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目的:观察疏肝清热方对桥本甲状腺炎(HT)患者甲状腺过氧化酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)、促甲状腺素受体抗体(TR-Ab)、促甲状腺激素(TSH)以及临床症状的影响,评价疏肝清热方的临床疗效,研究外周淋巴细胞CCR5、CD30在HT患者中的表达,探讨疏肝清热方干预Th1/Th2的机制。方法:甲状腺功能正常或亚临床甲状腺功能减退的HT患者80例,随机分为中药组和优甲乐组各40例,健康对照组20例。中药组单纯服用中药复方颗粒剂,优甲乐组单纯服用小剂量优甲乐25μg,1次/d。结果:中药组治疗后TPO-Ab水平较治疗前明显下降(P≤0.01),与优甲乐组比较有显著性差异(P≤0.05),中药组治疗后中医证候积分下降明显(P≤0.01),与优甲乐组比较有显著性差异(P≤0.05),HT患者的CD30%和CCR5%的表达均高于健康对照组(P≤0.01),与TPO-Ab、Tg-Ab、TRAb呈正相关。结论:疏肝清热方可以改善HT患者的抗体水平及临床症状,CCR5、CD30可作为评价HT的指标,Th1和Th2细胞可能共同参与了HT的发病。
Objective: To observe the effect of Shugan Qingre prescription on the expression of thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (Tg-Ab), thyrotropin-receptor antibody (TR-Ab) Thyroid hormone (TSH) and clinical symptoms, evaluate the clinical curative effect of Shugan Qingre prescription, study the expression of peripheral blood lymphocytes CCR5 and CD30 in HT patients, and explore the mechanism of Shugan Qingre prescription interfering Th1 / Th2. Methods: Eighty HT patients with normal thyroid function or subclinical hypothyroidism were randomly divided into TCM group (40 cases) and Euthyrox group (40 cases), and healthy control group (20 cases). Chinese medicine group simply take traditional Chinese medicine granules, Euthyrox group simply take a small dose of Euthyrox 25μg, 1 time / d. Results: The levels of TPO-Ab in TCM group were significantly lower than those before treatment (P≤0.01), and were significantly different from those in Euthyrox group (P≤0.05). The TCM syndrome scores of TCM group decreased significantly after treatment (P≤0.01) 0.01). The expression of CD30% and CCR5% in HT patients was significantly higher than that in healthy controls (P≤0.01) TRAb was positively correlated. Conclusion: Shugan Qingre recipe can improve antibody level and clinical symptoms in HT patients. CCR5 and CD30 can be used as indices for evaluating HT, and Th1 and Th2 cells may participate in the pathogenesis of HT.