中药汤剂联合左甲状腺素钠片治疗甲状腺结节的Meta分析  

A Meta-analysis of treating thyroid nodules with TCM decoction plus levothyroxine sodium tablets

作　　者：刘明月 王素美[2] LIU Mingyue

机构地区：[1]山东中医药大学,山东济南250000 [2]泰安市中医医院,山东泰安271000

出　　处：《中医临床研究》2023年第8期99-105,共7页Clinical Journal Of Chinese Medicine

摘　　要：目的:系统评价中药汤剂联合左甲状腺素钠片治疗甲状腺结节的临床疗效及安全性。方法:检索中国知网、万方数据库、维普期刊资源整合服务平台、PubMed和Cochrane Library自建库至2021年12月23日发表的中药汤剂联合左甲状腺素钠片治疗甲状腺结节的临床随机对照试验,通过Cochrane质量评估工具对纳入文献进行质量及偏倚风险评估,运用RevMan 5.4软件对提取的相关数据进行Meta分析。结果:最终纳入20篇文献,共有患者2136例,包括对照组1052例、试验组1084例。Meta分析结果显示:中药汤剂联合左甲状腺素钠片治疗甲状腺结节在提高临床有效率、降低促甲状腺激素水平、提高血清游离甲状腺素水平、缩小结节直径、降低不良反应发生率方面优于单用左甲状腺素钠片,差异有统计学意义(均有P<0.05);对于改善血清游离三碘甲状原氨酸的水平,试验组的效果与对照组相比不明显,差异无统计学意义。结论:中药汤剂联合左甲状腺素钠片治疗甲状腺结节在提高临床疗效,改善促甲状腺激素、游离甲状腺素水平,缩小甲状腺结节直径,减少不良反应发生方面优于单用左甲状腺素钠片。Objective:To systematically evaluate the clinical efficacy and safety of TCM decoction plus levothyroxine sodium tablets on thyroid nodules.Methods:In CNKI database,Wanfang data,VIP Chinese journal database,PubMed and Cochrane Library,the studies on randomized controlled trials of treating thyroid nodules with TCM decoction plus levothyroxine sodium tablets from database initial stage to December 23,2021 were retrieved.The Cochrane quality assessment tool was used to assess the quality and risk of bias of the included literature.A meta-analysis was performed on the extracted data by RevMan 5.4 software.Results:A total of 20 studies with 2136 cases were included finally,including 1052 cases in the control group and 1084 cases in the treatment group.The meta-analysis results showed that TCM decoction plus levothyroxine sodium tablet in the treatment of thyroid nodule was superior to levothyroxine sodium tablet alone in improving clinical efficiency,reducing thyroid stimulating hormone level,increasing serum free thyroxine level,reducing nodule diameter and the occurrence of adverse reactions,and the differences were all statistically significant(all P<0.05).The level of serum free triiodothyronine in the treatment group was not significantly ameliorated compared with the control group,and the difference was not statistically significant.Conclusion:TCM decoction plus levothyroxine sodium tablets on thyroid nodule is superior to levothyroxine sodium tablets alone in improving clinical efficacy,ameliorating thyroid stimulating hormone and free thyroxine levels,and reducing the nodules diameter and adverse reactions.

关 键 词：中药汤剂 左甲状腺素钠片 甲状腺结节 随机对照试验 META分析 

分 类 号：R581.2[医药卫生—内分泌]