益氣化瘀方治療甲狀腺功能正常橋本甲狀腺炎的臨床研究

羅遠(yuǎn)林+邵迎新+周濤

[摘要] 目的 觀察益氣化瘀方對甲狀腺功能正常的橋本甲狀腺炎（HT）患者甲狀腺自身抗體和甲狀腺功能的影響。 方法 選取湖北省黃岡市中醫(yī)醫(yī)院甲狀腺科2016年7月～2017年2月收治的甲狀腺功能正常的HT患者112例，采用隨機(jī)數(shù)字表法將其隨機(jī)分為治療組和對照組，各56例。治療組給予益氣化瘀中藥復(fù)方制劑，對照組不服用任何藥物治療，僅要求低碘飲食。兩組治療6個(gè)月，測定治療前后甲狀腺自身抗體[甲狀腺過氧化物酶抗體（TPOAb）、甲狀腺球蛋白抗體（TgAb）]、甲狀腺功能[促甲狀腺激素（TSH）、游離三碘甲腺原氨酸（FT3）、游離甲狀腺素（FT4）]。 結(jié)果 治療組治療后TPOAb、TgAb水平均較治療前下降，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05），并且明顯低于對照組治療后（P < 0.05）。對照組治療后TPOAb、TgAb較治療前上升，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。對照組治療后TSH水平較治療前上升，且明顯高于治療組（P < 0.05）。治療組治療前后TSH水平比較，差異無統(tǒng)計(jì)學(xué)意義（P > 0.05）。兩組治療前后FT3、FT4水平比較，差異無統(tǒng)計(jì)學(xué)意義（P > 0.05）。 結(jié)論 益氣化瘀中藥復(fù)方可以降低甲狀腺功能正常的HT患者TPOAb、TgAb水平，但是對于甲狀腺功能的影響不大；單純低碘飲食不能控制HT患者TPOAb、TgAb及TSH水平的升高。

[關(guān)鍵詞] 橋本甲狀腺炎；益氣化瘀方；甲狀腺自身抗體；甲狀腺功能

[中圖分類號(hào)] R581 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2017）12（a）-0074-04

[Abstract] Objective To observe the effects of Yiqi Huayu Recipe on the thyroid autoantibodies and thyroid function in Hashimoto thyroiditis （HT） patients with normal thyroid function. Methods From July 2016 to February 2017， a total of 112 patients of HT with normal thyroid function in Department of Thyroid， Hubei Huanggang Hospital of Traditional Chinese Medicine， were recruited in this study. They were randomly classified into treatment group and control group， with 56 cases in each group. The treatment group was given Chinese medicine compound preparation of Yiqi Huayu Recipe， the control group did not take any medication， they were only taken iodine deficient diet. The two groups were treated for 6 months， The thyroid autoantibodies [thyroid peroxidase antibody （TPOAb）， thyroglobulin antibodies （TgAb）] and thyroid function [thyrotropic hormone （TSH）， free triiodothyronine （FT3）， free thyroxine （FT4）] were measured before and after treatment. Results The levels of TPOAb and TgAb in the treatment group were both lower than those before treatment， the differences were statistically significant （P < 0.05）， which were significantly lower than those of control group （P < 0.05）； the levels of TPOAb and TgAb in the control group were significantly higher than those before treatment， the differences were statistically significant （P < 0.05）. After treatment， the level of TSH in the control group was significantly higher than that before treatment， which was significantly higher than that of treatment group （P < 0.05）， there was no statistically significant difference of TSH in the treatment group before and after treatment （P > 0.05）. There were no statistically significant differences of FT3 and FT4 before and after treatment in the two groups （P > 0.05）. Conclusion Chinese medicine compound preparation of Yiqi Huayu Recipe can reduce the levels of TPOAb and TgAb in HT patients with normal thyroid function， but it has little effects on thyroid function； iodine deficient diet can not control the increase of TPOAb， TgAb and TSH in HT patients.endprint

[Key words] Hashimoto thyroiditis； Yiqi Huayu Recipe； Thyroid autoantibodies； Thyroid function

橋本甲狀腺炎（Hashimotos thyroiditis，HT）又稱慢性淋巴細(xì)胞性甲狀腺炎，為常見的器官特異性自身免疫性疾病，主要是導(dǎo)致甲狀腺功能減退癥（甲減）、甲狀腺腫大和甲狀腺結(jié)節(jié)。本病易伴發(fā)甲狀腺乳頭狀癌以及風(fēng)濕性關(guān)節(jié)炎、腎病綜合征、自身免疫性肝病等多種其他自身免疫性疾病，還嚴(yán)重影響女性的生殖健康[1]。《中國甲狀腺疾病診治指南》[2]中的慢性淋巴細(xì)胞性甲狀腺炎診治指南制定較早（2008年），指南推薦甲狀腺功能正常的患者不治療，僅要求低碘飲食，隨訪觀察。由于……