莲蓣消瘿汤联合中药透药法外治治疗桥本甲状腺炎随机对照非盲研究

目的观察莲蓣消瘿汤联合中药透药治疗肝郁脾虚型甲状腺功能正常桥本甲状腺炎(Hashimoto thyroiditis,HT)疗效。方法收集2017年1月—2019年7月上海市嘉定区中医医院内分泌门诊就诊的甲状腺功能正常HT肝郁脾虚证患者,随机分成莲蓣消瘿汤组、透药组、莲蓣消瘿汤联合透药组(简称联合组),每组44例,分别予以莲蓣消瘿汤、中药透药、莲蓣消瘿汤联合透药治疗,观察治疗12周后甲状腺功能、甲状腺大小、自身抗体、中医证候积分及临床疗效。结果治疗后3组自身抗体即甲状腺球蛋白抗体(TgAb)和甲状腺过氧化物酶抗体(TPOAb)均低于治疗前(P<0.01),联合组低于莲蓣消瘿汤组、透药组(P<0.05),莲蓣消瘿汤组低于透药组(P<0.05);3组甲状腺左叶、右叶、峡部厚度均较治疗前减小(P<0.05),联合组小于莲蓣消瘿汤组、透药组(P<0.05),透药组小于莲蓣消瘿汤组(P<0.05);3组证候积分较治疗前明显降低(P<0.05),联合组、莲蓣消瘿汤组低于透药组(P<0.05),莲蓣消瘿汤组低于透药组(P<0.05);联合组总有效率明显高于莲蓣消瘿汤组及透药组,数据差异具有统计学意义(P<0.05)。结论莲蓣消瘿汤联合中药透药治疗能够降低甲状腺抗体水平,减轻甲状腺肿,改善临床症状。

Randomized Controlled Non-blind Study on Lianyu Xiaoying Decoction Combined with External Therapy of Traditional Chinese Medicine Penetration in the Treatment of Hashimoto Thyroiditis

Objective To investigate the clinical effect of Lianyu Xiaoying(LYXY)decoction combined with traditional Chinese medicine penetration in treatment of Hashimoto thyroiditis(HT)with normal thyroid function due to liver depression and spleen deficiency.Methods Patients with hashimoto thyroiditis in department of endocrinology of Jiading District Hospital of Traditional Chinese Medicine were randomly divided into LYXY group,traditional Chinese medicine(TCM)penetration group and combined group,and were treated with Lianyu Xiaoying decoction,traditional Chinese medicine penetration and Lianyu Xiaoying decoction combined with traditional Chinese medicine penetration respectively.Treatment after 12 weeks,the TCM clinical symptoms,TPO-Ab and TG-Ab titer change and improvement of thyroid enlargement were evaluated.Results TPO-Ab,TG-Ab was significantly lower in the three groups after treatment than before treatment(P<0.01).The combined group were significantly lower than that of LYXY group and TCM penetration group(P<0.05).The LYXY group were lower than that of TCM penetration group(P<0.05).After treatment,the size of thyroid gland in the left lobe,right lobe and isthmus decreased in all three groups(P<0.05).The combined group was decreased than that of LYXY group and TCM penetration group(P<0.05).The TCM penetration group was decreased than that of LYXY group(P<0.05).Total Symptom Score(TSS)was significantly lower after treatment than before treatment in all three groups(P<0.05).TSS of combined group and LYXY group were lower than that of TCM penetration group(P<0.05).TSS of LYXY group was lower than that of TCM penetration group(P<0.05).Conclusion LYXY decoction combined with TCM penetration has decreased TPO-Ab and TG-Ab titer of Hashimoto thyroiditis,can reduce goiter,and improve clinical symptoms.