柴胡消瘿汤联合小剂量泼尼松治疗亚急性甲状腺炎30例

目的观察柴胡消瘿汤联合小剂量泼尼松治疗亚急性甲状腺炎(subacute thyroiditis,SAT)患者的临床疗效以及对甲状腺功能和炎症因子水平的影响。方法将60例SAT毒热炽盛证患者随机分成对照组与治疗组,每组30例。对照组患者口服泼尼松,每次10mg,每日3次,服药2周后,每周递减5mg,待血沉降至正常,热退痛减后再减量至5mg,每日1次;治疗组患者口服加减柴胡消瘿汤,每日1剂,同时口服泼尼松5mg,每日2次,服药2周后,改为每日5mg。两组疗程均为8周。观察并比较两组临床疗效及退热时间、疼痛消退时间、肿胀消退时间,治疗前后分别检测血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid-stimulating hormone,TSH)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、血沉(erythrocyte sedimentation rate,ESR)水平及不良反应发生率。结果治疗组临床疗效明显优于对照组(P<0.05);治疗组退热时间,甲状腺疼痛、肿胀消退时间较对照组明显缩短(P<0.05);治疗组在降低ESR,血清FT3、FT4、CRP、IL-6水平及升高血清TSH水平方面明显优于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论中药联合小剂量泼尼松治疗SAT的临床疗效明显,能有效改善患者甲状腺功能,同时可以下调患者炎症因子水平。

Clinical Efficacy of Chaihu Xiaoying Decoction Combined with Low-Dose Prednisone in Treatment of Subacute Thyroiditis: An Analysis of 30 Cases

Objective To observe the clinical efficacy of Chaihu Xiaoying Decoction combined with low-dose prednisone in the treatment of subacute thyroiditis (SAT) and its effects on thyroid function and the levels of inflammatory factors. Methods Sixty patients with SAT were randomly divided into control group and treatment group, with 30 cases in each group. The patients in control group received oral prednisone 10 mg three times a day; after two weeks of administration, the dose was reduced by 5 mg per week till the erythrocyte sedimentation rate (ESR) decreased to normal; the dose was reduced to 5 mg once daily after fever and pain resolved. The patients in treatment group received oral modified Chaihu Xiaoying Decoction one dose daily as well as prednisone 5 mg twice a day (reduced to 5 mg daily after two weeks of administration). The course of treatment was 8 weeks for both groups. The two groups were compared in terms of clinical outcome, fever clearance time, pain resolution time, and swelling disappearance time, and the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), C-reactive protein (CRP), interleukin-6 (IL-6), and ESR before and after treatment, as well as the incidence of adverse reactions, were measured. Results Compared with the control group, the treatment group had a significantly better clinical outcome (P<0.05), significantly shorter fever clearance time, thyroid pain resolution time, and swelling disappearance time (P<0.05), significantly greater reductions in ESR and serum levels of FT3, FT4, CRP, and IL-6 (P<0.05), and a significantly greater increase in serum TSH level (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Traditional Chinese medicine combined with low-dose prednisone has good clinical efficacy in the treatment of SAT, as it can efficiently improve the thyroid function of patients and reduce their levels of inflammatory factors.