扶正解毒消瘿方治疗正虚痰毒瘀互结型桥本甲状腺炎临床研究  

Clinical effect of Fuzheng Jiedu Xiaoying decoction in treating Hashimoto’s thyroiditis

作　　者：王李宁 牟淑敏[2] WANG Lining;MOU Shumin(Shandong University of Traditional Chinese Medicine,Jinan 250055,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250011

出　　处：《陕西中医》2023年第2期205-208,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：山东省科技发展计划项目(2014GSF119040);山东省中医药科技发展计划项目(2011-067)。

摘　　要：目的:观察扶正解毒消瘿方对正虚痰毒瘀互结型桥本甲状腺炎的临床治疗效果及其对辅助性T细胞17(Th17)和调节性T细胞(Treg)的影响。方法:随机将60例患者分为中药组和对照组,各30例,中药组给予扶正解毒消瘿方治疗,对照组给予亚硒酸钠治疗,观察两组临床综合疗效;酶联免疫吸附(ELISA)测定血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)及血清白细胞介素17(IL-17)、白细胞介素6(IL-6)等细胞因子水平;测定甲状腺体积;流式细胞技术测定Th17细胞、Treg细胞比率。结果:中药组综合疗效有效率86.7%高于对照组70.0%(P<0.05);治疗后中药组中医症候总积分、甲状腺体积下降优于对照组(P<0.05);治疗后中药组血清中FT4比对照组增高显著(P<0.05),TSH比对照组下降显著(P<0.05),FT3变化差异无统计学意义(P>0.05);治疗后中药组TG-Ab、TPO-Ab比对照组下降显著(P<0.05);治疗后中药组Treg比率比对照组增高明显(P<0.05),Th17比率、Th17/Treg比值、IL-17、IL-6比对照组下降显著(P<0.05)。结论:扶正解毒消瘿方治疗桥本甲状腺炎不仅能够明显改善患者临床症状及体征,降低患者甲状腺抗体水平,而且可以升高Treg细胞比率,降低Th17细胞比率,减少甲状腺功能减退症的发生。Objective:To observe the clinical effect of Fuzheng Jiedu Xiaoying decoction on Hashimoto’s thyroiditis with syndrome of deficiency of vital energy,phlegm,toxin and blood stasis and its effect on helper T cell 17(Th17)and regulatory T cell Treg.Methods:A total of 60 patients were randomly divided into Chinese medicine group and control group,30 cases in each group.The Chinese medicine group was treated with Fuzheng Jiedu Xiaoying decoction,and the control group was treated with sodium selenite.Serum free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),thyroglobulin antibody(TG-Ab),thyroid peroxidase antibody(TPO-Ab)and serum interleukin-17(IL-17),interleukin-6(IL-6)were measured by enzyme-linked immunosorbent assay(ELISA).Determination of thyroid volume;determination of Th17 and Treg cell ratio by flow cytometry.Results:The effective rate of the traditional Chinese medicine group was 86.7%,which was higher than 70.0%of the control group(P<0.05).After treatment,TG-Ab and TPO-Ab in the Chinese medicine group were significantly lower than those in the control group(P<0.05).After treatment,the Treg ratio in the Chinese medicine group were significantly higher than those in the control group(P<0.05),and the Th17 ratio,Th17/Treg ratio,IL-17 and IL-6 were significantly lower than those in the control group(P<0.05).Conclusion:Fuzheng Jiedu Xiaoying decoction can not only significantly improve the clinical symptoms and signs of patients with Hashimoto’s thyroiditis,reduce thyroid antibody,but also increase the ratio of Treg cells,reduce the ratio of Th17 cells,and reduce the incidence of hypothyroidism.

关 键 词：桥本甲状腺炎 扶正解毒消瘿方 正虚痰毒瘀互结 三碘甲腺原氨酸 促甲状腺素 

分 类 号：R581[医药卫生—内分泌]