养阴散结汤辅助治疗分化型甲状腺癌疗效及对患者术后甲状腺、免疫功能和血清学指标的影响

目的:探讨养阴散结汤对分化型甲状腺癌术后患者的临床疗效。方法:选择分化型甲状腺癌患者70例,按照治疗方式不同分为观察组和对照组各35例,其中对照组患者术后给予左旋甲状腺素片(L-T4)治疗,观察组在对照组的基础上加养阴散结汤治疗,观察两组患者治疗前后的甲状腺功能、免疫功能变化,比较治疗前后两组患者血清中细胞角蛋白19片段(Cyfra 21.1)、半乳糖血凝素-3(Gal-3)、血管内皮生长因子(VEGF)水平情况,比较两组疗效及不良反应情况。结果:治疗后,两组血清三碘甲状腺原氨酸(FT₃)、血清游离甲状腺素(FT₄)和血清促甲状腺素(TSH)水平明显改善,观察组更明显(P<0.05)。治疗后,对照组CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺水平比较差异无统计学意义(P>0.05),观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平均明显升高,CD8⁺水平下降(P<0.05)。治疗后,两组血清Cyfra 21.1、Gal-3水平升高,VEGF水平降低,观察组更明显(P<0.05)。观察组疗效优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:养阴散结汤在分化型甲状腺癌患者术后治疗中,疗效明显,可改善患者甲状腺功能及免疫功能,利于促进患者术后的恢复。

Effects of Yangyin Sanjie decoction on thyroid gland,immune function and serological indexes in postoperative patients with differentiated thyroid cancer

Objective:To explore the curative effect of Yangyin Sanjie decoction on postoperative patients with differentiated thyroid cancer.Methods:70 patients with differentiated thyroid cancer were selected retrospectively and divided into observation group(35 cases)and control group(35 cases)according to different treatment methods.The patients in the control group were treated with levothyroxine(L-T4)after operation.The observation group was treated with Yangyin Sanjie decoction on the basis of the control group.The changes of thyroid function and immune function before and after treatment were observed,the expression levels of cytokeratin 19 fragment(Cyfra 21.1),galactose hemagglutinin-3(Gal-3)and vascular endothelial growth factor(VEGF)in the serum of the two groups were compared before and after treatment.The curative effects of the two groups were observed.The adverse reactions of the two groups were observed.Results:After treatment,the levels of serum TSH,FT₃ and FT₄ in the two groups were significantly improved,especially in the observation group(P<0.05).After treatment,there was no significant change in the levels of CD3⁺,CD4⁺,CD8⁺ and CD4⁺/CD8⁺ in the control group(P>0.05).The levels of CD3⁺,CD4⁺,CD4⁺ / CD8⁺ in the observation group increased significantly and the level of CD8⁺ decreased(P<0.05).After treatment,the levels of serum Cyfra 21.1 and Gal-3 increased and VEGF decreased in the two groups,especially in the observation group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Yangyin Sanjie decoction is effective in the postoperative treatment of patients with differentiated thyroid cancer.It can improve the thyroid function and immune function,and promote the recovery of prognosis.