疏肝健脾法配合优甲乐治疗桥本甲状腺炎的研究

摘要

目的：观察疏肝健脾法配合优甲乐治疗桥本甲状腺炎的临床疗效及对血清抗甲状腺过氧化物酶抗体（ TPOAb）、抗甲状腺球蛋白抗体（ TGAb）的影响。方法将80例桥本甲状腺炎患者随机分为观察组和对照组各40例，对照组给予优甲乐治疗，观察组在对照组治疗基础上给予疏肝健脾法治疗，连续治疗3个月后统计2组临床治疗效果，观察治疗前后颈部肿大、怕冷、神疲乏力、面目水肿、食欲减退、体质量增加、大便秘结症状积分及甲状腺激素水平和血清TPOAb、TGAb水平变化，彩超观察甲状腺体积变化。结果观察组有效率明显高于对照组（P＜0．05）；治疗后2组颈部肿大、怕冷、神疲乏力、面目水肿、食欲减退、体质量增加、大便秘结症状积分及血清TSH、TGAb和TPOAb水平均明显降低（P均＜0．05），血清FT3、FT4均明显升高（P均＜0．05），甲状腺左右叶及峡部厚度均明显减小（P均＜0．05），且观察组上述各指标改善情况均明显优于对照组（P均＜0．05）；2组治疗过程中均未发生明显不良反应。结论疏肝健脾法配合优甲乐治疗桥本甲状腺炎临床疗效好，能有效降低甲状腺自身免疫性抗体水平，且安全性好，值得推广应用。%Objective It is to observe the clinical effects of soothing liver and activating spleen method combined with eu -thyrox in treatment of hashimoto thyroiditis and its influence on serum thyroid peroxidase antibody ( TPOAb) and thyroglobulin antibody ( TGAb) .Methods 80 patients with hashimoto thyroiditis were divided into observation group and control group , 40 patients for each group .The patients were treated with euthyrox in the control group , while soothing liver and activating spleen method combined with euthyrox in the observation group .After three months of continuous treatment , the efficacy of the two groups was statistically analyzed .Before and after treatment , the symptom scores of swelling cervical , feeling of coldness, loss of vitality and strength , facial edema , poor appetite , weight gain , constipation ,and the levels of thyroid hormone , TPOAb and TGAb were observed , and the changes of thyroid volume were observed by color Doppler ultrasonography .Rseults After the treatment , the effective rate of the observation group was obviously higher than that of the control group ( P<0.05 ) .The symptom scores like swelling cervical , feeling of coldness , loss of vitality and strength , facial edema , poor appetite , weight gain and constipation , and the levels of TSH, TPOAb and TGAb were significantly decreased (all P<0.05), and the levels of FT3, FT4 were significantly increased (all P<0.05), and the thickness of both the left and right lobe of and the isthmus of the thyroid were obviously decreased (all P<0.05) than before treatment in both groups , and all the above indicators in the observation group were obviously better than those in the control group (all P<0.05).There was no adverse reaction was ob-served in both groups during the treating process .Conclusion The treatment of soothing liver and activating spleen method combined with euthyrox in hashimoto thyroiditis has a good clinical curative effect , it can effectively lower the autoimmune an-tibody index of the thyroid , with better security , and it deserves further clinical application .