| ObjectiveTo observe the clinical effect of Shugan Jianpi Xiaoying Decoction combined with levothyroxine sodium tablets in the treatment of Hashimoto thyroiditis with hypothyroidism,to confirm the effect of Shugan Jianpi Xiaoying Decoction in the treatment of Hashimoto thyroiditis,to summarize the experience of traditional Chinese medicine in the treatment of Hashimoto thyroiditis,and to provide theoretical basis for clinical practice.MethodsFrom May 2018 to December 2018,126 patients who met the inclusion and exclusion criteria were randomly enrolled in the outpatient department of endocrinology of Shenzhen Hospital of Traditional Chinese Medicine.And then 126 patients were divided into control group and treatment group by random number grouping method,63 cases in each group.The control group was treated with routine levothyroxine sodium tablets,while the treatment group was treated with Shugan Jianpi Xiaoying Decoction on the basis of routine treatment in the control group.The treatment group was treated with four weeks as a course of treatment,and three courses of treatment were observed continuously.Finally,we compared the changes of TCM syndrome score,thyroid function,TPOAb and TgAb levels,interleukin-17 and thyroid size before and after treatment,and observed the safety of treatment,collated the relevant data,and made statistical analysis.Results(1)Of the 126 patients included in this study,3 patients in the treatment group could not insist on taking traditional Chinese medicine and voluntarily withdraw from the trial.2 patients in the control group were lost to follow-up.The final number of patients included in the statistical analysis was 60 in the treatment group and 61 in the control group.(2)Compared with general data,there was no significant difference in sex ratio between the treatment group and the control group(P>0.05),and there was no significant difference in age and course of disease between the two groups(P>0.05).(3)Compared with curative effect index,after treatment,the total clinical effective rate was 91.67%in the treatment group and 78.69%in the control group.There was a significant difference between the two groups(P<0.05).Before treatment,there was no significant difference in TCM syndrome scores between the two groups(P>0.05),and after treatment,there was significant difference(P<0.01).It was suggested that Shugan Jianpi Xiaoying Decoction combined with levothyroxine sodium tablets in improving clinical symptoms and clinical efficacy was due to the use of levothyroxine sodium tablets alone.(4)Compared with other observational indicators,before treatment.there were no significant differences in TSH,FT3,FT4,TPOAb,TgAb,IL-17,anteroposterior diameterleft of left,right and isthmus of thyroid between the two groups(P<0.05).After treatment,the TSH,FT4 and FT3 of the treatment group and the control group were improved compared with those before treatment(P<0.01).Compared with the difference between the two groups before and after treatment,the improvement of TSH and FT4 of the treatment group was better than that of the control group(P<0.05).But there was no significant difference in FT3 between treatment group and control group(P>0.05).These results suggest that the therapeutic effect of the treatment group is better than that of the control group in the treatment of hypothyroidism.In terms of thyroid immune response,the levels of TPOAb,TgAb and IL-17 in both groups decreased after treatment(P<0.01).Compared with the control group,the level of TPOAb,TgAb and IL-17 in the treatment group decreased more significantly(P<0.01).This suggests that TCM has advantages in reducing autoantibody titer and thyroid immune inflammation.As for goiter,the diameter of the left and right lobes and isthmus in the treatment group decreased significantly compared with that before treatment(P<0.01);the diameter of the isthmus in the control group decreased significantly compared with that before treatment(P<0.01),but the diameter of the left and right lobes did not decrease significantly compared with that before treatment(P>0.05);after treatment,the difference between the two groups and before and after treatment showed that the diameter of the left and right lobes and isthmus in the treatment group decreased significantly compared with that in the control group(P<0.01),suggesting that the combination of Huatan Sanjie Chinese herbal medicine has a better effect on goiter.ConclusionsShugan Jianpi Xiaoying Decoction can significantly alleviate the clinical symptoms and signs of Hashimoto thyroiditis with hypothyroidism,improve thyroid function,reduce the titer of thyroid autoantibodies,improve thyroid autoimmune inflammation,and has no obvious adverse reactions. |
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