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IgG4的影响

发布时间：2019-03-04 14:15

【摘要】：目的:探索玄夏消瘿汤治疗桥本氏甲状腺炎患者的临床疗效及对IgG4的影响,并探讨玄夏消瘿汤治疗桥本氏甲状腺炎的可能作用机制。方法:选取60例确诊诊断为痰结血瘀型桥本氏甲状腺炎的患者,并将其平均分为治疗组和对照组,用随机数表法进行;治疗组患者予玄夏消瘿汤治疗,对照组患者予夏枯草颗粒治疗,疗程为12周;观察治疗前后两组患者甲状腺体积的情况,血清甲状腺功能(FT3、FT4、TSH)以及甲状腺自身抗体(TPOAb、TGAb)的水平,细胞因子(IGG4)的水平,中医证候积分,利用统计学软件对所有数据进行分析,从而得出综合的临床疗效评价。结果:1.就患者甲状腺体积来看,治疗组小于对照组,P0.05,统计学差异明显,治疗后治疗组甲状腺体积小于其治疗前体积,P0.05,统计学差异明显。2.就患者体内IgG4水平来看,治疗组低于对照组,差异具有统计学意义(P0.05)。治疗后,治疗组患者IgG4水平低于其治疗前IgG4水平,P0.05,统计学差异明显;3.就患者单项症状或体征积分来看,治疗组低于对照组,P0.05,统计学差异明显,治疗后治疗组单项症状或体征积分低于其治疗前积分,P0.05,统计学差异明显。4.治疗后,治疗组患者中医证候疗效总有效率为96.67%,治疗组中医证候疗效明显优于对照组,P0.05,统计学差异明显。结论:1.玄夏消瘿汤使桥本氏病患者的甲状腺体积明显缩小。2.玄夏消瘿汤使桥本氏病患者体内抗体水平显著下调。3.玄夏消瘿汤改善患者的临床症状、体征(中医)。其潜在作用机制可能为下调患者的IgG4的水平,降低患者自身免疫反应,缩小甲状腺体积。
[Abstract]:Aim: to explore the clinical efficacy of Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis and its effect on IgG4, and to explore the possible mechanism of Xuanxia Xiaoying decoction in treating Hashimoto's thyroiditis. Methods: 60 patients with Hashimoto's thyroiditis of phlegm and blood stasis type were selected and divided into treatment group and control group. The patients in the treatment group were treated with Xuanxia Xiaoying decoction and the patients in the control group were treated with Prunella subtilis granules for 12 weeks. The thyroid volume, serum thyroid function (FT3,FT4,TSH), thyroid autoantibody (TPOAb,TGAb), cytokine (IGG4) and TCM syndrome score were observed before and after treatment. All the data were analyzed by statistical software to get a comprehensive evaluation of clinical efficacy. Results: 1. The volume of thyroid in the treatment group was smaller than that in the control group (P 0.05). After treatment, the thyroid volume in the treatment group was smaller than its pre-treatment volume, P 0.05, and the difference was significant. 2. The level of IgG4 in the treatment group was lower than that in the control group, the difference was statistically significant (P0.05). After treatment, the level of IgG4 in the treatment group was lower than that in the pre-treatment group (P0.05, P 0.05, P < 0.05). The score of single symptom or sign in the treatment group was lower than that in the control group (P 0.05, P 0.05). After treatment, the single symptom or sign score in the treatment group was lower than that before treatment, P 0.05, the statistical difference was significant. 4. After treatment, the total effective rate of TCM syndrome in the treatment group was 96.67%, and the curative effect of TCM syndrome in the treatment group was obviously better than that in the control group (P 0.05, P < 0.05). Conclusions: 1. Xuanxia Xiaoying decoction significantly reduced thyroid volume in Hashimoto's disease patients. 2. Xuanxia Xiaoying decoction significantly decreased antibody level in Hashimoto's disease patients. 3. Xuanxia Xiaoying decoction improves the clinical symptoms and signs of patients (TCM). Its potential mechanism may be to down-regulate the level of IgG4, reduce the autoimmune response of patients, and reduce the volume of thyroid gland.
【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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