柴胡清肝汤对亚急性甲状腺炎毒热炽盛证患者血清促炎症因子水平的影响  

Effects of Chaihu Qinggan decoction on serum pro-inflammatory factor levels in patients with subacute thyroiditis belonging to toxic heat flourishing type

作　　者：洪兵[1] 陈丽娟[1] 殷学超[1] 柴海兰 于一江 王文爱[1] 

机构地区：[1]江苏省淮安市中医院,江苏淮安223001

出　　处：《现代中西医结合杂志》2015年第14期1504-1506,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察单独应用柴胡清肝汤对亚急性甲状腺炎毒热炽盛证患者血清促炎因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及(hs-CRP)水平的影响。方法将36例亚急性甲状腺炎毒热炽盛证患者随机分成对照组18例给予泼尼松15mg/d口服,治疗组18例给予柴胡清肝汤口服,2组疗程均为2周,观察2组治疗前后临床表现、血沉、甲状腺功能[血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]、甲状腺吸131I率及血清IL-6、TNF-α及hs-CRP水平的变化情况和不良反应。结果 2组临床总有效率比较差异无统计学意义,2组治疗2周后血沉,血清FT3、FT4,血清IL-6、TNF-α及hs-CRP水平均较治疗前明显下降(P均<0.05),甲状腺吸131I率均较治疗前明显增加(P均<0.05);治疗2周后2组血沉,血清IL-6、TNF-α、hs-CRP水平及甲状腺吸131I率比较差异均无统计学意义。治疗组不良反应发生率显著低于对照组(P<0.05)。结论单独应用柴胡清肝汤同样能显著降低亚急性甲状腺炎毒热炽盛证患者血清促炎因子IL-6、TNF-α及hs-CRP的水平,提示抑制促炎症因子表达是本方治疗亚急性甲状腺炎的机制之一。Objective It is to observe the clinical efficacy of Chaihu Qinggan decoction alone on subacute thyroiditis be- longing to toxic heat flourishing type and its effects on serum pro-inflammatory factor interleukin（IL） -6 ,tumor necrosis factor alpha（TNF- a）and high- sensitive C reactive protein（ hs- CRP） levels. Methods 36 patients with subacute thyroiditis be- longing to toxic heat flourishing type were randomly divided into control group （18 cases） given prednisone with oral 15 mg/d and treatment group （18 cases） treated only with Chaihu Qinggan decoction. Both the treatment courses were 2 weeks. The changes before and after treatment were compared between the two groups including clinical manifestation, erythrocyte sedi- mentation rate, thyroid function [ levels of serum free three triiodothyronine （ FT3 ） and free thyroxine （ FT4 ）, thyroid 131 I ab- sorption rate ] and serum IL - 6,TNF - a, hs - CRP levels, as well as the side effects. Results After two weeks＇ treatment the clinical total effective rate wasn＇ t significantly different between two groups. Levels of erythrocyte sedimentation rate, serum FT3, FT4, IL- 6, TNF- a and hs -CRP were significantly decreased after two weeks treatment in both groups（P 〈 O. 05 ） while thyroid 131I absorption rate was significantly increased in both groups（ P 〈 0.05 ）. There was no significant difference in- erythrocyte sedimentation rate, serum IL - 6, TNF - a and hs - CRP between two group after treatment. Compared to the con- trol group, the treatment group had lower incidence of side effects （ P 〈 0. 05 ）. Conclusion Compared with prednisone, appli- cation of Chaihu Qinggan decoction alone can also signiflcantly decrease levels of serum IL - 6, TNF - a and hs - CRP in pa- tients with subacute thyroiditis belonging to toxic heat flourishing type, which indicate that inhibition of proinflammatory cyto- kine expression may be one of the mechanisms of the decoction in the treatment of subacute thyroiditis.

关 键 词：亚急性甲状腺炎 毒热炽盛证 柴胡清肝汤 泼尼松 促炎症因子 

分 类 号：R581.4[医药卫生—内分泌]