橋本甲狀腺炎自身抗體與甲功的相關性及與中醫(yī)證型的關系
發(fā)布時間：2018-11-23 07:42
【摘要】：目的:分析橋本甲狀腺炎(HT)患者的甲狀腺微粒體抗體(TmAb)和甲狀腺球蛋白抗體(TgAb)與甲狀腺功能的相關性,并探討橋本甲狀腺炎(HT)與癭病辨證分型的關系。方法:收集就診于南京中醫(yī)藥大學第一附屬醫(yī)院內分泌科門診符合要求的甲狀腺腫大患者313例,按照中醫(yī)癭病辨證分型標準分為氣郁痰阻型141例,肝火熾盛型62例,脾腎陽虛型110例,記錄性別、年齡,檢測血清TmAb、TgAb、TSH、FT_3、FT_4、TT_3、TT_4,B超檢查甲狀腺,按照西醫(yī)診斷標準分為橋本甲狀腺炎132例和非橋本甲狀腺炎181例,研究HT患者自身抗體與甲狀腺功能的相關性,并探討橋本甲狀腺炎與癭病辨證分型的關系。結果:1.甲狀腺腫大患者三組證型之間性別和年齡存在不同程度的差異性,其中,女性患病率:脾腎陽虛證氣郁痰阻證肝火熾盛證,(P0.05)。脾腎陽虛證年齡為32.01±10.08歲,顯著低于其他證型(P0.05);2.三組證型的HT患病率有顯著性差異,脾腎陽虛證肝火熾盛證氣郁痰阻證,(P0.05);3.HT患者年齡低于非HT,TSH高于非HT患者(均P0.05);HT女性患者的TSH、TmAb和TgAb與男性無顯著差異,但FT3、FT4、TT3、TT4低于男性(P0.05);4.Pearson相關分析顯示HT患者中,TmAb與TSH呈正相關(P0.05),與 FT4呈負相關(P0.05),TgAb 與 FT_3、FT_4、TT_4呈負相關(P0.05)。結論:1.橋本甲狀腺炎患者以脾腎陽虛證最為常見,提示脾腎陽虛證與橋本甲狀腺炎的發(fā)病關系密切。2.性別可作為HT患者甲功的影響因素之一,在初診HT患者自身抗體無顯著性差異時,女性的甲狀腺功能較男性患者受損更顯著。3.HT患者自身抗體與甲功存在密切關系,但兩種抗體在甲狀腺損傷過程中呈現(xiàn)不同作用特點。
[Abstract]:Objective: to analyze the relationship between thyroid microsomal antibody (TmAb) and thyroglobulin antibody (TgAb) and thyroid function in patients with Hashimoto's thyroiditis (HT), and to explore the relationship between (HT) and syndrome differentiation and classification of Hashimoto's thyroiditis. Methods: a total of 313 patients with goitre were collected from the Department of Endocrinology of the first affiliated Hospital of Nanjing University of traditional Chinese Medicine. According to the criteria of syndrome differentiation of gall disease, 141 cases were classified as qi depression and phlegm obstruction type, 62 cases as liver-fire type. One hundred and ten patients with deficiency of spleen and kidney yang were recorded by sex, age, and serum TmAb,TgAb,TSH,FT_3,FT_4,TT_3,TT_4, B ultrasound was used to examine thyroid gland. According to the diagnostic criteria of western medicine, 132 cases of Hashimoto's thyroiditis and 181 cases of non-Hashimoto 's thyroiditis were divided into two groups. The correlation between autoantibodies and thyroid function in patients with HT was studied, and the relationship between Hashimoto's thyroiditis and syndrome differentiation and classification of gall diseases was discussed. Results: 1. There were differences in sex and age among the three groups of patients with goitre, among which, the prevalence rate of female was: spleen and kidney yang deficiency syndrome qi stagnation phlegm stagnation syndrome liver fire flourishing syndrome (P0.05). The age of spleen and kidney yang deficiency syndrome was 32.01 鹵10.08 years old, which was significantly lower than that of other syndrome types (P0.05). The prevalence of HT was significantly different among the three groups (P0.05), and the age of 3.HT patients was lower than that of non-HT patients (P0.05). There was no significant difference in TSH,TmAb and TgAb between female and male patients with HT, but FT3,FT4,TT3,TT4 was lower than that in male (P0.05). 4.Pearson correlation analysis showed that there was a positive correlation between TmAb and TSH (P0.05) and a negative correlation with FT4 (P0.05) between), TgAb and FT_3,FT_4,TT_4 in HT patients (P0.05). Conclusion: 1. The syndrome of deficiency of spleen and kidney yang is the most common in Hashimoto's thyroiditis, suggesting that deficiency of spleen and kidney yang is closely related to the pathogenesis of Hashimoto's thyroiditis. 2. Sex can be regarded as one of the influencing factors of thyroid function in patients with HT. When there is no significant difference in autoantibodies in newly diagnosed HT patients, the thyroid function of women is more significantly damaged than that of male patients. There is a close relationship between autoantibodies and thyroid function in patients with 3.HT. However, the two antibodies showed different characteristics in the process of thyroid injury.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259
本文編號：2350811
[Abstract]:Objective: to analyze the relationship between thyroid microsomal antibody (TmAb) and thyroglobulin antibody (TgAb) and thyroid function in patients with Hashimoto's thyroiditis (HT), and to explore the relationship between (HT) and syndrome differentiation and classification of Hashimoto's thyroiditis. Methods: a total of 313 patients with goitre were collected from the Department of Endocrinology of the first affiliated Hospital of Nanjing University of traditional Chinese Medicine. According to the criteria of syndrome differentiation of gall disease, 141 cases were classified as qi depression and phlegm obstruction type, 62 cases as liver-fire type. One hundred and ten patients with deficiency of spleen and kidney yang were recorded by sex, age, and serum TmAb,TgAb,TSH,FT_3,FT_4,TT_3,TT_4, B ultrasound was used to examine thyroid gland. According to the diagnostic criteria of western medicine, 132 cases of Hashimoto's thyroiditis and 181 cases of non-Hashimoto 's thyroiditis were divided into two groups. The correlation between autoantibodies and thyroid function in patients with HT was studied, and the relationship between Hashimoto's thyroiditis and syndrome differentiation and classification of gall diseases was discussed. Results: 1. There were differences in sex and age among the three groups of patients with goitre, among which, the prevalence rate of female was: spleen and kidney yang deficiency syndrome qi stagnation phlegm stagnation syndrome liver fire flourishing syndrome (P0.05). The age of spleen and kidney yang deficiency syndrome was 32.01 鹵10.08 years old, which was significantly lower than that of other syndrome types (P0.05). The prevalence of HT was significantly different among the three groups (P0.05), and the age of 3.HT patients was lower than that of non-HT patients (P0.05). There was no significant difference in TSH,TmAb and TgAb between female and male patients with HT, but FT3,FT4,TT3,TT4 was lower than that in male (P0.05). 4.Pearson correlation analysis showed that there was a positive correlation between TmAb and TSH (P0.05) and a negative correlation with FT4 (P0.05) between), TgAb and FT_3,FT_4,TT_4 in HT patients (P0.05). Conclusion: 1. The syndrome of deficiency of spleen and kidney yang is the most common in Hashimoto's thyroiditis, suggesting that deficiency of spleen and kidney yang is closely related to the pathogenesis of Hashimoto's thyroiditis. 2. Sex can be regarded as one of the influencing factors of thyroid function in patients with HT. When there is no significant difference in autoantibodies in newly diagnosed HT patients, the thyroid function of women is more significantly damaged than that of male patients. There is a close relationship between autoantibodies and thyroid function in patients with 3.HT. However, the two antibodies showed different characteristics in the process of thyroid injury.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259
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