夏枯草颗粒联合甲巯咪唑片治疗毒性弥漫性甲状腺肿伴甲状腺功能亢进症患者临床研究

Clinical Study on Xiakucao Granules Combined with Thiamazole Tablets for Toxic Diffuse Goiter Complicated with Thyroid Hyperfunction

目的:观察夏枯草颗粒联合甲巯咪唑片治疗毒性弥漫性甲状腺肿伴甲状腺功能亢进症患者的疗效及对血清成纤维细胞生长因子21(FGF21)、促甲状腺素受体抗体(TR-Ab)水平的影响。方法:选择78例毒性弥漫性甲状腺肿伴甲状腺功能亢进患者为研究对象,随机分为对照组与观察组各39例。对照组接受甲巯咪唑片治疗,观察组在对照组基础上联合夏枯草颗粒治疗。比较2组临床疗效,比较2组治疗前后血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)及FGF21、TR-Ab水平。结果:治疗前,2组血清FT3、FT4、TSH水平比较,差异无统计学意义(P>0.05);治疗后,2组血清FT3、FT4水平均降低(P<0.05),TSH水平升高(P<0.05),且观察组FT3、FT4水平低于对照组,TSH水平高于对照组(P<0.05)。治疗前,2组血清FGF21、TR-Ab水平比较,差异无统计学意义(P>0.05);治疗后,2组血清FGF21水平升高(P<0.05),TR-Ab水平降低(P<0.05),且观察组FGF21水平高于对照组(P<0.05),TR-Ab水平低于对照组(P<0.05)。治疗后,观察组治疗总有效率92.31%,高于对照组76.92%(P<0.05)。结论:夏枯草颗粒联合甲巯咪唑片治疗毒性弥漫性甲状腺肿伴甲状腺功能亢进,在改善甲状腺功能方面比单用甲巯咪唑更有优势,且可以调节血清FGF21、TR-Ab水平,提高临床疗效。

Objective:To observe the curative effect of Xiakucao Granules combined with Thiamazole Tablets for patients with toxic diffuse goiter complicated with thyroid hyperfunction,and its effect on levels of fibroblast growth factor 21(FGF21)and thyrotropin receptor antibody(TRAb)in serum.Methods:A total of 78 cases of patients with toxic diffuse goiter complicated with thyroid hyperfunction were selected as the study subjects and randomly divided into the control group and the observation group,with 39 cases in each group.The control group was treated with Thiamazole Tablets,and the observation group was additionally treated with Xiakucao Granules based on the treatment of the control group.Clinical effects were compared between the two groups.Before and after treatment,the levels of free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),FGF21,and TR-Ab in serum were compared between the two groups.Results:Before treatment,there was no significant difference being found in the comparison of levels of FT3,FT4 and TSH in serum between the two groups(P>0.05).After treatment,the levels of FT3 and FT4 in serum in the two groups were decreased(P<0.05),and TSH levels were increased(P<0.05);the levels of FT3 and FT4 in the observation group were lower than those in the control group,and TSH level was higher than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of FGF21 and TR-Ab in serum between the two groups(P>0.05).After treatment,the FGF21 levels in serum in the two groups were increased(P<0.05),and TR-Ab levels were decreased(P<0.05);the FGF21 level in the observation group was higher than that in the control group(P<0.05),and TR-Ab level was lower than that in the control group(P<0.05).After treatment,the total effective rate was 92.31%in the observation group,higher than that of 76.92%in the control group(P<0.05).Conclusion:In the treatment of toxic diffuse goiter complicated with thyroid hyperfunction,Xiakucao Granules combined with Thiamazole Tablets has more advantages than Thiamazole alone in improving thyroid function,and can regulate levels of FGF21 and TR-Ab in serum,and improve clinical effect.