| 王英娜,高天舒,李品,等.柴胡疏肝散化裁方治疗肝郁脾虚证桥本甲状腺炎合并甲减患者临床疗效观察[J].浙江中医药大学学报,2023,47(3):291-295, 311. |
| 柴胡疏肝散化裁方治疗肝郁脾虚证桥本甲状腺炎合并甲减患者临床疗效观察 |
| Effects of Chaihu Shugan Powder on Hashimoto，s Thyroiditis with Hypothyroidism of Liver Qi Stagnation and Spleen Deficiency Syndrome |
| DOI：10.16466/j.issn1005-5509.2023.03.013 |
| 中文关键词: 桥本甲状腺炎 甲状腺功能减退症 肝郁脾虚证 柴胡疏肝散 临床疗效 炎症因子 |
| 英文关键词: Hashimoto,s thyroiditis hypothyroidism liver Qi stagnation and spleen deficiency syndrome Chaihu Shugan Powder clinical efficacy inflammatory factor |
| 基金项目:国家自然科学基金面上项目(81874441)；国家中医临床研究基地开放课题资助项目(JD2019SZXZD09) |
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| 中文摘要: |
| [目的] 观察柴胡疏肝散化裁方治疗肝郁脾虚证桥本甲状腺炎(Hashimoto，s thyroiditis，HT)合并甲减患者的临床疗效及对炎症因子的影响。 [方法] 采用随机数字表法，将84例肝郁脾虚证HT合并甲减患者分为观察组(42例)和对照组(42例)。对照组给予西医常规治疗，观察组在对照组基础上给予柴胡疏肝散化裁方治疗，疗程均为12周。观察比较两组患者临床疗效，两组患者治疗前后中医证候积分；甲状腺激素[游离三碘甲状腺原氨酸(free triiodothyronine，FT3)、游离四碘甲状腺原氨酸(free tetraiodothyronine，FT4)、促甲状腺激素(thyroid stimulating hormone，TSH)]，甲状腺自身抗体[甲状腺球蛋白抗体(thyroglobulin antibody，TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody，TPOAb)]以及炎症因子[白细胞介素23(interleukin-23，IL-23)、IL-6、干扰素-γ(interferon-γ，IFN-γ)]水平；甲状腺体积(左叶轴径、右叶轴径、峡部厚度)大小。[结果] 治疗12周后，观察组临床有效率(90.48%)显著高于对照组(73.81%)，差异有统计学意义(P＜0.05)。与对照组比较，治疗12周后观察组中医证候积分、TSH、TgAb、TPOAb水平及右叶轴径显著降低，FT3、FT4水平显著升高(P＜0.05，P＜0.01，P＜0.001)。与对照组比较，治疗12周后观察组血清IL-23、IL-6、IFN-γ表达水平显著降低(P＜0.05，P＜0.01，P＜0.001)。[结论] 柴胡疏肝散化裁方联合西医常规治疗肝郁脾虚证HT合并甲减患者，临床效果显著，能够有效改善中医临床症状，减轻炎症反应，调控免疫失衡状态，值得临床应用。 |
| 英文摘要: |
| [Objective] To evaluate clinical efficacy of Chaihu Shugan Powder in treatment of Hashimoto，s thyroiditis(HT) with hypothyroidism of liver Qi stagnation and spleen deficiency syndrome and influence on inflammatory factors. [Methods] Eighty-four patients of HT with hypothyroidism of liver Qi stagnation and spleen deficiency syndrome were randomly divided into observation group(42 cases) and control group(42 cases). The control group was given routine treatment of western medicine， and the observation group was given Chaihu Shugan Powder on the basis of control group， the course of treatment covered for twelve weeks. The clinical efficacy and the traditional Chinese medicine(TCM) syndrome score were compared between two groups； thyroid hormone including free triiodothyronine(FT3)， free tetraiodothyronine(FT4)， thyroid stimulating hormone(TSH)； thyroid autoantibodies including thyroglobulin antibody(TgAb)， thyroid peroxidase antibody(TPOAb)； thyroid volume including left axial diameter， right axial diameter， isthmus thickness and inflammatory factors including interleukin-23(IL-23)， IL-6 and interferon-γ(IFN-γ) were observed before and after treatment between two groups. [Results] After twelve weeks of treatment， the clinical effective rate of observation group(90.48%) was higher than that of the control group(73.81%)， and the difference was statistically significant(P＜0.05). Compared with control group， the TCM syndrome score， TSH， TgAb， TPOAb and right axial diameter levels in observation group were significantly decreased， and FT3， FT4 levels were significantly increased after twelve weeks of treatment(P＜0.05，P＜0.01，P＜0.001). Compared with control group， the expression levels of serum IL-23， IL-6， IFN-γ in observation group were significantly decreased after twelve weeks of treatment(P＜0.05，P＜0.01，P＜0.001). [Conclusion] Chaihu Shugan Powder combined with conventional western medicine has a significant clinical effect on HT with hypothyroidism of liver Qi stagnation and spleen deficiency syndrome. It can effectively relieve clinical symptoms， inhibit inflammatory reactions and regulate immune imbalance， which is worthy of clinical application. |
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