玄夏消瘿汤治疗痰结血瘀型桥本甲状腺炎的疗效观察及对HLA-DR的影响
发布时间：2018-11-24 21:32
【摘要】：目的:通过观察玄夏消瘿汤对痰结血瘀型桥本甲状腺炎的疗效,对比外周血HLA-DR的表达变化,从而探讨HLA-DR在HT患者免疫紊乱发展过程中的作用及该方对HT免疫的调节机制。方法:将60例诊断为痰结血瘀型桥本甲状腺炎的患者,采用随机数表,分成治疗组、对照组,每组各30例;治疗组予以玄夏消瘿汤口服,对照组予以夏枯草颗粒口服,两组均观察12周;比较治疗前后两组甲状腺体积的变化、甲状腺自身抗体及HLA-DR的表达和中医证候积分,采用SPSS17.0对以上数据进行统计和分析,从而得出玄夏消瘿汤治疗痰结血瘀型桥本甲状腺炎的临床疗效评价。结果:1.治疗后,治疗组患者甲状腺体积与治疗前比较明显缩小,具有显著统计学差异(P0.01);对照组患者甲状腺体积与治疗前比较缩小,差异具有统计学意义(P0.05);治疗组患者甲状腺体积与对照组比较明显缩小,差异具有统计学意义(P0.05)。2.治疗后,治疗组患者单项症状或体征积分与治疗前比较明显减少,具有显著统计学差异(P0.01);对照组患者单项症状或体征积分与治疗前比较减少,差异具有统计学意义(P0.05);治疗组与对照组比较,单项症状或体征积分明显减少,差异具有统计学意义(P0.05)。3.治疗后,治疗组患者的中医证候疗效总有效率为93.33%,对照组患者中医证候疗效总有效率为60.00%;经Ridit分析,治疗组患者的中医证候疗效明显优于对照组,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比治疗前下降,具有显著统计学差异(P0.01),对照组患者组内比较甲状腺自身抗体水平也有下降,差异有统计学意义(P0.05)。但治疗组患者甲状腺自身抗体水平较对照组下降更显著,差异具有统计学意义(P0.05)。5.治疗后,治疗组患者HLA-DR比治疗前显著下降,差异具有统计学意义(P0.01),对照组患者HLA-DR水平也较前水平下降,差异具有统计学意义(P0.01)。但治疗组患者HLA-DR水平较对照组下降更显著,差异具有统计学意义(P0.01)。结论:1.玄夏消瘿汤可缩小HT患者肿大甲状腺体积。2.玄夏消瘿汤可使TPOAb、TGAb水平下降。3.玄夏消瘿汤可改善本病患者的中医证候。4.玄夏消瘿汤可能是通过降低HLA-DR的表达,改善免疫紊乱状态,起到治疗HT的疗效。
[Abstract]:Objective: to observe the curative effect of Xuanxia Xiaoying decoction on Hashimoto's thyroiditis with phlegm and blood stasis, and to compare the expression of HLA-DR in peripheral blood. To explore the role of HLA-DR in the development of immune disorder in patients with HT and the regulatory mechanism of the prescription for HT immunity. Methods: sixty patients with Hashimoto's thyroiditis of 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 and the control group was given the Prunus subtilis granule. The two groups were observed for 12 weeks. The changes of thyroid volume, the expression of thyroid autoantibodies, HLA-DR and TCM syndromes were compared before and after treatment. The above data were statistically analyzed by SPSS17.0. The clinical efficacy of Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis with phlegm and blood stasis was evaluated. Results: 1. After treatment, the thyroid volume of the patients in the treatment group was significantly smaller than that before the treatment (P0.01), and the volume of the thyroid gland in the control group was smaller than that before the treatment (P0.05). The thyroid volume in the treatment group was significantly smaller than that in the control group, and the difference was statistically significant (P0.05). After treatment, the scores of single symptoms or signs of the patients in the treatment group were significantly reduced compared with those before treatment (P0.01). The scores of single symptoms or signs in the control group were significantly lower than those before treatment (P0.05). Compared with the control group, the single symptoms or signs of the treatment group significantly reduced the score, the difference was statistically significant (P0.05). After treatment, the total effective rate of TCM syndromes was 93.33 in the treatment group and 60.00g in the control group. By Ridit analysis, the treatment group patients with TCM syndrome efficacy was significantly better than the control group, the difference was statistically significant (P0.05). After treatment, the level of thyroid autoantibodies in the treatment group was significantly lower than that before treatment (P0.01), and the level of thyroid autoantibodies in the control group was also decreased (P0.05). However, the level of thyroid autoantibodies in the treatment group was significantly lower than that in the control group (P0.05). After treatment, the HLA-DR in the treatment group was significantly lower than that before the treatment, the difference was statistically significant (P0.01), and the HLA-DR level in the control group was also lower than the previous level (P0.01). However, the level of HLA-DR in the treatment group was significantly lower than that in the control group (P0.01). Conclusion: 1. Xuanxia Xiaoying decoction can reduce the volume of enlarged thyroid gland in patients with HT. Xuanxia Xiaoying decoction can reduce TPOAb,TGAb level. Xuanxia Xiaoying decoction can improve the TCM syndromes of patients with this disease. 4. Xuanxia Xiaoying decoction may reduce the expression of HLA-DR, improve the immune disorder, and play a therapeutic effect on 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
[Abstract]:Objective: to observe the curative effect of Xuanxia Xiaoying decoction on Hashimoto's thyroiditis with phlegm and blood stasis, and to compare the expression of HLA-DR in peripheral blood. To explore the role of HLA-DR in the development of immune disorder in patients with HT and the regulatory mechanism of the prescription for HT immunity. Methods: sixty patients with Hashimoto's thyroiditis of 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 and the control group was given the Prunus subtilis granule. The two groups were observed for 12 weeks. The changes of thyroid volume, the expression of thyroid autoantibodies, HLA-DR and TCM syndromes were compared before and after treatment. The above data were statistically analyzed by SPSS17.0. The clinical efficacy of Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis with phlegm and blood stasis was evaluated. Results: 1. After treatment, the thyroid volume of the patients in the treatment group was significantly smaller than that before the treatment (P0.01), and the volume of the thyroid gland in the control group was smaller than that before the treatment (P0.05). The thyroid volume in the treatment group was significantly smaller than that in the control group, and the difference was statistically significant (P0.05). After treatment, the scores of single symptoms or signs of the patients in the treatment group were significantly reduced compared with those before treatment (P0.01). The scores of single symptoms or signs in the control group were significantly lower than those before treatment (P0.05). Compared with the control group, the single symptoms or signs of the treatment group significantly reduced the score, the difference was statistically significant (P0.05). After treatment, the total effective rate of TCM syndromes was 93.33 in the treatment group and 60.00g in the control group. By Ridit analysis, the treatment group patients with TCM syndrome efficacy was significantly better than the control group, the difference was statistically significant (P0.05). After treatment, the level of thyroid autoantibodies in the treatment group was significantly lower than that before treatment (P0.01), and the level of thyroid autoantibodies in the control group was also decreased (P0.05). However, the level of thyroid autoantibodies in the treatment group was significantly lower than that in the control group (P0.05). After treatment, the HLA-DR in the treatment group was significantly lower than that before the treatment, the difference was statistically significant (P0.01), and the HLA-DR level in the control group was also lower than the previous level (P0.01). However, the level of HLA-DR in the treatment group was significantly lower than that in the control group (P0.01). Conclusion: 1. Xuanxia Xiaoying decoction can reduce the volume of enlarged thyroid gland in patients with HT. Xuanxia Xiaoying decoction can reduce TPOAb,TGAb level. Xuanxia Xiaoying decoction can improve the TCM syndromes of patients with this disease. 4. Xuanxia Xiaoying decoction may reduce the expression of HLA-DR, improve the immune disorder, and play a therapeutic effect on 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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相关期刊论文 前10条
1 王晗;杨宁;于长明;李伯安;;HCV相关自身免疫性甲状腺疾病自身抗体研究进展[J];检验医学与临床;2017年05期
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