基于“态-靶-因-果”辨治策略的消瘰丸加味配方颗粒治疗桥本甲状腺炎的有效性及安全性研究  

Study on the Efficacy and safety of Xiaoluo pill modified formula granules in the treatment of Hashimoto's thyroiditis based on the"state-targetcause-effect"treatment strategy

作　　者：吴学敏 钟小美 张蓝月 周寒 张微 WU Xuemin;ZHONG Xiaomei;ZHANG Lanyue(Department of Endocrinology,Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine(Futian),Shenzhen 518000,China;不详)

机构地区：[1]广州中医药大学深圳医院(福田)内分泌科,广东深圳518000 [2]广州中医药大学深圳医院(福田)福中社区健康服务站,广东深圳518000

出　　处：《医师在线》2025年第3期90-93,共4页Journal of Doctors Online

基　　金：广东省中医药局科研项目(20232149);2022年深圳市引进中医药高层次医学团队立项项目(SZZYSM202202010)。

摘　　要：目的探究基于“态-靶-因-果”辨治策略的消瘰丸加味配方颗粒治疗桥本甲状腺炎的疗效及安全性。方法选择2023年7月~2024年6月期间于广州中医药大学深圳医院(福田)就诊且符合条件的40例气郁痰凝型桥本甲状腺炎患者作为研究对象,采用随机双盲对照临床观察方法对患者进行分组,其中,对照组采用左甲状腺素钠片治疗(n=20),观察组在对照组治疗的基础上联用消瘰丸加味配方颗粒治疗(n=20),比较治疗前后两组患者甲状腺功能指标[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)]、免疫炎症因子水平[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、甲状腺体积、中医证候积分、临床疗效和不良反应发生情况。结果治疗后,观察组的FT3和FT4水平高于对照组,免疫炎症因子水平、甲状腺体积、中医证候积分以及TSH、TgAb和TPOAb水平显著低于对照组(P<0.05)。观察组治疗总有效率为95.00%,显著高于对照组(P<0.05)。两组不良反应发生情况差异无统计学意义(P>0.05)。结论基于“态-靶-因-果”辨治策略的消瘰丸加味配方颗粒治疗桥本甲状腺炎具有良好的临床疗效和安全性,可缓解患者的临床症状,改善机体免疫炎症代谢和甲状腺功能。Objective To explore the efficacy and safety of the treatment of Hashimoto's thyroiditis with Xiaoluo pill modified formula granules based on the strategy of"state-target-cause-effect".Methods A total of 40 eligible patients with Hashimoto's thyroiditis with Qi stagnation and phlegm coagulation type who were treated in Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine(Futian)from July 2023 to June 2024 were selected as the study objects,and the patients were divided into groups by randomized double-blind clinical observation method.The control group was treated with levothyroxine sodium tablets(n=20).The observation group was treated with Xiaoluo pill modified formula granules on the basis of control group(n=20).The thyroid function indicators[free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb)],immunoinflammatory factors[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],the thyroid volume,TCM syndrome score,clinical efficacy and occurrence of adverse reactions were compared between the two groups before and after treatment.Results After treatment,the levels of the FT3 and FT4 in observation group were higher than those in the control group,and the levels of immune-inflammatory factors,thyroid volume,TCM symptom score,TSH,TgAb and TPOAb were significantly lower than those of the control group(P<0.05).The total effective rate of the observation group was 95.00%,which was significantly higher than that of the control group(P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion Based on the strategy of"state-target-cause-effect",Xiaoluo pill modified formula granules have good clinical efficacy and safety in the treatment of Hashimoto's thyroiditis,which can alleviate clinical symptoms,improve immune inflammatory metabolism and thyroid function.

关 键 词：消瘰丸加味配方颗粒 气郁痰凝型 桥本甲状腺炎 态靶辨证 代谢 

分 类 号：R58[医药卫生—内分泌]