健脾益肾温阳法对妊娠早期亚临床甲状腺功能减退症TSH、TP0-Ab影响的临床研究  

Clinical Study on Effect of Strengthening Spleen and Tonifying Kidney and Warming Yang Method on TSH and TP0-Ab in Patients with Subclinical Hypothyroidism in Early Pregnancy

作　　者：许莉[1] 陈尧[2] 边文会[1] 楚健子[1] 陈慧娟[1] 秦玉璇 李俊柳[3] XU Li;CHEN Yao;BIAN Wenhui;CHU Jianzi;CHEN Huijuan;QIN Yuxuan;LI Junliu(Department of Gynecology of Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China;Neurosurgery Department,Hebei Provincial People’s Hospital,Shijiazhuang 050011,Hebei,China;Laboratory Department,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北省中医院妇科,河北石家庄050011 [2]河北省人民医院神经外科,河北石家庄050051 [3]河北省中医院检验科,河北石家庄050011

出　　处：《中华中医药学刊》2019年第8期2042-2045,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2014037)

摘　　要：目的:研究健脾益肾温阳法对妊娠早期亚临床甲状腺功能减退症患者的临床效果。方法:100例妊娠合并亚临床甲状腺功能减退患者随机分为对照组和观察组(各50例),对照组患者在常规治疗基础上给予左旋甲状腺素钠片治疗,观察组患者在对照组治疗基础上给予健脾益肾温阳方治疗,两组疗程均为3个月。于入院时和分娩前1周,采用电化学发光法测定甲状腺功能指标,包括TSH、FT3、FT4、抗甲状腺过氧化物酶自身抗体(TPOAb);观察并记录治疗过程中高血压、糖代谢异常、胆汁淤积并发症发生情况;观察并记录两组患者的妊娠结局,包括剖宫产、早产、产后出血、出生后低体质量和新生儿窒息;于新生儿出生后6个月,采用婴幼儿发育量表(BSID)评估新生儿发育情况。结果:分娩前1周,观察组TSH水平和TPOab阳性率显著低于对照组(P<0.05),FT3和FT4显著高于对照组(P<0.05);观察组孕妇高血压、糖代谢异常、胆汁淤积并发症发生率显著低于对照组(P<0.05);观察组剖宫产、早产、产后出血、胎儿生长受限、出生后低体质量和新生儿窒息发生率显著低于对照组(P<0.05);观察组婴儿BSID、MDI和PDI评分均显著高于对照组(P<0.05)。结论:健脾益肾温阳法可以有效改善妊娠亚临床甲状腺功能减退患者甲状腺功能,显著降低妊娠并发症发生率,降低妊娠不良结局,促进胎儿发育。Objective:To study the clinical effect of strengthening spleen and tonifying kidney and warming Yang method on patients with subclinical hypothyroidism in early pregnancy.Methods:One hundred patients with pregnancy and subclinical hypothyroidism were randomly divided into the control group and the observation group(50 cases in each). The control group received levothyroxine sodium tablets on the basis of conventional treatment, and the observation group received the treatment based on the treatment in the control group. Two groups were treated for 3 months. At the time of admission and 1 week before delivery, the thyroid function was measured by electrochemiluminescence, including TSH, FT3, FT4, anti-thyroid peroxidase autoantibody(TPOAb). We observed and recorded hypertension, abnormal glucose metabolism during treatment, complications of cholestasis and pregnancy outcomes in both groups, including cesarean section, premature delivery, postpartum hemorrhage, postnatal low body mass and neonatal asphyxia. Six months after birth, infant development scale(BSID) was used to assess the neonatal development.Results: At 1 week before delivery, the TSH level and TPOab positive rate in the observation group were significantly lower than those in the control group(P<0.05), and FT3 and FT4 were significantly higher than those of the control group(P<0.05). The observation group had hypertension and abnormal glucose metabolism. The incidence of cholestasis complications was significantly lower than that of the control group(P<0.05). The incidence of cesarean section, premature delivery, postpartum hemorrhage, fetal growth restriction, postnatal low body mass and neonatal asphyxia were significantly lower in the observation group than those in the control group(P<0.05). The BSID, MDI and PDI scores of the infants in the observation group were significantly higher than those in the control group(P<0.05). Conclusion:strengthening spleen and tonifying kidney and warming Yang method can effectively improve thyroid function in pat

关 键 词：健脾益肾温阳 妊娠早期亚临床甲状腺功能减退症 临床效果 

分 类 号：R581.2[医药卫生—内分泌]