玄夏消癭湯治療痰結血瘀型橋本甲狀腺炎的療效觀察及對HLA-DR的影響
發(fā)布時間：2018-11-24 21:32
【摘要】：目的:通過觀察玄夏消癭湯對痰結血瘀型橋本甲狀腺炎的療效,對比外周血HLA-DR的表達變化,從而探討HLA-DR在HT患者免疫紊亂發(fā)展過程中的作用及該方對HT免疫的調節(jié)機制。方法:將60例診斷為痰結血瘀型橋本甲狀腺炎的患者,采用隨機數(shù)表,分成治療組、對照組,每組各30例;治療組予以玄夏消癭湯口服,對照組予以夏枯草顆�？诜�,兩組均觀察12周;比較治療前后兩組甲狀腺體積的變化、甲狀腺自身抗體及HLA-DR的表達和中醫(yī)證候積分,采用SPSS17.0對以上數(shù)據(jù)進行統(tǒng)計和分析,從而得出玄夏消癭湯治療痰結血瘀型橋本甲狀腺炎的臨床療效評價。結果:1.治療后,治療組患者甲狀腺體積與治療前比較明顯縮小,具有顯著統(tǒng)計學差異(P0.01);對照組患者甲狀腺體積與治療前比較縮小,差異具有統(tǒng)計學意義(P0.05);治療組患者甲狀腺體積與對照組比較明顯縮小,差異具有統(tǒng)計學意義(P0.05)。2.治療后,治療組患者單項癥狀或體征積分與治療前比較明顯減少,具有顯著統(tǒng)計學差異(P0.01);對照組患者單項癥狀或體征積分與治療前比較減少,差異具有統(tǒng)計學意義(P0.05);治療組與對照組比較,單項癥狀或體征積分明顯減少,差異具有統(tǒng)計學意義(P0.05)。3.治療后,治療組患者的中醫(yī)證候療效總有效率為93.33%,對照組患者中醫(yī)證候療效總有效率為60.00%;經(jīng)Ridit分析,治療組患者的中醫(yī)證候療效明顯優(yōu)于對照組,差異具有統(tǒng)計學意義(P0.05)。4.治療后,治療組患者甲狀腺自身抗體水平比治療前下降,具有顯著統(tǒng)計學差異(P0.01),對照組患者組內比較甲狀腺自身抗體水平也有下降,差異有統(tǒng)計學意義(P0.05)。但治療組患者甲狀腺自身抗體水平較對照組下降更顯著,差異具有統(tǒng)計學意義(P0.05)。5.治療后,治療組患者HLA-DR比治療前顯著下降,差異具有統(tǒng)計學意義(P0.01),對照組患者HLA-DR水平也較前水平下降,差異具有統(tǒng)計學意義(P0.01)。但治療組患者HLA-DR水平較對照組下降更顯著,差異具有統(tǒng)計學意義(P0.01)。結論:1.玄夏消癭湯可縮小HT患者腫大甲狀腺體積。2.玄夏消癭湯可使TPOAb、TGAb水平下降。3.玄夏消癭湯可改善本病患者的中醫(yī)證候。4.玄夏消癭湯可能是通過降低HLA-DR的表達,改善免疫紊亂狀態(tài),起到治療HT的療效。
[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.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：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.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259
【參考文獻】
相關期刊論文 前10條
1 王晗;楊寧;于長明;李伯安;;HCV相關自身免疫性甲狀腺疾病自身抗體研究進展[J];檢驗醫(yī)學與臨床;2017年05期
2 熊q，
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