消瘿散结汤联合左甲状腺素钠治疗桥本氏甲状腺炎合并甲状腺功能减退床疗效分析

Clinical Efficacy of Xiaoyong Sanjie Decoction(消瘿散结汤)Combined with Levothyroxine Sodium Tablets in the Treatment of Hashimoto's Thyroiditis Complicated with Hypothyroidism

目的探讨消瘿散结汤联合左甲状腺素钠片治疗桥本氏甲状腺炎(hashimoto's thyroiditis,HT)合并甲状腺功能减退患者的临床疗效。方法选择2022年1月—2022年12月辽宁中医药大学附属第二医院收治的80例HT合并甲状腺功能减退患者,按照随机数字表法为对照组和观察组各40例。对照组予以左甲状腺素钠治疗;观察组在对照组基础上加用消瘿散结汤口服治疗。观察两组临床疗效、中医证候积分变、血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)、血清γ干扰素(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)等。结果治疗后,观察组总有效率高于对照组(P<0.05)。两组TGAb、TPOAb抗体滴度均降低,观察组低于对照组(P<0.05);两组中医证候总积分均降低,观察组低于对照组(P<0.05);两组IFN-γ、IL-2水平均降低(P<0.05),观察组低于对照组(P<0.05)。结论消瘿散结汤联合左甲状腺素钠片治疗HT合并甲状腺功能减退有效,且可在一定程度上降低TGAb、TPOAb及IL-2、IL-4、IL-10水平,改善甲状腺功能及临床症状,提升临床治疗有效率,值得推广。

Objective To investigate the clinical efficacy of Xiaoying Sanjie Decoction(消瘿散结汤)combined with levothyroxine sodium tablets in the treatment of patients with Hashimoto's thyroiditis(HT)complicated with hypothyroidism.Methods Eighty patients with HT complicated with hypothyroidism admitted to the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2022 to December 2022 were selected and divided into the control group and the observation group according to the random number table method.The control group was given levothyroxine sodium;the observation group was given Xiaoying Sanjie Decoction on the basis of the control group.The clinical efficacy of the two groups,the integrated changes of traditional Chinese medicine syndromes,serum free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),anti-thyroglobulin antibody(TGAb),anti-thyroid peroxidase antibody(TPOAb),serum interferon gamma(IFN-γ),interleukin-2(IL-2),interleukin-4(IL-4),interleukin-10(IL-10),etc.were observed.Results After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The titers of TGAb and TPOAb antibodies in both groups decreased,which was lower in the observation group than in the control group(P<0.05);the total TCM syndrome scores in both groups decreased,which was lower in the observation group than in the control group(P<0.05);the levels of IFN-γand IL-2 in both groups decreased(P<0.05),which was lower in the observation group than in the control group(P<0.05).Conclusion Xiaoying Sanjie Decoction combined with levothyroxine sodium tablets is effective in the treatment of HT complicated with hypothyroidism,and can reduce the levels of TGAb,TPOAb and IL-2,IL-4,IL-10 to a certain extent,improve thyroid function and clinical symptoms,and improve clinical treatment effectiveness.It is worth promoting.