芪郁方联合维生素D对气虚肝郁型桥本甲状腺炎疗效研究  

Effect of combination of Qiyu prescription and vitamin D in the treatment of Hashimoto's thyroiditis of Qi deficiency and liver depression syndrome

作　　者：王佳媛 杨华[1] 吴腾飞[1] 丛亿蕾 刘博文 WANG Jiayuan;YANG Hua;WU Tengfei;CONG Yilei;LIU Bowen(Department of Endocrinology,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院内分泌科,上海200032

出　　处：《世界临床药物》2024年第6期642-647,共6页World Clinical Drug

基　　金：第五批“龙医学者”临床科技创新培育项目(PY2022005)。

摘　　要：目的观察芪郁方联合维生素D治疗气虚肝郁型桥本甲状腺炎(Hashimoto's thyroiditis,HT)的效果。方法纳入我院2023年3月至12月内分泌科气虚肝郁型HT患者113例,随机分为中药组(n=38,基础治疗+芪郁方)、中药+维生素D组(n=38,基础治疗+芪郁方+阿法骨化醇)及对照组(n=37,基础治疗),均治疗12周。观察治疗前后3组甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)、促甲状腺刺激激素(thyroid-stimulating hormone,TSH)水平及中医证候评分情况等。结果中药组、中药+维生素D组临床有效率分别为78.95%、84.21%,均高于对照组的40.54%(P<0.05)。中药组、中药+维生素D组甲状腺自身抗体滴度较前均下降(P<0.05),抗体变化率均优于对照组,且中药+维生素D组TPOAb变化率优于中药组(P<0.05)。中药组、中药+维生素D组中医证候积分较前均下降(P<0.05),且优于对照组(P<0.05)。结论芪郁方联合维生素D对气虚肝郁型HT疗效较佳,可降低血清TPOAb、TgAb水平,相较单纯使用中药对TPOAb疗效更显著。Objective To observe the effect of combination of Qiyu prescription and vitamin D on Hashimoto's thyroiditis(HT)of Qi deficiency and liver depression syndrome.Methods A total of 113 HT patients with Qi deficiency and liver depression syndrome in department of endocrinology of our hospital from March to December 2023 were included and randomly divided into traditional Chinese medicine(TCM)group(n=38,basic treatment+Qiyu prescription),TCM+vitamin D group(n=38,basic treatment+Qiyu prescription+alfacalcidol)and control group(n=37,basic treatment).All patients were treated for 12 weeks.Thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb),thyroid-stimulating hormone(TSH)levels and TCM syndrome scores of three groups were observed before and after treatment.Results The clinical effective rates of TCM group and TCM+vitamin D group were 78.95%and 84.21%,which were higher than control group(40.54%)(P<0.05).The titers of thyroid autoantibody in TCM group and TCM+vitamin D group were lower than before treatment(P<0.05),and the change rates of antibody were better than that in control group,and the change rates of TPOAb in TCM+vitamin D group were better than that in TCM group(P<0.05).TCM syndrome scores in TCM group and TCM+vitamin D group were lower than before treatment(P<0.05),and better than control group(P<0.05).Conclusion Combination of Qiyu prescription and vitamin D has a better effect on HT patients with Qi deficiency and liver depression syndrome,and can reduce serum TPOAb and TgAb levels,which is more effective on TPOAb compared to the use of TCM alone.

关 键 词：芪郁方 维生素D 气虚肝郁型 桥本甲状腺炎 

分 类 号：R259[医药卫生—中西医结合] R581.4[医药卫生—中医内科学]