左甲状腺素钠联合夏枯草胶囊治疗桥本甲状腺炎的效果评价  

Efficacy Evaluation of Levothyroxine Sodium Combined with Prunella Capsule in the Treatment of Hashimoto Thyroiditis

作　　者：赵鹏新[1] 郝增方[2] 马雨昕 崔晗婧 周静[3] ZHAO Pengxin;HAO Zengfang;MA Yuxin;CUI Hanjing;ZHOU Jing(Department of Gland Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050017,China;Department of Pathology,the Second Hospital of Hebei Medical University,Shijiazhuang 050017,China;Department of Endocrinology,the Second Hospital of Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]河北医科大学第二医院腺体外科,石家庄050017 [2]河北医科大学第二医院病理科,石家庄050017 [3]河北医科大学第二医院内分泌科,石家庄050017

出　　处：《临床误诊误治》2025年第8期46-51,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药管理局项目(2022393)。

摘　　要：目的研究左甲状腺素钠联合夏枯草胶囊治疗桥本甲状腺炎(HT)的效果。方法选取2021年1月至2022年12月收治的HT患者60例,采用随机数字表法分为观察组和对照组,每组均30例。对照组给予左甲状腺素钠单药治疗,观察组给予左甲状腺素钠联合夏枯草胶囊治疗,均治疗3个月。治疗3个月后评价2组治疗效果和不良反应发生情况,并比较2组治疗前后甲状腺功能指标[游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)、促甲状腺激素(TSH)]、中医证候积分、两侧甲状腺大小、炎性因子[干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)、白细胞介素-12(IL-12)、白细胞介素-10(IL-10)]水平。结果观察组治疗后总有效率为93.33%(28/30)高于对照组的66.67%(20/30),差异有统计学意义(P<0.05)。治疗后2组TSH均降低,FT 3、FT 4均升高,且观察组TSH降低幅度及FT 3、FT 4升高幅度均大于对照组(P<0.05,P<0.01)。治疗后2组中医证候积分均降低,且观察组降低幅度显著大于对照组(P<0.05,P<0.01)。治疗后2组两侧甲状腺前后径、上下径、左右径均减小,且观察组减小幅度均大于对照组(P<0.05,P<0.01)。治疗后2组IFN-γ、IL-6和IL-12降低,IL-10升高,且观察组IFN-γ、IL-6、IL-12降低幅度及IL-10升高幅度明显大于对照组(P<0.05,P<0.01)。2组治疗期间总不良反应发生率比较差异无统计学意义(P>0.05)。结论左甲状腺素钠联合夏枯草胶囊治疗HT效果显著,可有效减轻患者各项症状,改善患者甲状腺增大情况,有利于促进甲状腺功能的恢复,且治疗安全性良好。Objective To study the effect of Levothyroxine Sodium combined with Prunella capsule on Hashimoto thyroiditis(HT).Methods A total of 60 HT patients admitted from January 2021 to December 2022 were divided into the observation group and the control group by random number table method,with 30 patients in each group.The control group was treated with Levothyroxine Sodium monotherapy,and the observation group was treated with Levothyroxine Sodium combined with Prunelle capsule for 3 months.After 3 months of treatment,the efficacy and adverse reactions of the two groups were evaluated.Thyroid function indexes[free triiodothyronine(FT 3),free thyroxine(FT 4),thyrotropin(TSH)],traditional Chinese medicine(TCM)syndrome scores,bilateral thyroid size,inflammatory factors[interferon-γ(IFN-γ),interleukin-6(IL-6),interleukin-12(IL-12),interleukin-10(IL-10)]levels before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 93.33%(28/30),which was higher than that of control group[66.67%(20/30)],showing significant difference(P<0.05).After treatment,TSH decreased,while FT 3 and FT 4 increased in both groups;the decrease in TSH and the increase in FT 3 and FT 4 in the observation group were greater than those in the control group(P<0.05,P<0.01).After treatment,the TCM syndrome scores of both groups were decreased,and the reduction in the observation group was significantly greater than that in the control group(P<0.05,P<0.01).After treatment,both sides of the thyroid decreased in anteroposterior,upper and lower diameters,and left and right diameters,and the reduction in the observation group was greater than that in the control group(P<0.05,P<0.01).After treatment,IFN-γ,IL-6 and IL-12 decreased,while IL-10 increased in the two groups;the decrease in IFN-γ,IL-6 and IL-12 and the increase in IL-10 in the observation group were significantly greater than those in the control group(P<0.05,P<0.01).There was no significant difference in the total incidence of advers

关 键 词：桥本甲状腺炎 左甲状腺素钠 夏枯草胶囊 游离三碘甲状腺原氨酸 中医证候 干扰素-Γ 白细胞介素-6 药物毒性 

分 类 号：R581.4[医药卫生—内分泌]