疏肝温肾方对桥本甲状腺炎并发亚临床甲状腺功能减退症患者甲状腺功能和甲状腺自身抗体的影响  

Effect of Shugan Wenshen Recipe on thyroid function and thyroid autoimmunity in patients with hashimoto thyroiditis concurrent with subclinical hypothyroidism

作　　者：陈号[1] 杨文娟[1] 秦书彦 郭乃刚 CHEN Hao;YANG Wenjuan;QIN Shuyan;GUO Naigang(Department of Endocrinology,Yancheng Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Yancheng 224002)

机构地区：[1]南京中医药大学附属盐城市中医院内分泌科,江苏盐城224002

出　　处：《河北中医》2021年第3期416-419,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发〔2017〕24号)。

摘　　要：目的观察疏肝温肾方对桥本甲状腺炎(HT)并发亚临床甲状腺功能减退症(SCH)患者甲状腺功能和甲状腺自身抗体的影响。方法将137例HT并发SCH患者按照随机数字表法分为2组,对照组68例予左甲状腺素钠片治疗,治疗组68例在对照组治疗基础上加疏肝温肾方治疗,2组疗程均12周。比较2组治疗前后甲状腺功能促甲状腺激素(TSH)、游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3)),甲状腺自身抗体甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb),血脂指标总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)变化。结果2组治疗后TSH均较本组治疗前降低(P<0.05),FT_(4)、FT_(3)均较本组治疗前升高(P<0.05);治疗组治疗后TSH低于对照组(P<0.05),FT_(4)、FT_(3)均高于对照组(P<0.05)。2组治疗后TPOAb、TgAb均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后TC、TG、LDL-C均较本组治疗前降低(P<0.05),HDL-C较本组治疗前升高(P<0.05),且治疗组降低更明显(P<0.05),治疗组升高更明显(P<0.05)。结论疏肝温肾方治疗HT并发SCH,能有效减轻患者自身免疫反应,改善甲状腺功能,降低TSH及血脂水平。Objective To observe the clinical effect ofShuganWenshen Recipe on thyroid function and thyroid autoimmunity in patients with hashimoto thyroiditis(HT)concurrent withsubclinical hypothyroidism(SCH).Methods Totally 137 SCH cases diagnosed as HT were randomly divided into two groups,68 cases in the control group were treated with oral levothyroxine standard treatment,68 cases in the treatment group were treated with ShuganWenshen Decoction on the basis of oral levothyroxine standard treatment,the course of treatment was 12 weeks.Changes including thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyroid peroxidase antibody(TPO Ab),thyroglobulin antibody(TgAb),blood lipid indexes[total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C)and low density lipoprotein-cholesterol(LDL-C)]were compared between two groups before and after treatment.Results Compared with before treatment,TSH after treatment in both groups was lower(P<0.05),which in treatment group was significantly decreased(P<0.05);FT_(4) and FT_(3) in both groups were higher(P<0.05),which in the treatment group were significantly increased(P<0.05),TPO-Ab and TgAb in the both groups were lower(P<0.05),and which in the treatment group was significantly decreased(P<0.05).Compared with before treatment,TC,TG and LDL-C after treatment in both groups were lower(P<0.05),which in the treatment group were significantly decreased(P<0.05);HDL-C after treatment in both groups was higher(P<0.05),which in the treatment group was significantly increased(P<0.05).Conclusion When HT is concurrent with SCH,using ShuganWenshen therapy can effectively relieve autoimmune response of patient,improve thyroid function and reduce effectively the level of TSH.

关 键 词：甲状腺炎 自身免疫性 甲状腺功能减退症 中药疗法 

分 类 号：R581.4[医药卫生—内分泌] R581.2[医药卫生—内科学]