硒酵母片联合保元胶囊治疗慢性淋巴细胞性甲状腺炎的疗效及对淋巴细胞亚群和甲状腺自身抗体的影响

目的:探讨硒酵母片联合保元胶囊治疗慢性淋巴细胞性甲状腺炎的临床疗效及对淋巴细胞亚群和甲状腺自身抗体的影响。方法:选取2016年11月至2020年1月石家庄市中医院收治的慢性淋巴细胞性甲状腺炎患者146例,按照随机数字表法分为观察组和对照组,每组73例。对照组患者给予左甲状腺素钠片治疗,观察组患者在对照组的基础上加用硒酵母片联合保元胶囊进行治疗,疗程6个月。观察两组患者中医证侯的改善情况、甲状腺体积及不良反应发生情况,T淋巴细胞亚群和甲状腺激素及抗体[血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(Tg Ab)]水平。结果:治疗6个月后,观察组患者颈前肿块、畏寒肢冷、面色恍白、神疲乏力、食少纳呆和小便频数等中医证侯的改善情况明显优于对照组,TSH、Tg Ab和TPOAb水平明显低于对照组,FT3和FT4水平明显高于对照组,上述差异均有统计学意义(P<0.05)。两组患者治疗后甲状腺左右叶及峡部厚度均有所降低,但是与治疗前比较以及两组组间比较,差异均无统计学意义(P>0.05)。观察组患者治疗3、6个月后的CD3⁺、CD4⁺、CD4⁺/CD8⁺水平较对照组明显升高,CD8⁺水平则较对照组明显降低,差异均有统计学意义(P<0.05)。两组患者治疗过程中均未发生明显的不良反应。结论:硒酵母片联合保元胶囊治疗慢性淋巴细胞性甲状腺炎的临床疗效明显,可以有效降低甲状腺自身抗体水平,改善T淋巴细胞亚群的紊乱。

Efficacy of Selenium Yeast Tablets Combined with Baoyuan Capsules in the Treatment of Chronic Lymphocytic Thyroiditis and its Effects on Lymphocyte Subsets and Thyroid Autoantibodies

OBJECTIVE:To probe into the clinical efficacy of Selenium yeast tablets combined with Baoyuan capsules in the treatment of chronic lymphocytic thyroiditis and its effects on lymphocyte subsets and thyroid autoantibodies.METHODS:Totally 146 patients with chronic lymphocytic thyroiditis admitted into Shijiazhuang Hospital of Traditional Chinese Medicine from Nov.2016 to Jan.2020 were extracted to be divided into the observation group and the control group via the random number table,with 73 cases in each group.The control group was treated with Levothyroxine tablets,while the observation group received Selenium yeast tablets combined with Baoyuan capsules based on the control group.Both groups were treated for 6 months.The improvement of traditional Chinese medicine syndromes,thyroid volume,the incidence of adverse reactions,levels of T lymphocyte subsets,thyroid hormones and antibodies[serum free triiodothyronine(FT3),serum free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb)and thyroid globulin antibody(TgAb)]in two groups were observed.RESULTS:After 6 months of treatment,the improvement of anterior lump,pale complexion,fatigue,poor appetite,anorexia and frequent urination in the observation group was better than that in the control group;the levels of TSH,TgAb and TPOAb in the observation group were significantly lower than those in the control group,while the levels of FT3 and FT4 were significantly higher than those of the control group,the difference was statistically significant(P<0.05).After treatment,the thickness of left and right lobes and isthmus of thyroid decreased in both groups,yet there was no statistical significance compared with that before treatment,and after treatment between two groups(P>0.05).After 3 and 6 months of treatment,the levels of CD3⁺,CD4⁺and CD4⁺/CD8⁺in the observation group were significantly higher than those in the control group,while the levels of CD8⁺were significantly lower than those in the control group,with statistically significant difference(P<0.05).During the treatment,neither of two groups encountered significant adverse drug reactions.CONCLUSIONS:The clinical efficacy of Selenium yeast tablets combined with Baoyuan capsules in the treatment of chronic lymphocytic thyroiditis is significant,which can effectively reduce the level of thyroid autoantibodies and improve the disorder of T lymphocyte subsets.