Clinical Observation Of Prunella Oral Liquid To TPOAb Titer

Background:Hashimoto's thyroiditis is a chronic autoimmune thyroid disease with no cure.For HT patients with mild diffuse goiter,normal thyroid function,and no obvious compression symptoms,our guidelines recommend observation.However,patients with normal thyroid function may also develop secondary thyroid dysfunction with further deterioration of thyroid tissue.Clinical HT treatment includes traditional Chinese medicine,glucocorticoids,selenium preparations,vitamin D,L-T4 replacement therapy when hypothyroidism or subclinical hypothyroidism occurs.However,each of these methods has advantages and disadvantages.It has different effects on reducing Thyroid peroxidase antibody titers,and lacks long-term clinical observation.Therefore,most HT patients have not been effectively treated.Prunella oral liquid(Chinese medicine standard Z19990052)is prepared from a single Chinese medicine Prunella vulgaris,which has the functions of clearing fire,dissolving and reducing swelling.Recent studies have shown that it can reduce TPOAb and Thyroglobulin antibody levels in HT patients.In this study,prunella vulgaris oral solution was used to treat HT patients with normal thyroid function and TPOAb positive.To observe the effectiveness of prunella vulgaris liquid to reduce TPOAb titer,and to provide a new method for clinical treatment of HT.Methods: This study collected 53 cases of HT patients diagnosed in the outpatient clinic of the First Affiliated Hospital of China Medical University from 2018 to 2019(normal thyroid function,TPOAb> 300 IU / mL)and randomly divided into prunella oral liquid group(10 mL each time,daily Twice,test group)and placebo control group(10 mL placebo each time,twice daily,control group),followed up 3 months,and recorded the general situation of patients,thyroid ultrasound results,serum FT3,FT4,TSH,TPOAb and TgAb and other data,calculate the TPOAb change rate.SPSS software(version 23.0,SPSS Inc.Cary,NJ,USA)was used for statistical analysis.Results: There was no statistical difference between the test group and the control group at baseline age,gender,weight,BMI,heart rate,TPOAb titer,TgAb titer,TSH,FT4,maximum thyroid nodule diameter and number of thyroid nodules(P> 0.05).The FT3 level in the control group was higher than the test group,but all were within the normal range(P <0.05).In the 3 months of follow-up,there was no statistical difference in the number of cases of TPOAb decline between the test group and the control group(P>0.05).There was also no statistical difference after analysis by TPOAb titer and age stratification(P> 0.05).Within 3 months of follow-up,there was no statistical difference in the TPOAb titer and TPOAb change rate between the test group and the control group.According to the stratified analysis based on the TPOAb titer,it was found that the lower titer of TPOAb(L-TPOAb)in the test group increased the TPOAb decline rate with the prolonged time(P<0.05),but the high titer of TPOAb(H-TPOAb)did not have this.Age stratified analysis showed no statistical difference in titers and change rates of TPOAb between the two groups(P> 0.05).Conclusion:Patients with normal thyroid function received oral prunella solution,10 ml each time,twice a day for 3 consecutive months.The TPOAb titer of HT patients with TPOAb titers between 300 IU / mL and 1000 IU / mL decreased,after taking the drug,the TPOAb titer decreased by 22.89%.But it has no significant effect on TgAb titers,FT3,FT4,TSH,maximum diameter of thyroid nodules,and number of thyroid nodules.