| 杨海涛,康磊,李晓雪.清瘿化痰汤内服及消瘿膏外敷联合口服硒酵母片治疗桥本甲状腺炎37 例[J].安徽医药,2022,26(8):1663-1667. |
| 清瘿化痰汤内服及消瘿膏外敷联合口服硒酵母片治疗桥本甲状腺炎37 例 |
| Clinical efficacy of oral administration of Qingying Huatan decoction and external application of Xiaoying ointment combined with selenious yeast in the treatment of Hashimoto' s thyroiditis: 37 cases |
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| DOI：10.3969/j.issn.1009-6469.2022.08.042 |
| 中文关键词: 甲状腺炎，自身免疫性 中西结合疗法 桥本甲状腺炎 超声图像 甲状腺血流动力学 硒酵母 |
| 英文关键词: Thyroiditis,autoimmune Combination of Chinese and western medication Hashimoto' s thyroiditis Ultrasonic im?age Thyroid hemodynamics Selenious yeast |
| 基金项目:秦皇岛市科学技术局资助项目(201805A115) |
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| 中文摘要: |
| 目的观察中西医结合治疗桥本甲状腺炎(HT)的效果。方法选取2018年2月至2019年2月秦皇岛市工人医院诊治的HT病人74例，采用数字表法随机分成观察组和对照组，每组37例；对照组口服硒酵母片，观察组在对照组基础上口服自拟方剂清瘿化痰汤及外用中药膏剂消瘿膏，在治疗8周后，比较两组临床疗效，测定两组治疗前后的甲状腺功能，并通过超声观察甲状腺形态及血流动力学变化。结果治疗8周后观察组比对照组甲状腺过氧化物酶抗体(TPOAb)［(230.25±34.26)U/mL比(319.50±40.28)U/mL］、甲状腺球蛋白抗体(TGAb)［(510.27±74.36)U/mL比(761.12±80.21)U/mL］、游离三碘甲状腺原氨(FT3)［(5.30±1.25)pmol/L比(3.87±1.18)pmol/L］、游离甲状腺素(FT4)［(17.28±2.46)pmol/L比(12.15±3.14)pmol/L］及促甲状腺激素(TSH)［(2.13±0.40)mIU/L比(2.46±0.51)mIU/L］均有改善(P<0.05)；观察组治疗总有效率为94.59%，显著高于对照组的78.38%(P<0.05)；通过超声观察，治疗后观察组甲状腺动脉收缩期峰值流速(PSV)［(46.26±5.03)cm/s比(52.73±4.88)cm/s］及左叶厚度［(13.80±1.22)mm比(15.57±1.31)mm］、右叶厚度［(14.01±1.16)mm比(15.39±1.30)mm］、峡部厚度［(4.02±0.33)mm比(4.61±0.39)mm］均低于对照组(P<0.05)，而两组阻力指数(RI)［(0.64±0.02)比(0.63±0.03)］比较，差异无统计学意义(P>0.05)；治疗6 个月后复查时，观察组血清FT3［(6.25±1.15)pmol/L 比(4.02±1.02)pmol/L］、FT4［(19.52±3.47)pmol/L 比(13.65±3.02)pmol/L］水平显著高于对照组(P<0.05)，TSH［(2.02±0.28)mIU/L比(2.89±0.62)mIU/L］、TPOAb［(226.52±28.71)U/mL比(286.95±36.17)U/mL］、TGAb［(516.52±24.95)U/mL比(536.85±21.45)U/mL］水平显著低于对照组(P<0.05)。结论采用中西医结合治疗HT，能明显改善病人甲状腺功能，促进甲状腺形态和血流动力学良好恢复。 |
| 英文摘要: |
| Objective To explore the effects of integrated Chinese and Western medication in the treatment of Hashimoto' s thyroid?itis (HT).Methods A total of 74 patients with HT diagnosed and treated in the Qinhuangdao Workers Hospital between February 2018 and February 2019 were selected, and they were randomly divided into the experimental group and the reference group by the number table method, with 37 cases in each group. The reference group was treated with selenious yeast while the experimental group received oral administration of Qingying Huatan decoction and external application of Xiaoying ointment combined with selenious yeast. After 8 weeks of treatment, the clinical efficacy of the two groups was compared and analyzed, and the levels of thyroid function indicators were measured before and after treatment. The thyroid morphology and hemodynamic changes were observed by ultrasound.Results The thyroid peroxidase antibody (TPOAb) [(230.25±34.26) U/mL vs. (319.50±40.28) U/mL], thyroglobulin antibody (TGAb)[(510.27±74.36) U/mL vs. (761.12±80.21) U/mL], free triiodothyronine (FT3) [(5.30±1.25) pmol/L vs. (3.87±1.18) pmol/L], free thyrox?ine (FT4) [(17.28±2.46) pmol/L vs. (12.15±3.14) pmol/L] and thyroid stimulating hormone (TSH) [(2.13±0.40) mIU/L vs. (2.46±0.51)mIU/L] were improved after treatment in both groups (P<0.05). The total effective rate of treatment was 94.59% in the experimental group, which was significantly higher than 78.38% in the reference group (P<0.05). By ultrasound observation, the peak systolic veloci?ty (PSV) [(46.26±5.03) cm/s vs. (52.73±4.88) cm/s], left lobe thickness [(13.80±1.22) mm vs. (15.57±1.31) mm], right lobe thickness[(14.01±1.16) mm vs. (15.39±1.30) mm] and isthmus thickness [(4.02±0.33) mm vs. (4.61±0.39) mm] in the experimental group were lower than those in the reference group after treatment (P<0.05), but there was no significant difference in resistance index (RI) [(0.64±0.02) vs. (0.63±0.03)] (P>0.05). At re-examination after 6 months of treatment, the levels of serum FT3 [(6.25±1.15) pmol/L vs. (4.02±1.02) pmol/L] and FT4 [19.52±3.47) pmol/L vs. (13.65±3.02) pmol/L] in the experimental group were significantly higher than those in the reference group group (P<0.05), while the levels of TSH [(2.02±0.28) mIU/L vs. (2.89±0.62) mIU/L], TPOAb [226.52±28.71) U/mL vs. (286.95± 36.17) U/mL] and TGAb [516.52±24.95) U/mL vs. (536.85±21.45) U/mL] were significantly lower than those in the refer?ence group (P<0.05).Conclusion The combination of Chinese and Western medication in the treatment of HT can better improve the thyroid function and promote the good recovery of thyroid morphology and hemorheology. |
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