玄夏消瘿汤治疗痰结血瘀型桥本氏甲状腺炎的疗效观察及对IL-17的影响

发布时间：2018-05-27 22:15

本文选题：玄夏消瘿汤 + 痰结血瘀　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:试探玄夏消瘿汤在痰结血瘀型桥本氏甲状腺炎患者临床上的疗效及对血清IL-17的影响,并探求玄夏消瘿汤对桥本氏甲状腺炎的治疗的可能作用机理。方法:选出60例门诊诊断为痰结血瘀型桥本氏甲状腺炎的患者,随机性的分为治疗组和对照组,每组各30例。治疗组:给以玄夏消瘿汤150ml每袋,每日早晚各1袋,餐后温服;对照组:给以夏枯草颗粒一次1袋,每日服用2次,两组均观察12周。观察治疗前与治疗后患者中医证候积分,甲状腺彩超的情况及自身免疫抗体测定(TPOAb、TGAb)的水平,细胞因子IL-17的水平,从而做出临床疗效评价。结果:1.治疗后,治疗组与对照组比较,中医单项症状或体征积分明显减少,具有显著统计学差异(P0.05)。2.治疗后,治疗组患者甲状腺体积与对照组比较明显缩小,差异具有显著统计学意义(P0.05)。3.治疗后,两组患者组内比较IL-17水平均有不同程度下降。但治疗组患者IL-17的程度较对照组下降更显著,差异具有统计学意义(P0.05)。4.治疗后,治疗组患者甲状腺自身抗体水平较对照组下降明显,差异具有统计学意义(P0.05)。5.治疗后,两组患者证候积分总有效率比较,治疗组为93.33%,对照组为60.00%;Ridit分析后,前者即治疗组患者中医证候总疗效明显较后者即对照组更优,具有统计学差异(P0.05)。结论:1.玄夏消瘿汤治疗痰结血瘀型桥本氏甲状腺炎,可以明显改善患者颈前喉结两旁肿大及咽异物感、胸胁刺痛及脘腹痞闷的中医临床症状;2.玄夏消瘿汤治疗桥本氏甲状腺炎,患者增大的甲状腺体积明显缩小;3.玄夏消瘿汤治疗桥本氏甲状腺炎,可以减低患者甲状腺自身抗体(TPOAb、TGAb);4.玄夏消瘿汤治疗桥本氏甲状腺炎,可以减低患者外周血的IL-17,从而调节患者免疫功能,调节患者免疫功能为其达到治疗HT的可能作用机制。
[Abstract]:Objective: to explore the clinical efficacy of Xuanxia Xiaoying decoction (XXXD) in treating Hashimoto's thyroiditis with phlegm and blood stasis type and its effect on serum IL-17, and to explore the possible mechanism of Xuanxia Xiaoying decoction (XXXD) in the treatment of Hashimoto's thyroiditis. Methods: 60 cases of Hashimoto's thyroiditis diagnosed as phlegm and blood stasis type were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was given Xuanxia Xiaoying decoction (150ml) in each bag, 1 bag in the morning and evening after meal, while the control group was given 1 bag of Prunella subtilis granules once a day, 2 times a day, both groups were observed for 12 weeks. The TCM syndromes score, thyroid color Doppler ultrasound and autoimmune antibody were observed before and after treatment, and the levels of cytokines IL-17 were measured to evaluate the clinical efficacy. The result is 1: 1. After treatment, compared with the control group, the scores of single symptoms or signs in the treatment group were significantly reduced, with a significant statistical difference (P 0.05). 2. After treatment, the thyroid volume of the patients in the treatment group was significantly smaller than that in the control group, and the difference was statistically significant (P 0.05. 3). After treatment, the level of IL-17 decreased in different degree in both groups. However, the degree of IL-17 in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (P 0.05. 4). After treatment, the level of thyroid autoantibodies in the treatment group was significantly lower than that in the control group, and the difference was statistically significant. After treatment, the total effective rate of syndromes integral was 93.33 in the treatment group and 60.00g in the control group. After Ridit analysis, the total curative effect of TCM syndrome in the former group was significantly better than that in the latter group (P 0.05). Conclusion 1. Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis with phlegm and blood stasis can obviously improve the clinical symptoms of patients with cervical anterior larynx enlargement and foreign body sensation of pharynx chest and hypochondriac prickle and abdominal and epigastric distension. Xuanxia Xiaoying decoction in the treatment of Hashimoto's thyroiditis patients increased thyroid volume significantly reduced by 3. Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis can reduce the thyroid autoantibody TPOAb and TGAbA4. Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis can reduce the level of IL-17 in peripheral blood of patients, thus regulate the immune function of patients, and regulate the immune function of patients as the possible mechanism for the treatment of HT.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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