【摘要】：目的:探索玄夏消癭湯治療橋本氏甲狀腺炎患者的臨床療效及對IgG4的影響,并探討玄夏消癭湯治療橋本氏甲狀腺炎的可能作用機制。方法:選取60例確診診斷為痰結(jié)血瘀型橋本氏甲狀腺炎的患者,并將其平均分為治療組和對照組,用隨機數(shù)表法進行;治療組患者予玄夏消癭湯治療,對照組患者予夏枯草顆粒治療,療程為12周;觀察治療前后兩組患者甲狀腺體積的情況,血清甲狀腺功能(FT3、FT4、TSH)以及甲狀腺自身抗體(TPOAb、TGAb)的水平,細胞因子(IGG4)的水平,中醫(yī)證候積分,利用統(tǒng)計學(xué)軟件對所有數(shù)據(jù)進行分析,從而得出綜合的臨床療效評價。結(jié)果:1.就患者甲狀腺體積來看,治療組小于對照組,P0.05,統(tǒng)計學(xué)差異明顯,治療后治療組甲狀腺體積小于其治療前體積,P0.05,統(tǒng)計學(xué)差異明顯。2.就患者體內(nèi)IgG4水平來看,治療組低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。治療后,治療組患者IgG4水平低于其治療前IgG4水平,P0.05,統(tǒng)計學(xué)差異明顯;3.就患者單項癥狀或體征積分來看,治療組低于對照組,P0.05,統(tǒng)計學(xué)差異明顯,治療后治療組單項癥狀或體征積分低于其治療前積分,P0.05,統(tǒng)計學(xué)差異明顯。4.治療后,治療組患者中醫(yī)證候療效總有效率為96.67%,治療組中醫(yī)證候療效明顯優(yōu)于對照組,P0.05,統(tǒng)計學(xué)差異明顯。結(jié)論:1.玄夏消癭湯使橋本氏病患者的甲狀腺體積明顯縮小。2.玄夏消癭湯使橋本氏病患者體內(nèi)抗體水平顯著下調(diào)。3.玄夏消癭湯改善患者的臨床癥狀、體征(中醫(yī))。其潛在作用機制可能為下調(diào)患者的IgG4的水平,降低患者自身免疫反應(yīng),縮小甲狀腺體積。
[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.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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