清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察  

Observation on clinical effect of LT-4 and selenium combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism

作　　者：耿文倩 祁烁[2] 商建伟[1] 袁姣姣 张旭帆[2] 丁治国[2] GENG Wen-qian;QI Shuo;SHANG Jian-wei;YUAN Jiao-jiao;ZHANG Xu-fan;DING Zhi-guo(Department of Thyroid Disease,Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100020,China;Department of Thyroid Disease,Sunsimiao Hospital of Beijing University of Chinese Medicine,Tongchuan 721700)

机构地区：[1]北京中医药大学东直门医院甲状腺病科,北京100020 [2]北京中医药大学孙思邈医院甲状腺病科,铜川721700

出　　处：《北京中医药》2023年第2期146-150,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：北京市中医管理局“薪火传承3+3工程”建设项目(2016-SZ-C-61);陕西省中医药管理局2021-2022年度科研项目(2021-GJ-LC001)。

摘　　要：目的观察清肝散结消瘿方、硒制剂联合左甲状腺素钠片(LT-4)治疗桥本甲状腺炎(HT)合并甲状腺功能减退症疗效。方法选择2021年1月1日—10月31日于北京中医药大学孙思邈医院甲状腺病科门诊就诊的HT合并甲状腺功能减退症患者120例,采用随机数字表法分为对照组、中药组和联合用药组,各40例。对照组给予LT-4口服治疗,中药组在对照组基础上加清肝散结消瘿方口服治疗,联合用药组在中药组基础上加硒制剂口服治疗,3组均连续用药3个月。对比各组治疗前后甲状腺功能指标(FT3、FT4、TSH)、甲状腺相关自身抗体(TPOAb、TGAb)、中医证候积分、甲状腺病症状群评价指标[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、疲劳严重程度量表(FSS)]、甲状腺病下肢局部症状和淋巴水肿评分。结果治疗后,中药组、联合用药组FT3、FT4均优于对照组(P<0.05),3组TSH比较差异无统计学意义(P>0.05);中药组与联合用药组TPOAb、TGAb比较差异无统计学意义(P>0.05);中药组、联合用药组中医证候积分、各项甲状腺病症状群指标、下肢淋巴水肿评分均优于对照组(P<0.05)。结论清肝散结消瘿方与硒制剂联合使用能够降低桥本甲状腺炎患者的甲状腺自身抗体水平、改善甲状腺功能及临床症状。Objective To observe the clinical effect of LT-4,selenium preparation combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism.Methods A total of 120 patients with Hashimoto thyroiditis complicated with hypothyroidism were included,who visited Department of Thyroid Disease,Sunsimiao Hospital of Beijing University of Chinese Medicine from 1 January 2021 to 31 October2021,and according to random number table method,they were divided into control group(LT-4),TCM group(LT-4+TCM)and combined group(LT-4+TCM+selenium preparation)of 40 cases in each one.After 3 months of follow-up,the therapeutic effect was evaluated according to thyroid function(FT3、FT4、TSH),thyroid-related autoantibodies(TPOAb、TGAb),TCM syndrome score,thyroid disease symptom group evalluation index including HAMA,HAMD,PSQI,FSS and local symptoms of lower limbs and lymphedema score.Results After treatment,FT3 and FT4 in TCM group and the combined drug group were better than those in the control group(P<0.05),and there was no statistical difference in TSH among the three groups(P>0.05).There was no significant difference in TPOAb and TGAb between TCM group and combined drug group(P>0.05).The TCM syndrome score,the indexes of thyroid disease symptom groups and the lymphedema score of lower limbs in TCM group and the combined medication group were better than those in the control group(P<0.05).Conclusion Qinggan Sanjie Xiaoying Decoction combined with selenium preparation can reduce the level of thyroid autoantibodies,improve thyroid function and clinical symptoms for patients with Hashimoto thyroiditis.

关 键 词：桥本甲状腺炎 甲状腺功能减退症 清肝散结消瘿方 硒 

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