关键词:

亚急性甲状腺炎, 清热化痰散结方, 糖皮质激素, 甲状腺功能, 炎症因子

Abstract:

Objective　To observe the clinical efficacy of Qingre Huatan Sanjie Formula combined with glucocorticoids in the treatment of patients with subacute thyroiditis (SAT), and to explore the effect of this formula on the related inflammatory factors. Methods　One hundred patients with SAT treated at Guangdong Second Provincial General Hospital from June 1, 2021 to May 31, 2023 were selected as the study objects, and were divided into a control group and an observation group according to the treatment methods, with 50 cases in each group. There were 23 males and 27 females in the control group; they were 32-73 (39.36±3.12) years old. There were 18 males and 32 females in the observation group; they were 34-69 (41.57±3.23) years old. The control group orally took prednisone acetate tablets 10 mg per time, 3 times/d in the first two weeks; after 2 weeks' treatment, when their conditions were better, they orally took prednisone acetate tablets 10 mg per time, twice a day, and the dosage was reduced 5 mg every week until they stopped using the drug. The observation group orally took prednisone acetate tablets as the control group, and orally took Qingre Huatan Sanjie Formula (the formula was cook to 200 ml, and was taken in the morning and at night, one dose per day) and externally used the formula (the formula was grinded to powder and coated it on the neck part with pain, and this part was wrapped with gauze for 6 h every day) for 8 weeks. The thyroid function [free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), and thyroid stimulating hormone receptor antibody (TRAb)] and inflammatory factors [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), and interleukin-6 (IL-6)] before and 8 weeks after the treatment, traditional Chinese medicine syndromes, and clinical efficacies were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the levels of FT3, FT4, TSH, TGAb, TPOAb, and TRAb in the observation group were better than those in the control group [(3.86±0.85) pmol/L vs. (4.53±0.87) pmol/L, (11.87±2.06) pmol/L vs. (13.74±2.12) pmol/L, (2.82±0.09) mIU/L vs. (1.57±0.15) mIU/L, (82.70±9.98) U/ml vs. (104.44±9.08) U/ml, (25.90±2.69) U/ml vs. (31.82±3.31) U/ml, and (1.01±0.45) U/L vs. (1.80±0.91) U/L], with statistical differences (t=-5.19, -4.46, 50.13, -11.39, -9.81, and -5.47; all P<0.05). After the treatment, the levels of inflammatory factors were lower than those before the treatment in both groups, and the levels in the observation group were lower than those in the control group (all P<0.05). The time for disappearance of thyroid swelling, pain relieving time, and fever disappearing time in the observation group were shorter than those in the control group [(7.40±1.44) d vs. (9.02±1.67) d, (4.00±1.31) d vs. (6.94±1.38) d, and (3.30±0.54) d vs. (5.12±0.82) d], with statistical differences (t=-5.19, -10.94, and -13.03; all P<0.05). The total effective rate in the observation group was higher than that in the control group [98.00% (49/50) vs. 88.00% (44/50)], with a statistical difference (χ²=8.21, P=0.042). Conclusion　The combination of oral and external application of Qingre Huatan Sanjie Formula with glucocorticoids for patients with SAT is more effective than simple glucocorticoids, so it is worth being clinically applied.

Key words:

Subacute thyroiditis, Qingre Huatan Sanjie Formula, Glucocorticoids, Thyroid function, Inflammatory factors