健脾消瘿汤治疗桥本甲状腺炎的临床研究

摘要

目的:观察健脾消瘿汤对桥本甲状腺炎患者抗过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)及γ干扰素/白细胞介素4(IFN-γ/IL-4)比值的影响.方法:将桥本甲状腺炎患者108例采用随机、对照、平行试验设计方法分为中药组36例、西药组36例、中药+西药组36例,中药组口服健脾消瘿汤早晚各1次,200 mL/次;西药组口服硒酵母胶囊早晚各2粒;中药+西药组给予健脾消瘿汤及硒酵母胶囊,服用方法同上,连续用药12周后观察治疗前后3组患者的临床症状、体征、TPOAb、TGAb及IFN-γ/IL-4比值改善情况.结果:与治疗前比较,中药组和中药+西药组TPOAb、TGAb下降,差异有统计学意义(P＜0.01),西药组无明显下降(P＞0.05);中药组和中药+西药组临床症状、体征和IFN-γ/IL-4比值较治疗前改善,差异有统计学意义(P＜0.01).组间比较,中药组、中药+西药组在降低TPOAb、TGAb及改善临床症状、体征方面均优于西药组(P＜0.01),在降低IFN-γ/IL-4比值方面3组比较差异无统计学意义(P＞0.05).结论:健脾消瘿汤可明显降低桥本甲状腺炎患者自身抗体TPOAb、TGAb滴度,改善患者临床症状、体征,临床疗效优于硒酵母;同时可降低IFN-γ/IL-4比值,疗效与硒酵母相当.%Objective: To observe the influence of JianPi XiaoYing decoction on TPOAb, TGAb and IFN-γ/IL-4 on the patients with Hashimoto's thyroiditis (HT). Methods: All 108 HT patients were divided into 36 cases of the herbal group, 36 cases of the group of western medicine and 36 cases of the group of herbs and Western medicine by randomized, controlled, parallel experimental design method, the herbal group took JianPi XiaoYing decoction in the morning and evening, 200 mL each time; the group of Western medicine took selenium yeast capsules, two pills each time, in the morning and evening, the group of herbs and Western medicine were given JianPi XiaoYing decoction and selenium yeast capsules, the incidence of adverse reactions, the improvements of IFN-γ, IL-4, TGAb and TPOAb, body signs and clinical symptoms of the patients in three groups were observed before treating and after treating after they were treated for 12 weeks consecutively. Results: Compared with before treating, the levels of TGAb and TPOAb lowered in the herbal group and the group of herbs and Western medicine, and the difference had statistical meaning (P ＜0.01), there was no decrease in the group of Western mediicine (P＞0.05); clinical symptoms, body signs and the ratio of IFN-γ/IL-4 improved compared with before treating, in the herbal group and the group of herbs and Western medicine and the difference showed statistical meaning (P＜0.01).The comparisons between the groups, the herbal group, the group of herbs and Western medicine were superior to the group of Western medicine in reducing TGAb and TPOAb, improving clinical symptoms and body signs (P＜0.01), the difference had no statistical meaning in the comparisons among three groups in the aspects of lowering IFN-γ/IL-4 (P＞0.05). Conclusion: JianPi XiaoYing decoction could notably decrease the titer of TGAb and TPOAb of HT patients, improve clinical symptoms and body signs, its clinical effects are superior to these of selenium yeast, simultaneously it could lower the ratio of IFN-γ/IL-4, its effects are equivalent to these of selenium yeast.