论文部分内容阅读
目的:探讨优甲乐、硒酵母片联合海藻玉壶汤加减疗法治疗桥本甲状腺炎合并甲状腺功能减退症（简称甲减）的临床疗效。方法:采用前瞻性设计，以2015年1月至2017年7月胜利油田中心医院收治的147例桥本甲状腺炎合并甲减患者作为研究对象。根据不同治疗方案，将研究对象按随机数字表法分为3组，A组（n n=46）给予优甲乐，B组（n n=43）给予优甲乐+硒酵母片，C组（n n=58）给予优甲乐+硒酵母片+海藻玉壶汤加减。治疗3个月后，比较3组临床疗效，甲状腺功能[游离甲状腺素（FTn 4）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FTn 3）]、甲状腺自身抗体[甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）]以及T淋巴细胞亚群（CD3n +、CD4n +、CD8n +、CD4n +/CD8n +）水平变化。n 结果:3组治疗总有效率[67.39%（31/46）、76.74%（33/43）、93.10%（54/58）]比较，差异有统计学意义（χn 2=11.237，n P < 0.05）；其中，C组治疗总有效率显著高于A、B组（χ n 2=10.282、12.382，n P均< 0.05）。治疗后C组FTn 4、FTn 3水平[（18.16 ± 2.79）、（5.06 ± 0.80）pg/ml]明显高于A、B组[（13.52 ± 2.98）、（3.56 ± 0.58），（15.62 ± 3.04）、（4.22 ± 0.49）pg/ml，n P均< 0.05]，TSH水平[（4.02 ± 2.14）mU/L]明显低于A、B组[（13.42 ± 3.41）、（6.63 ± 3.19）mU/L，n P均< 0.05]。治疗后C组TGAb、TPOAb水平明显低于A、B组（n P均< 0.05）。治疗后C组CD3n +、CD4n +、CD4n +/CD8n +水平明显高于A、B组（n P均< 0.05）。n 结论:优甲乐、硒酵母片联合海藻玉壶汤加减疗法治疗桥本甲状腺炎合并甲减疗效显著，并降低甲状腺自身抗体水平，改善机体免疫功能，值得推广运用。“,”Objective:To investigate the clinical efficacy of Euthyrox and selenium yeast tablets combined with seaweed Yuhu decoction in the treatment of Hashimoto's thyroiditis complicated with hypothyroidism.Methods:The prospective design was used to study 147 patients with Hashimoto's thyroiditis and hypothyroidism in Shengli Oilfield Central Hospital from January 2015 to July 2017. According to different treatment plans, the subjects were randomly divided into 3 groups. Group A (n n=46) was given Euthyrox, group B (n n=43) was given Euthyrox+selenium yeast tablets, and group C (n n=58) was given Euthyrox+selenium yeast tablets+seaweed Yuhu decoction. After 3 months of treatment, the clinical efficacy, thyroid function [free thyroxine (FTn 4), thyroid stimulating hormone (TSH), free triiodothyronine (FTn 3)], thyroid autoantibody [thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb)] and T lymphocyte subsets (CD3n +, CD4n +, CD8n +, CD4n +/CD8n +) levels were compared among the 3 groups.n Results:The total effective rates [67.39% (31/46), 76.74% (33/43), 93.10% (54/58)] of the 3 groups were compared, the difference was statistically significant (χn 2=11.237, n P < 0.05); the total effective rate of group C was significantly higher than that of group A and group B (χ n 2=10.282, 12.382, n P < 0.05). After treatment, the levels of FT n 4 and FTn 3 in group C [(18.16 ± 2.79), (5.06 ± 0.80) pg/ml] were significantly higher than those in group A and group B [(13.52 ± 2.98), (3.56 ± 0.58), (15.62 ± 3.04), (4.22 ± 0.49) pg/ml, n P < 0.05], TSH level [(4.02 ± 2.14) mU/L] was significantly lower than that in group A and group B [(13.42 ± 3.41), (6.63 ± 3.19) mU/L, n P < 0.05]. After treatment, the levels of TGAb and TPOAb in group C were significantly lower than those in group A and group B ( n P < 0.05). After treatment, the levels of CD3 n +, CD4n +, CD4n +/CD8n + in group C were significantly higher than those in group A and group B (n P < 0.05).n Conclusion:Euthyrox and selenium yeast tablets combined with seaweed Yuhu decoction has a significant effect in the treatment of Hashimoto's thyroiditis complicated with hypothyroidism, and reduces the level of thyroid autoantibody, and improves the immune function of the body, which is worthy of promotion and application.