芪箭消瘿方治疗气虚血瘀型桥本甲状腺炎的疗效及对铁死亡标志物GPX4、LPO、COX-2的影响  

Effect of Qijian Xiaoying Decoction(芪箭消瘿方)on Hashimoto's Thyroiditis of Qi Deficiency and Blood Stasis Type and Its Influence on GPX4,LPO and COX-2 Markers of Ferroptosis

作　　者：赵勇[1,2,3] 谭艳 夏方妹 裴迅 汪晓露[1] 李扬 华川 左新河[1,2,3] ZHAO Yong;TAN Yan;XIA Fangmei;PEI Xun;WANG Xiaolu;LI Yang;HUA Chuan;ZUO Xinhe(Hubei Hospital of Traditional Chinese Medicine,Wuhan 430074,Hubei,China;Hubei University of Chinese Medicine,Wuhan 430065,Hubei,China;Hubei Shizhen Laboratory,Wuhan 430065,Hubei,China)

机构地区：[1]湖北省中医院,湖北武汉430074 [2]湖北中医药大学,湖北武汉430065 [3]湖北时珍实验室,湖北武汉430065

出　　处：《辽宁中医药大学学报》2024年第4期190-194,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：全国中医学术流派传承工作室第二轮建设项目(国中医药人教函[2019]62号),湖北省中医院2021年院级课题(2021YJKT-9)。

摘　　要：目的基于铁死亡探讨芪箭消瘿方治疗气虚血瘀型桥本甲状腺炎(HT)的作用机制。方法将60例甲状腺功能正常的气虚血瘀型HT患者随机分为试验组和对照组,每组各30例,其中试验组予以芪箭消瘿方治疗,对照组予以硒酵母片治疗,治疗周期为12周,观察比较两组患者甲状腺自身抗体[甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)]水平及疗效、甲状腺体积、中医证候积分及疗效;比较治疗前后甲状腺功能水平及铁死亡标志物谷胱甘肽过氧化物酶4(GPX4)、脂质过氧化物(LPO)、环氧合酶2(COX-2)的水平。结果治疗后试验组TGAb、TPOAb水平较治疗前下降,且疗效优于对照组(P<0.05);试验组治疗后中医证候积分较治疗前下降(P<0.05),且中医证候疗效总有效率明显高于对照组(P<0.05);试验组治疗后GPX4水平较治疗前上升,LPO水平较治疗前下降,且疗效优于对照组(P<0.05);试验组治疗后COX-2水平较治疗前有下降趋势,但差异无统计学意义(P>0.05),对照组COX-2水平下降,差异有统计学意义(P<0.05),两组间差异无统计学意义(P>0.05)。结论芪箭消瘿方治疗桥本甲状腺炎具有较好疗效,能明显降低患者TGAb、TPOAb水平,缩小甲状腺体积,改善患者临床症状,并能升高GPX4水平,提高抗氧化能力,减少LPO的积累和COX-2及炎症因子产生,减轻机体炎症损伤,其作用机制可能与抑制细胞铁死亡相关。Objective To investigate the mechanism of Qijian Xiaoying Decoction(芪箭消瘿方)in treating Hashimoto's thyroiditis(HT)of Qi deficiency and blood stasis type based on ferroptosis.Methods Sixty patients with normal thyroid function of Qi deficiency and blood stasis type HT were randomly divided into experimental group and control group,with 30 cases in each group.The experimental group was treated with Qijian Xiaoying Decoction,and the control group was treated with selenium yeast tablets.The treatment cycle was 12 weeks.The level and efficacy of thyroid autoantibodies(TGAb,TPOAb),thyroid volume,TCM syndrome score and efficacy of the two groups were observed and compared.The levels of thyroid function and ferroptosis markers glutathione peroxidase 4(GPX4),lipid peroxidase(LPO)and cyclooxygenase-2(COX-2)were compared before and after treatment.Results The levels of TGAb and TPOAb in experimental group were decreased after treatment,and the efficacy was better than that in control group(P<0.05).After treatment,the scores of TCM syndromes in experimental group decreased compared with before treatment(P<0.05),and the total effective rate of TCM syndromes in experimental group was significantly higher than that in control group(P<0.05).After treatment,the level of GPX4 in experimental group was higher than that before treatment,and the level of LPO was lower than that before treatment,and the efficacy of experimental group was better than that of control group(P<0.05).The level of COX-2 in the experimental group decreased after treatment,but the difference was not statistically significant(P>0.05),the level of COX-2 in the control group decreased,the difference was statistically significant(P<0.05),and the difference was not statistically significant between the two groups(P>0.05).Conclusion Qijian Xiaoying Decoction has good curative effect in the treatment of Hashimoto's thyroiditis,which can significantly reduce TGAb and TPOAb levels,shrink thyroid volume,improve clinical symptoms of patients,increase GPX4 level

关 键 词：瘿病 桥本甲状腺炎 气虚血瘀型 芪箭消瘿方 铁死亡 

分 类 号：R259[医药卫生—中西医结合]