疏肝健脾活血汤辅助治疗桥本甲状腺炎合并甲状腺功能减退效果分析  

Effect analysis of Shugan Jianpi Huoxue Decoction in the treatment of Hashimoto's thyroiditis complicated with hypothyroidism

作　　者：薛敏 冯帆 田源 XUE Min;FENG Fan;TIAN Yuan(Shanghai Jiading District Nanxiang Hospital/Nanxiang Branch of Ruijin Hospital,Shanghai 201802,China)

机构地区：[1]上海市嘉定区南翔医院/瑞金医院南翔分院,上海201802

出　　处：《吉林中医药》2024年第6期692-696,共5页Jilin Journal of Chinese Medicine

基　　金：上海市嘉定区卫生健康委员会中医药科研课题计划任务项目(2021-KY-ZYY-05)。

摘　　要：目的分析疏肝健脾活血汤辅助治疗桥本甲状腺炎(HT)合并甲状腺功能减退(CH)的临床效果。方法选取2021年2月-2023年1月期间医院收治的97例HT合并CH患者,以治疗方法不同分为试验组(n=49)与对照组(n=48)。2组均接受基础治疗,对照组:左甲状腺素钠片,试验组:左甲状腺素钠片联合疏肝健脾活血汤。2组均治疗12周。对比2组中医证候评分、甲状腺功能、临床疗效、炎症因子、抑郁情况及安全性。结果治疗后,2组主症评分、次症评分及总评分、过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、广泛性焦虑量表(GAD-7)评分、抑郁情绪量表(PHQ-9)评分均降低(P<0.05),且试验组更低(P<0.05)。治疗后,2组血清游离甲状腺素(FT4)、游离甲状腺三碘原氨酸(FT3)水平均升高,且试验组更高(P<0.05)。试验组总有效率(97.96%)高于对照组(83.33%)(P<0.05)。2组不良反应总发生率比较(P>0.05)。结论疏肝健脾活血汤联合左甲状腺素钠片可改善HT合并CH患者临床症状,减轻炎症反应,疗效确切,改善患者甲状腺功能,减轻抑郁程度,且安全性良好。Objective To analyze the clinical effect of Shugan Jianpi Huoxue Decoction in the treatment of Hashimoto's thyroiditis(HT)complicated with hypothyroidism(CH).Methods A total of 100 patients with HT complicated with CH admitted to the hospital from February 2021 to January 2023 were divided into an experimental group and a control group by a random number table method,with 50 cases in each group.All of them received a basic treatment,with the control group treated with levothyroxine sodium tablets while the experimental group treated with levothyroxine sodium tablets combined with Shugan Jianpi Huoxue Decoction,both for 12 weeks.The TCM syndrome scores,thyroid function,clinical efficacy,inflammatory factors,depression and safety were compared between the two groups after treatment.Results After treatment,the main symptom scores,secondary symptom scores,total scores,peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),serum interferon gamma(IFN-),interleukin-4(IL-4),General Anxiety Disorder-7(GAD-7)scores and Patient Health Questionnaire-9(PHQ-9)scores were all decreased in both groups(P<0.05),and they were much lower in the experimental group(P<0.05).After treatment,the serum levels of free thyroxine(FT4)and free thyrotriodothyronine(FT3)were increased in both groups,and they were much higher in the experimental group(P<0.05).The total effective rate of the experimental group(97.96%)was higher than that of the control group(83.33%)(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Shugan Jianpi Huoxue Decoction combined with levothyroxine sodium tablets is effective in improving the clinical symptoms of HT patients with hypothyroidism,which can reduce inflammatory reactions,improve the thyroid function,reduce the degree of depression,and have a good safety.

关 键 词：疏肝健脾活血汤 左甲状腺素钠片 桥本甲状腺炎 甲状腺功能减退 临床疗效 安全性 

分 类 号：R255.9[医药卫生—中医内科学]