清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察

耿文倩; 祁烁; 商建伟; 袁姣姣; 张旭帆; 丁治国

doi:10.16025/j.1674-1307.2023.02.006

您当前的位置：

首页 >

文章列表页 >

清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察

临床研究 | 更新时间：2023-06-16

- 清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察
- Observation on clinical effect of LT⁃4 and selenium combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism
- 北京中医药 2023年42卷第2期页码：146-150
- 作者机构：
  
  1.北京中医药大学东直门医院甲状腺病科，北京 100020
  2.北京中医药大学孙思邈医院甲状腺病科，铜川 721700
- 作者简介：
  
  耿文倩，女，29岁，博士研究生。研究方向：甲状腺疾病的中西医结合诊疗。
  丁治国，E-mail：dingzhiguo_1@163.com
- 基金信息：
  
  北京市中医管理局“薪火传承3+3工程”建设项目(2016-SZ-C-61);陕西省中医药管理局2021-2022年度科研项目(2021-GJ-LC001)
- DOI：10.16025/j.1674-1307.2023.02.006
  中图分类号：
扫描看全文
耿文倩，祁烁，商建伟，等.清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察［J］.北京中医药，2023，42（2）：146-150.

GENG Wen-qian,QI Shuo,SHANG Jian-wei,et al.Observation on clinical effect of LT⁃4 and selenium combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(02):146-150.
耿文倩，祁烁，商建伟，等.清肝散结消瘿方联合硒制剂治疗桥本甲状腺炎合并甲状腺功能减退症疗效观察［J］.北京中医药，2023，42（2）：146-150. DOI： 10.16025/j.1674-1307.2023.02.006.

GENG Wen-qian,QI Shuo,SHANG Jian-wei,et al.Observation on clinical effect of LT⁃4 and selenium combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(02):146-150. DOI： 10.16025/j.1674-1307.2023.02.006.

摘要

目的,2,观察清肝散结消瘿方、硒制剂联合左甲状腺素钠片（LT⁃4）治疗桥本甲状腺炎（HT）合并甲状腺功能减退症疗效。,方法,2,选择2021年1月1日—10月31日于北京中医药大学孙思邈医院甲状腺病科门诊就诊的HT合并甲状腺功能减退症患者120例，采用随机数字表法分为对照组、中药组和联合用药组，各40例。对照组给予LT⁃4口服治疗，中药组在对照组基础上加清肝散结消瘿方口服治疗，联合用药组在中药组基础上加硒制剂口服治疗，3组均连续用药3个月。对比各组治疗前后甲状腺功能指标（FT,3,、FT,4,、TSH）、甲状腺相关自身抗体（TPOAb、TGAb）、中医证候积分、甲状腺病症状群评价指标［汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数（PSQI）、疲劳严重程度量表（FSS）］、甲状腺病下肢局部症状和淋巴水肿评分。,结果,2,治疗后，中药组、联合用药组FT,3,、FT,4,均优于对照组（,P,<,0.05），3组TSH比较差异无统计学意义（,P,>,0.05）；中药组与联合用药组TPOAb、TGAb比较差异无统计学意义（,P,>,0.05）；中药组、联合用药组中医证候积分、各项甲状腺病症状群指标、下肢淋巴水肿评分均优于对照组（,P,<,0.05）。,结论,2,清肝散结消瘿方与硒制剂联合使用能够降低桥本甲状腺炎患者的甲状腺自身抗体水平、改善甲状腺功能及临床症状。

Abstract

Objective,2,To observe the clinical effect of LT⁃4，selenium preparation combined with Qinggan Sanjie Xiaoying Prescription in the treatment of Hashimoto thyroiditis complicated with hypothyroidism.,Methods,2,A total of 120 patients with Hashimoto thyroiditis complicated with hypothyroidism were included， who visited Department of Thyroid Disease， Sunsimiao Hospital of Beijing University of Chinese Medicine from 1 January 2021 to 31 October2021， and according to random number table method，they were divided into control group （LT⁃4）， TCM group （LT⁃4+TCM） and combined group （LT⁃4+TCM+selenium preparation）of 40 cases in each one. After 3 months of follow-up， the therapeutic effect was evaluated according to thyroid function （FT,3,、FT,4,、TSH），thyroid-related autoantibodies （TPOAb、TGAb），TCM syndrome score， thyroid disease symptom group evalluation index including HAMA， HAMD， PSQI， FSS and local symptoms of lower limbs and lymphedema score.,Results,2,After treatment，FT,3, and FT,4, in TCM group and the combined drug group were better than those in the control group （,P,<,0.05），and there was no statistical difference in TSH among the three groups （,P,>,0.05）.There was no significant difference in TPOAb and TGAb between TCM group and combined drug group （,P,>,0.05）.The TCM syndrome score，the indexes of thyroid disease symptom groups and the lymphedema score of lower limbs in TCM group and the combined medication group were better than those in the control group （,P,<,0.05）.,Conclusion,2,Qinggan Sanjie Xiaoying Decoction combined with selenium preparation can reduce the level of thyroid autoantibodies，improve thyroid function and clinical symptoms for patients with Hashimoto thyroiditis.

关键词

桥本甲状腺炎甲状腺功能减退症清肝散结消瘿方硒

Keywords

Hashimoto thyroiditishypothyroidismQinggan Sanjie Xiaoying Prescriptionselenium

references

CATUREGLI P, DE REMIGIS A, ROSE NR. Hashimoto thyroiditis: clinical and diagnostic criteria[J]. Autoimmun Rev,2014,13(4-5):391-397.

TUNBRIDGE WM, BREWIS M, FRENCH JM, et al. Natural history of autoimmune thyroiditis[J]. Br Med J (Clin Res Ed),1981,282(6260):258-262.

DE LEO S, LEE SY, BRAVERMAN LE. Hyperthyroidism[J]. Lancet,2016,388(10047):906-918.

MARTINEZ QUINTERO B, YAZBECK C, SWEENEY LB. Thyroiditis: evaluation and treatment[J]. Am Fam Physician,2021,104(6):609-617.

HU S,RAYMAN MP. Multiple nutritional factors and the risk of Hashimoto's thyroiditis[J]. Thyroid,2017,27(5):597-610.

程璟.桥本甲状腺炎甲减患者情绪状况及归芪逍遥合剂干预的疗效评价研究[D].合肥:安徽中医药大学,2021.

丁治国.靥本相应论：甲状腺疾病中医诊疗新思路[M].北京:清华大学出版社,2021:45-49.

中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南[J].中华内科杂志,2008,47(9):784-788.

陈家伦.临床内分泌学[M].上海:上海科学出版社,2011:388-392.

郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:364-366.

周炯,王荫华.焦虑抑郁量表评价分析[J].中国心理卫生杂志,2006,20(10):665.

卢美枚.肝郁化火型广泛性焦虑障碍患者睡眠质量与甲状腺激素的相关研究[D].北京:北京中医药大学,2020.

曲姣.甲状腺功能减退症脾气虚乏力症状的客观测评[D].济南；山东中医药大学,2020.

YOST KJ,CHEVILLE AL,WEAVER AL, et al. Development and validation of a self-report lower-extremity lymphedema screening questionnaire in women[J]. Phys Ther,2013,93(5):694-703.

PYZIK A, GRYWALSKA E, MATYJASZEK-MATUSZEK B, et al. Immune disorders in Hashimoto's thyroiditis: what do we know so far?[J]. J Immunol Res,2015,2015:979167.

王迪,梁伟娟,许雷鸣,等.桥本甲状腺炎西药治疗进展[J].医学综述,2021,27(22):4501-4505.

FAN Y, XU S, ZHANG H, et al. Selenium supplementation for autoimmune thyroiditis: a systematic review and meta-analysis[J]. Int J Endocrinol,2014,2014:904573.

WINTHER KH, WICHMAN JE, BONNEMA SJ, et al. Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis[J]. Endocrine,2017,55(2):376-385.

邹冉,冯圣钰,杨华,等.桥本甲状腺炎中医辨证论治研究进展[J].世界临床药物,2021,42(7):590-594.

李心爱,祁烁,陈晓珩,等.基于“靥本相应”探讨桥本氏甲状腺炎合并甲状腺功能减退治法[J].现代中西医结合杂志,2021,30(13):1417-1419,1453.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据