“消瘿方”外用联合优甲乐治疗桥本甲状腺炎合并甲状腺功能减退临床观察  

Clinical Observation on Hashimoto Thyroiditis with Hypothyroidism Treated by“Xiaoying Decoction(消瘿方)”Gel and Euthyrox

作　　者：朱小雨 李家磊 严莹 唐淑华 王小平[1] ZHU Xiaoyu;LI Jialei;YAN Ying;TANG Shuhua;WANG Xiaoping(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200040,China;Shanghai Street Community Health Service Center of Putuo District in Zhenru Town,Shanghai 200333,China;Shanghahi Central Hospital of Jing’an District,Shanghai 200040,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200040 [2]上海市普陀区真如镇街道社区卫生服务中心,上海200333 [3]上海静安区中心医院,上海200040

出　　处：《辽宁中医药大学学报》2024年第10期123-127,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中医药管理局科研项目(2018ZY03005);上海市科学技术委员会项目(17401933400);上海市中医医院“未来计划”项目(WLJH2021ZY-MZY009)。

摘　　要：目的探索“消瘿方”凝胶联合优甲乐对桥本甲状腺炎合并甲状腺功能减退患者临床疗效及安全性。方法纳入2022年3月—2022年10月上海中医药大学附属市中医医院外三科收治的90例桥本甲状腺炎合并甲状腺功能减退患者,按照1∶1比例随机分为治外用“消瘿方”+口服优甲乐组(观察组,45例),外用安慰剂(“消瘿方”的10%)+口服优甲乐组(对照组,45例)。连续治疗60 d后,对比治疗前后甲状腺激素、甲状腺大小、细胞因子、优甲乐剂量、临床症状来分析临床疗效,通过不良反应发生情况评估安全性。结果(1)与治疗前相比,两组治疗后血清FT3、TSH、TGAb、TPOAb均得到明显改善;治疗30 d后,观察组改善FT4、TSH、TPOAb优于对照组,P<0.05,差异均有统计学意义;治疗60 d后,观察组改善FT3、TSH、TPOAb、TGAb优于对照组,P<0.05,差异均有统计学意义。(2)与治疗前相比,治疗后两组甲状腺体积均减小;治疗60 d后观察组结节体积(32.24±1.27)mm3小于对照组(41.04±2.99)mm3,P<0.01。(3)与治疗前相比,治疗后两组均可下调IL-1β和IL-6的表达,P<0.05,差异有统计学意义;治疗60 d后,观察组(2.82±0.44)pg/mL IL-6低于对照组(3.16±0.43)pg/mL,P<0.01,差异有统计学意义。(4)与治疗前相比,治疗后两组优甲乐使用剂量均减小;治疗60 d后观察组(59.95±2.95)μg低于对照组(70.07±2.34)μg,P<0.01。(5)治疗60 d后两组中医临床证候积分均减小;治疗60 d后观察组(5.31±0.73)分低于对照组(6.49±0.66)分,P<0.01。(6)对照组局部不良反应发生率为8.89%。结论外用“消瘿方”凝胶联合优甲乐在桥本甲状腺炎合并甲状腺功能减退患者中的疗效是确切的、安全的。Objective To evaluate the clinical efficacy and safety of“Xiaoying Decoction(消瘿方)”gel combined with sodiumlevothyroxine in the treatment of Hashimoto thyroiditis with hypothyroidism(HTH).Methods A total of 90 HTH patients admitted to the department of third surgery of the Shanghai municipal hospital of traditional Chinese medicine,Shanghai university of traditional Chinese medicine from March 2022 to October 2022 were seslected.They were randomly assigned into treatment(“Xiaoying Decoction”gel combined with sodiumlevothyroxine,45 cases)and control groups(10%of“Xiaoying Decoction”gel combined with sodiumlevothyroxine,45 cases)in a 1∶1 ratio.After 60 days of continuous treatment,thyroid hormones,thyroid size,cytokines,eugal dose and clinical symptoms were compared to analyze the clinical efficacy.And safety was evaluated through the occurrence of adverse reactions.Results(1)After treatment,the observation and control group FT3,TSH,TGAb,TPOAb were ameliorated.After 30 days of treatment,the amelioration of FT4,TSH and TPOAb in the observation group were better than that in the control group,P<0.05,and the differences were statistically significant;and after 60 days of treatment,the amelioration of FT3,TSH,TPOAb and TGAb in the observation group were better than that in the control group,P<0.05,and the differences were statistically significant.(2)After treatment,the thyroid volume decreased in both groups;after 60 days of treatment,the nodule volume in the observation group(32.24±1.27)mm3 was smaller than that in the control group(41.04±2.99)mm3,P<0.01.(3)Two groups of serum IL-1β,IL-6 decreased(P<0.05)compared with before intervention;after 60 days of treatment,the serum IL-6 in the observation group(2.82±0.44)pg/mL was lower than that in the control group(3.16±0.43)pg/mL,P<0.01.(4)Two groups of the dosage of sodiumlevothyroxine decreased compared with before intervention;after 60 days of treatment,the observation(59.95±2.95)μg was lower than the control(70.07±2.34)μg,P<0.01.(5)Two group

关 键 词：消瘿方凝胶 桥本甲状腺炎 甲状腺功能减退 临床观察 

分 类 号：R255[医药卫生—中医内科学] R581.4[医药卫生—中医学] R582.2