化物酶抗体(Thyroidperoxidase Antibody,TPOAb)以及中医证候积分的变化,并观察中药组方的安全性。结果:经过3个月的治疗,试验组总有效率显著高于对照组(P<0.01);两组中医证候积分较本组治疗前明显下降(P<0.05),试验组中医证候积分较对照组下降更显著(P<0.01)。两组FT3、FT4、TSH水平较本组治疗前显著改善(P<0.05),试验组TSH的改善更加显著(P<0.01);两组TgAb、TPOAb较本组治疗前均显著下降(P<0.05),且试验组下降趋势更明显(P<0.01);在治疗过程中未见任何不良反应发生。结论:中医经方小柴胡汤合当归芍药散联合甲状腺素片治疗桥本氏甲状腺炎,相较于单纯甲状腺素片临床效果显著,值得进一步临床和实验研究。

Objective:The efficacy and safety of TCM ancient prescriptions in the treatment of modern diseases was explored by the method of scientific research verified clinical practice,so as to expand the applications of ancient prescriptions and seek out new methods for treating new diseases,and verify the clinical efficacy of TCM classical prescription the Xiao chaihu decoction(小柴胡汤)plus Danggui Shaoyao San(当归芍药散)on Hashimoto’s thyroiditis.Methods:A total of 181 cases were randomly divided into the control group(90 cases)and the test group(91 cases).The control group was given thyroxine tablets orally alone,while the test group was given additionally the Xiaochaihu decoction plus Danggui Shaoyao San more.Results:After 3 months of treatment,the total efficiency in the test group was significantly higher than the control group(P<0.01).After 3 months of treatment,the TCM syndrome scores in the two groups were significantly decreased compared with before(P<0.05),and the decrease in the test group were more significantly than the control group(P<0.01).After 3 months of treatment,the levels of FT3,FT4 and TSH in the two groups were significantly ameliorated(P<0.05),and the amelioration of TSH in the test group was more significant(P<0.01).After 3 months of treatment,TgAb and TPOAb levels in the two groups were significantly decreased(P<0.05),and the decrease trend in the test group was more obvious(P<0.01),with no adverse reaction during the treatment.Conclusion:Compared with thyroxine tablets alone,TCM classical prescription the Xiaochaihu decoction plus Danggui Shaoyao San and thyroxine tablets shows a significant clinical effect on Hashimoto’s thyroiditis,which is worthy of further clinical and experimental research.