温阳健脾法联合维生素D调节免疫失衡治疗桥本甲减的研究  

Study on the treatment of hashimoto hypothyroidism by warming yang and strengthening spleen therapycombined with vitamin D regulate immune imbalance

作　　者：汪燕燕[1] 张汝琪 刘娜娜 部翰明 张欣梅 WANG Yanyan;ZHANG Ruqi;LIU Nana;BU Hanming;ZHANG Xinmei(Ningxia Medical University,Yinchuan 750004,China;Yinchuan Hospital of Traditional Chinese Medicine,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏银川市中医医院,宁夏银川750001

出　　处：《宁夏医学杂志》2024年第2期121-124,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2021AAC03516)。

摘　　要：目的观察温阳健脾法联合维生素D调节免疫失衡,治疗桥本甲状腺炎(HT)合并甲减的疗效。同时通过检测HT甲减期患者治疗前后Th17和Treg细胞表达的百分率,以评估临床疗效。方法选取收治的住院及门诊病人64例作为研究对象,随机分为对照组和实验组各32例,对照组给予维生素D,试验组给予复方甲减平合剂+维生素D,疗程为8周,比较2组患者的中医证候疗效,血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPO-AB)、甲状腺球蛋白抗体(TGAb)、Th17和Treg细胞表达的百分率及甲状腺体积变化。结果治疗前后中医证候积分改善情况试验组明显优于对照组(P<0.05);2组患者在治疗后FT3、FT4、TSH水平及甲状腺体积对比疗效相当(P>0.05)。2组患者治疗前后甲状腺抗体指标比较,试验组的疗效优于对照组(P<0.05)。结论温阳健脾法联合维生素D治疗桥本甲减安全性较高,不良反应少,值得在临床中广泛应用。Objective To observe the efficacy of warming yang and strengthening spleen method combined with vitamin D to regulate immune imbalance in the treatment of Hashimoto′s thyroiditis(HT)combined with hypothyroidism.The clinical efficacy was also evaluated by detecting the percentage of Th17 and Treg cell expression before and after treatment in patients with HT hypothyroidism.Methods 64 cases of inpatient and outpatient were selected and randomly divided into control group and experimental group(with 32 cases in each group),the control group was given vitamin D,and the experimental group was given Fufang jiazhueping with vitamin D.The course of the treatment lasted for 8 weeks,and the efficacy of the traditional Chinese medicine(TCM)symptoms,serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid peroxidase antibody(TPO-AB),thyroglobulin antibody(TGAb),the percentage of expression of Th17 and Treg cells,and changes in the volume of the thyroid gland between the two groups were compared.Results The improvement of TCM symptom score before and after treatment was significantly better in the experimental group than that in the control group(P<0.05).The efficacy of FT3,FT4,TSH levels,and thyroid volume were same between the two groups after treatment(P>0.05).Comparison of thyroid antibody indexes between the two groups before and after treatment,the efficacy of the experimental group was better than that of the control group(P<0.05).Conclusion The warming yang and strengthening spleen method combined with vitamin D in the treatment of HT is safe with fewer adverse reactions,and deserves to be widely used in the clinical application.

关 键 词：桥本甲状腺炎合并甲状腺功能减退症 温阳健脾 维生素D 免疫失衡 

分 类 号：R581[医药卫生—内分泌]