摘要
目的探讨夏枯消瘿汤对桥本甲状腺炎患者疗效的影响。方法选取西安市人民医院(西安市第四医院)和陕西中医药大学第二附属医院2020年3月至2022年3月收治的94例肝郁痰凝型桥本甲状腺炎患者为研究对象,按照随机数表法分为对照组和观察组,每组47例,对照组患者采用硒酵母治疗,观察组患者在硒酵母治疗的基础上使用夏枯消瘿汤治疗。持续治疗12周后,比较两组患者的临床疗效、治疗前后的炎性因子水平、甲状腺自身抗体水平、甲状腺功能以及生活质量(SF-36评分)。结果观察组患者的治疗总有效率为95.74%,明显高于对照组的82.98%,差异有统计学意义(P<0.05);治疗后,两组患者的白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平均有所下降,且观察组患者的L-6、IFN-γ、TNF-α水平分别为(2.26±0.43)pg/mL、(1.78±0.37)pg/mL、(1.69±0.40)pg/mL,明显低于对照组的(2.59±0.51)pg/mL、(2.06±0.41)pg/mL、(2.01±0.46)pg/mL,差异均有统计学意义(P<0.05);治疗后,两组患者的氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平均有所下降,且观察组患者的TPOAb、TGAb水平分别为(245.90±32.56)IU/mL、(262.35±34.21)IU/mL,明显低于对照组的(268.61±35.33)IU/mL、(290.48±46.24)IU/mL,差异均具有统计学意义(P<0.05);治疗后,两组患者的三碘甲状原氨酸(FT3)、甲状腺素(FT4)水平均上升,且观察组患者的FT3、FT4分别为(5.07±0.82)pmol/L、(18.21±2.95)pmol/L,明显高于对照组的(4.58±0.47)pmol/L、(16.25±2.89)pmol/L,差异均具有统计学意义(P<0.05);治疗后,两组患者的促甲状腺激素(TSH)水平均下降,且观察组患者的TSH为(2.62±0.11)mIU/L,明显低于对照组的(4.03±0.15)mIU/L,差异有统计学意义(P<0.05);治疗后,两组患者的SF-36评分均上升,且观察组为(548.93±49.85)分,明显高于对照组的(520.05±39.41)分,差异有统计学意义(P<0.05)。结论夏枯消瘿汤联合硒酵母治疗肝郁痰凝型桥本甲状腺炎患者的疗效明显,其能降低患者的炎性因子及甲状腺自身抗体水平,改善患者甲状腺功能并提高生活质量。
Objective To explore the effect of Xiaku Xiaoying Decoction on Hashimoto's thyroiditis.Methods A total of 94 patients with Hashimoto's thyroiditis of liver stagnation and phlegm coagulation type admitted to Xi'an People's Hospital(Xi'an Fourth Hospital)and the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 47 patients in each group.Patients in the control group were treated with selenium yeast,and those in the observation group were treated with Xiaku Xiaoying Decoction on the basis of selenium yeast.After 12 weeks of continuous treatment,the clinical efficacy,levels of inflammatory cytokines,thyroid autoantibodies,thyroid function,and quality of life(SF-36 score)were compared between the two groups.Results The total effective rate of the observation group was 95.74%,which was significantly higher than 82.98% of control group(P<0.05).After treatment,the levels of interleukin-6(IL-6),interferon-γ(IFN-γ),and tumor necrosis factor-alpha(TNF-α)in both groups decreased;the levels in the observation group were(2.26±0.43)pg/mL,(1.78±0.37)pg/mL,and(1.69±0.40)pg/mL,respectively,which were significantly lower than(2.59±0.51)pg/mL,(2.06±0.41)pg/mL,and(2.01±0.46)pg/mL in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of oxidase antibody(TPOAb)and thyroglobulin antibody(TGAb)in the two groups were decreased;the levels in the observation group were(245.90±32.56)IU/mL and(262.35±34.21)IU/mL,respectively,significantly lower than(268.61±35.33)IU/mL and(290.48±46.24)IU/mL in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of triiodothyronine(FT3)and thyroxine(FT4)in the two groups were increased;FT3 and FT4 in observation group were(5.07±0.82)pmol/L and(18.21±2.95)pmol/L,respectively,significantly higher than(4.58±0.47)pmol/L,(16.25±2.89)pmol/L in the control group;the differences were statistically significant(P<0.05).After treatment,the level of thyroid stimulating hormone(TSH)in both groups decreased;TSH in the observation group was(2.62±0.11)mIU/L,which was significantly lower than(4.03±0.15)mIU/L in the control group;the differences was statistically significant(P<0.05).The SF-36 scores of both groups were increased after treatment;the score in the observation group was(548.93±49.85)points,significantly higher than(520.05±39.41)points in the control group;the differences were statistically significant(P<0.05).Conclusion Xiaku Xiaoying Decoction combined with selenium yeast has significant curative effect on Hashimoto's thyroiditis,which can reduce the inflammatory factors and thyroid autoantibody levels,improve thyroid function and quality of life in patients.
作者
张蕊
张辽
魏文静
王晶
ZHANG Rui;ZHANG Liao;WEI Wen-jing;WANG Jing(Endocrine and Metabolic Disease Center,Xi'an People's Hospital(Xi'an Fourth Hospital),Xi'an 710000,Shaanxi,CHINA;Department of Endocrinology and Metabolism,Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xi'an 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第17期2469-2474,共6页
Hainan Medical Journal
关键词
桥本甲状腺炎
夏枯消瘿汤
硒酵母
甲状腺功能
甲状腺自身抗体
生活质量
Hashimoto thyroiditis
Xiaku Xiaoying Decoction
Selenium yeast
Thyroid function
Thyroid autoantibodies
Quality of life
