左甲状腺素钠联合中药治疗SCH伴血脂异常的临床观察

Clinical Observation on the Use of Levothyroxine Sodium and Traditional Chinese Medicine to Cure SCH Dyslipidemia

目的观察左甲状腺素钠联合中药治疗亚临床甲状腺功能减退症(SCH)伴血脂异常的临床疗效。方法将98例SCH伴血脂异常的病例随机分为治疗组与对照组,每组49例,对照组予优甲乐口服治疗,治疗组在对照组基础上予自拟中药复方口服治疗。两组均治疗10周后观察疗效及左甲状腺素钠日用量,观察两组患者治疗前、治疗结束后甲状腺功能指标[包括促甲状腺激素(TSH)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)]及血脂水平[包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]变化情况。结果治疗组优甲乐用量明显低于对照组,差异有统计学意义(P<0.05)。治疗结束后两组血清TSH水平均显著下降,与治疗前比较差异有统计学意义(P<0.01)。两组TC、TG、LDL-C治疗前后比较,差异有统计学意义(P<0.05,P<0.01),治疗后治疗组TC水平低于对照组,差异有统计学意义(P<0.05)。治疗组总有效率优于对照组。结论激素替代治疗在SCH治疗中有不可替代的地位,中药复方可改善SCH伴血脂异常患者甲状腺功能,调节血脂并提高左甲状腺素钠的药物敏感性。

Objective To observe the efficacy of using levothyroxine sodium and traditional Chinese medicine to cure SCH dyslipidemia. Methods 98 cases of SCH dyslipidemia were randomly divided into the treatment group( n = 49) and control group( n = 49). The control group was given Euthyrox for treatment. The treatment group was given self- made TCM compound on the basis of the control group. The efficacy and the daily usage of Levothyroxine sodium was observed after 10 weeks’ treatment. And observed the index change of thyroid function( including TSH,FT3、FT4),blood lipid level( including TG,TC,HDL- C,LDL- C) before and after the treatment. Results The dose of the Euthyrox in the treatment group was obviously lower than that in the control group. It had statistical difference( P < 0. 05). The index of TSH of blood lipid after treatment was lower than that before treatment in both groups and had statistical difference( P < 0. 01). There was statistical difference( P < 0. 05,P < 0. 01) on the index change of TC,TG,LDL- C before and after the treatment in both groups. The index of TC of Treatment Group was lower than that of the control group after treatment. There was statistical difference( P < 0. 05). The total effective rate of the treatment group was better than of the control group. Conclusion Hormone replacement therapy plays an irreplaceable role in SCH treatment. The Chinese medicine compound can improve thyroid function in patients with SCH dyslipidemia,adjust blood lipid level and improve the drug sensitivity to levothyroxine sodium.