[1]王李宁,牟淑敏.扶正解毒消瘿方治疗正虚痰毒瘀互结型桥本甲状腺炎临床研究[J].陕西中医,2023,(2):205-208.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.015]
　WANG Lining,MOU Shumin.Clinical effect of Fuzheng Jiedu Xiaoying decoction in treating Hashimoto's thyroiditis[J].,2023,(2):205-208.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.015]
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扶正解毒消瘿方治疗正虚痰毒瘀互结型桥本甲状腺炎临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
205-208
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Clinical effect of Fuzheng Jiedu Xiaoying decoction in treating Hashimoto's thyroiditis
作者:
王李宁1; 牟淑敏2
(1.山东中医药大学,山东 济南 250355; 2.山东中医药大学附属医院,山东 济南 250011)
Author(s):
WANG Lining; MOU Shumin
(Shandong University of Traditional Chinese Medicine,Jinan 250055,China)
关键词:
桥本甲状腺炎;  扶正解毒消瘿方;  正虚痰毒瘀互结;  三碘甲腺原氨酸;  促甲状腺素
Keywords:
Hashimoto thyroiditis;  Fuzheng Jiedu Xiaoying decoction;  Positive deficiency phlegm toxin stasis type;  Free triiodothyronine;  Thyrotropin
分类号:
R 581
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.015
文献标志码:
A
摘要:
目的:观察扶正解毒消瘿方对正虚痰毒瘀互结型桥本甲状腺炎的临床治疗效果及其对辅助性T细胞17(Th17)和调节性T细胞(Treg)的影响。方法:随机将60例患者分为中药组和对照组,各30例,中药组给予扶正解毒消瘿方治疗,对照组给予亚硒酸钠治疗,观察两组临床综合疗效; 酶联免疫吸附(ELISA)测定血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)及血清白细胞介素17(IL-17)、白细胞介素6(IL-6)等细胞因子水平; 测定甲状腺体积; 流式细胞技术测定Th17细胞、Treg细胞比率。结果:中药组综合疗效有效率86.7%高于对照组70.0%(P<0.05); 治疗后中药组中医症候总积分、甲状腺体积下降优于对照组(P<0.05); 治疗后中药组血清中FT4比对照组增高显著(P<0.05),TSH比对照组下降显著(P<0.05),FT3变化差异无统计学意义(P>0.05); 治疗后中药组TG-Ab、TPO-Ab比对照组下降显著(P<0.05); 治疗后中药组Treg比率比对照组增高明显(P<0.05),Th17比率、Th17/Treg比值、IL-17、IL-6比对照组下降显著(P<0.05)。结论:扶正解毒消瘿方治疗桥本甲状腺炎不仅能够明显改善患者临床症状及体征,降低患者甲状腺抗体水平,而且可以升高Treg细胞比率,降低Th17细胞比率,减少甲状腺功能减退症的发生。
Abstract:
Objective:To observe the clinical effect of Fuzheng Jiedu Xiaoying decoction on Hashimoto's thyroiditis with syndrome of deficiency of vital energy,phlegm,toxin and blood stasis and its effect on helper T cell 17(Th17)and regulatory T cell Treg.Methods:A total of 60 patients were randomly divided into Chinese medicine group and control group,30 cases in each group.The Chinese medicine group was treated with Fuzheng Jiedu Xiaoying decoction,and the control group was treated with sodium selenite.Serum free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),thyroglobulin antibody(TG-Ab),thyroid peroxidase antibody(TPO-Ab)and serum interleukin-17(IL-17),interleukin-6(IL-6)were measured by enzyme-linked immunosorbent assay(ELISA).Determination of thyroid volume; determination of Th17 and Treg cell ratio by flow cytometry.Results:The effective rate of the traditional Chinese medicine group was 86.7%,which was higher than 70.0% of the control group(P<0.05).After treatment,TG-Ab and TPO-Ab in the Chinese medicine group were significantly lower than those in the control group(P<0.05).After treatment,the Treg ratio in the Chinese medicine group were significantly higher than those in the control group(P<0.05),and the Th17 ratio,Th17/Treg ratio,IL-17 and IL-6 were significantly lower than those in the control group(P<0.05).Conclusion:Fuzheng Jiedu Xiaoying decoction can not only significantly improve the clinical symptoms and signs of patients with Hashimoto's thyroiditis,reduce thyroid antibody,but also increase the ratio of Treg cells,reduce the ratio of Th17 cells,and reduce the incidence of hypothyroidism.

参考文献/References:

[1] 方 露,朱武飞,廖翔宇,等.桥本氏甲状腺炎患者年龄、性别分布及自身免疫抗体水平分析[J].微循环学杂志,2020,30(1):69-72.
[2] 赵 江,刘 维.桥本甲状腺炎中医药治疗研究进展[J].辽宁中医药大学学报,2019,21(2):151-154.
[3] Ralli M,Angeletti D,Fiore M,et al.Hashimoto's thyroiditis:An update on pathogenic mechanisms,diagnostic protocols,therapeutic strategies,and potential malignant transformation[J].Autoimmun Rev,2020,19(10):102649.
[4] 倪小军,沈红权,刘鑫晔.中医治疗单纯自身抗体异常的桥本甲状腺炎研究进展[J].中国临床医生杂志,2021,49(10):1156-1158.
[5] 白 耀.甲状腺病学——基础与临床[M].北京:科学技术文献出版社,2003:314.
[6] 国家中医药管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:230-231.
[7] 何旭梅,陈 红,胡乔玲,等.化痰散结法治疗亚急性甲状腺炎疗效及对患者炎症因子的影响[J].陕西中医,2020,41(8):1104-1106.
[8] 徐 莉,张玲玲,魏 伟.炎症小体参与自身免疫性疾病的研究进展[J].安徽医科大学学报,2020,55(9):169-172.
[9] Luty J,Ruckemann DK,Witkowski JM,et al.Immunological aspects of autoimmune thyroid disease-complex interplay between cells and cytokines[J].Cytokines,2019,116:128-133.
[10] Li Q,Wang B,Mu K,et al.The pathogenesis of thyroid autoimmune diseases:New T lymphocytes-cytokines circuits beyond the Th1-Th2 paradigm[J].J Cell Physiol,2019,234(3):2204-2216.
[11] Kushawaha PK,Gupta R,Sundar S,et al.Elongation factor-2,a Th1 stimulatory protein of leishmania donovani,generates strong IFN -γ and IL-12 response in cured leishmania-in-fected patients/hamsters and protects hamsters against leishmania challenge[J].J Immunol,2011,187(12):6417-6427.
[12] Backert I,Koralov SB,Wirtz S,et al.STAT3 activation in Th17 and Th22 cells controls IL-22-mediated epithelial host defense during infectious colitis[J].J Immunol,2014,193(11):5216-5225.
[13] Darmochwa KD,Oleszczuk J.The critical role of Th17 cells,Treg cells and co-stimulatory molecules in the development of pre-eclampsia[J].Dev Period Med,2014,18(2):141-147.
[14] Liang XS,Li CZ,Zhou Y,et al.Changes in circulating FoxP3(+)regulatory T cells and interleukin-17-producing T helper cells during HBV-related acute-on-chronic liver failure[J].World J Gastroenterol,2014,20(26):8558-8571.
[15] 李晓通,李莉华.桥本甲状腺炎外周血CD4+CD25+FoxP3+调节性T细胞与维生素D的相关性[J].中国慢性病预防与控制,2020,28(2):142-144.
[16] 胡春平,刘曼曼,冯珍凤,等.蒲黄消瘿贴治疗桥本甲状腺炎的效果及对血清炎性因子的影响[J].医药论坛杂志,2022,43(3):5-8.
[17] 李 姗.消瘿方治疗气阴两虚型桥本甲状腺炎及对甲状腺自身抗体水平的影响[J].陕西中医,2017,38(11):1581-1582.
[18] 郑怀刚,王凤英,邵迎新,等.桥本甲状腺炎从气虚辨治的探讨[J].中国医药导报,2018,15(30):141-144.
[19] 刘昕怡,彭 婧,夏仲元.扶正消瘿八法治疗桥本甲状腺炎[J].中国临床保健杂志,2020,23(5):717-720.
[20] 李思思,华 川,杨金月,等.中医药治疗桥本甲状腺炎用药规律研究[J].陕西中医,2021,42(3):389-392.

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备注/Memo

备注/Memo:
基金项目:山东省科技发展计划项目(2014GSF119040); 山东省中医药科技发展计划项目(2011-067)
更新日期/Last Update: 2023-02-08