益肾健脾消瘿汤治疗桥本甲状腺炎合并甲状腺功能减退临床研究  

Clinical Study on the Treatment of Hashimoto's Thyroiditis Complicated with Hypothyroidism with Kidney-Replenishing and Spleen-Fortifying and Goiter-Removing Decoction

作　　者：赵迎杰 夏松长 ZHAO Yingjie;XIA Songchang(Xiangcheng Hospital of Chinese Medicine,Xiangcheng,Henan,China,466200)

机构地区：[1]项城市中医院,河南项城466200

出　　处：《河南中医》2023年第7期1067-1071,共5页Henan Traditional Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190548)。

摘　　要：目的:观察益肾健脾消瘿汤治疗桥本甲状腺炎合并甲状腺功能减退的临床疗效。方法:将84例桥本甲状腺炎合并甲状腺功能减退患者按照随机数字表法分为对照组和观察组,每组各42例。对照组给予左甲状腺素钠片治疗,观察组在对照组治疗的基础上联合益肾健脾消瘿汤治疗。比较两组患者的临床疗效及治疗前后甲状腺功能[游离三碘甲状腺激素(three iodine thyroid hormone,T3)、游离四碘甲状腺激素(four iodine thyroid hormone,T4)、促甲状腺激素(thyroid stimulating hormone,TSH)]、抗甲状腺自身抗体[抗甲状腺球蛋白抗体(anti-thyroglobulin antibodies,TGAb)、抗甲状腺过氧化物酶抗体(anti-thyroid peroxidase antibody,TPoAb)]、甲状腺体积、峡部厚度变化情况。结果:观察组有效率高于对照组(P<0.05)。两组患者治疗后FT3、FT4高于本组治疗前,TSH水平低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后血清TGAb、TPOAb水平低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组治疗后甲状腺体积和峡部厚度小于本组治疗前,且治疗后观察组小于对照组(P<0.05)。结论:益肾健脾消瘿汤治疗桥本甲状腺炎合并甲状腺功能减退,可有效调节患者抗甲状腺自身抗体水平,缩小甲状腺体积,促进甲状腺功能恢复。Objective:To observe the clinical efficacy of Kidney-Replenishing and Spleen-Fortifying and Goiter-Removing Decoction on hashimoto's thyroiditis(HT)complicated with hypothyroidism.Methods:A total of 84 patients with HT complicated with hypothyroidism were randomly divided into the control group and the observation group,with 42 cases in each group.The control group was treated with Levothyroxine Tablets,while the observation group was treated with Kidney-Replenishing and Spleen-Fortifying and Goiter-Removing Decoction on the basis of the control group's treatment.Then the clinical efficacy and the changes of thyroid functions[including three iodine thyroid hormone(T3),four iodine thyroid hormone(T4),thyroid hormone(TSH)],anti-thyroid autoantibodies[including antithyroid autoantibodies(TGAb),anti Thyroid peroxidase antibody(TPoAb)],thyroid volume and isthmus thickness of the two groups before and after treatment were compared.Results:The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the FT3 and FT4 levels of the two groups were higher than those before treatment,while the TSH levels were lower than those before treatment.The differences between the two groups were statistically significant(P<0.05);The serum TGAb and TPOAb levels in both groups were lower than those before treatment,and the observation group's were lower than those of the control group(P<0.05);The thyroid volume and isthmus thickness of the two groups were smaller than those before treatment,and the observation group's were smaller than those of the control group(P<0.05).Conclusion:Kidney-Replenishing and Spleen-Fortifying and Goiter-Removing Decoction can effectively regulate the level of anti-thyroid autoantibodies in patients with HT complicated with hypothyroidism,reduce thyroid volume,and promote the recovery of thyroid function.

关 键 词：桥本甲状腺炎 甲状腺功能减退 益肾健脾消瘿汤 左甲状腺素钠片 中西医结合疗法 

分 类 号：R259.821[医药卫生—中西医结合]