益气养阴法治疗桥本甲状腺炎气阴两虚证疗效观察  

Yiqi Yangyin therapy on hashimoto's thyroiditis of Qi and Yin deficiency syndrome

作　　者：陈文信 张超 王树刚 宋以宁 高龙 张霞 张金梅[1] 李红[4] CHEN Wenxin;ZHANG Chao;WANG Shugang;SONG Yining;GAO Long;ZHANG Xia;ZHANG Jinmei;LI Hong(Department of TCM,Weifang Hospital of Traditional Chinese Medicine,Weifang,Shandong 261000;不详)

机构地区：[1]山东省潍坊市中医院中医科,山东潍坊261000 [2]河南省中医院内分泌科,河南郑州450002 [3]上海市普陀区中心医院内分泌科,上海200062 [4]上海中医药大学附属龙华医院内分泌科,上海200032

出　　处：《河北中医》2021年第5期731-735,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81373617);山东省2019—2020年度中医药科技发展计划项目(编号:2019-0700)。

摘　　要：目的观察益气养阴法治疗桥本甲状腺炎(HT)气阴两虚证的临床疗效。方法将74例HT气阴两虚证患者按照随机数字表法分为2组。对照组37例(后失访2例)予硒酵母胶囊口服治疗,治疗组37例(后失访2例)予桥本方口服治疗。2组均治疗12周。比较2组治疗前后中医证候评分、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、补体3(C3)、C4、C反应蛋白(CRP)、转化生长因子β(TGF-β)、血管内皮生长因子(VEGF)的变化情况,并统计疗效。结果治疗组总有效率71.43%(25/35),对照组总有效率34.29%(12/35),治疗组疗效优于对照组(P<0.05)。治疗组可有效改善HT气阴两虚证患者的中医证候评分,随着治疗时间的延长,中医证候评分下降越明显,且治疗组优于对照组(P<0.05)。治疗后2组血清TGAb、TPOAb滴度均较本组治疗前降低(P<0.05),治疗组血清TGAb滴度治疗前后差值大于对照组(P<0.05)。治疗后2组血清C3水平均较本组治疗前升高(P<0.05),治疗后治疗组血清CRP水平较本组治疗前降低(P<0.05)。治疗后治疗组血清TGF-β水平较本组治疗前升高(P<0.05),治疗后2组血清VEGF水平均较本组治疗前降低(P<0.05)。结论益气养阴法治疗HT气阴两虚证,可明显降低患者的中医证候评分,显著降低TGAb、TPOAb滴度,调节机体免疫及血管生成,值得临床进一步推广。Objective To observe the clinical effect of Yiqi Yangyin therapy on hashimoto's thyroiditis(HT)of Qi and Yin deficiency syndrome.Methods Totally 74 patients HT of Qi and Yin deficiency syndrome were randomly divided into two groups,37 cases(2 cases lost to follow-up)in the control group were treated with selenium yeast capsules orally,37 patients(2 cases lost to follow-up)in the treatment group were treated with Qiaoben Fang orally.Both groups were treated for 12 weeks.The traditional Chinese medicine(TCM)syndrome scores,and related aboratory indexes including thyroglobulin antibodies(TGAb),thyroid peroxidase antibody(TPOAb),complement C3,complement C4,C reactive protein(CRP),transforming growth factorβ(TGF-β),vascular endothelial growth factor(VEGF)were compared between the two groups before and after treament,and the clinical effect was counted.Results Total effective rate in the treatment group was better than that in the control group[71.43%(25/35)vs 34.29%(12/35),(P<0.05),respectively].TCM syndrome scores which can effectively improve HT of Qi and Yin deficiency syndrome decreased more obviously with time,and the treatment group was better than the control group(P<0.05).Compared with before treatment,serum TGAb and TPOAb titers after treatment in both groups was decreased(P<0.05);differentials of serum TGAb titer in the treatment group was higher than that in the control group before and after treament(P<0.05);serum complement C3 level after treatment in both groups was increased(P<0.05);serum CRP level after treatment in the treatment group was decreased(P<0.05);serum TGF-βlevel after treatment in the treatment group was increased(P<0.05);serum VEGF level after treatment in both groups was decreased(P<0.05).Conclusion For HT of Qi and Yin deficiency syndrome,using Yiqi Yangyin can significantly decrease TCM syndrome scores,effectively reduce the titer of TGAb and TPOAb,regulate the body's immunity,with worthy of further clinical promotion.

关 键 词：桥本病 甲状腺炎 益气养阴 中药疗法 

分 类 号：R581.405.31[医药卫生—内分泌]