2023 年第 6 期 第 18 卷

耳穴贴压联合左甲状腺素钠片治疗桥本甲状腺炎甲状腺功能减退的临床效果观察

Observation of clinical effect of auricular acupoint pressing combined with levothyroxine sodium tablets on the treatment of Hashimoto′s thyroiditis and hypothyroidism

作者：李军1徐筱青2李璐璐2谭方2潘慧钗2石君慧3孙艳杰3陈弘东2朱庆文4

英文作者：Li Jun1 Xu Xiaoqing2 Li Lulu2 Tan Fang2 Pan Huichai2 Shi Junhui3 Sun Yanjie3 Chen Hongdong2 Zhu Qingwen4

单位：1北京市和平里医院门诊部，北京100013；2北京市和平里医院内分泌科，北京100013；3北京市和平里医院儿科，北京100013；4北京中医药大学中医学院，北京100029

英文单位：1Outpatient Department Beijing Hepingli Hospital Beijing 100013 China; 2Department of Endocrinology Beijing Hepingli Hospital Beijing 100013 China; 3Department of Paediatrics Beijing Hepingli Hospital Beijing 100013 China; 4College of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing 100029 China

关键词：桥本甲状腺炎；甲状腺功能减退；耳穴贴压；左甲状腺素钠片

英文关键词：

• 摘要：

• 目的  观察耳穴贴压联合左甲状腺素钠片治疗桥本甲状腺炎甲状腺功能减退的临床效果。方法  选取2021年3月至2022年3月就诊于北京市和平里医院内分泌科的桥本甲状腺炎甲状腺功能减退患者40例。应用随机数字表法分为观察组和对照组，各20例。对照组给予左甲状腺素钠片治疗，观察组给予王不留行型耳穴贴贴压联合左甲状腺素钠片治疗。观察2组患者治疗前后甲状腺功能、血糖、血脂指标及中医症状积分变化情况。记录治疗期间有无贴敷部位过敏、肝肾功能及心电图异常等不良反应。结果  治疗12周后2组促甲状腺激素水平均低于治疗前，游离三碘甲状腺原氨酸、游离甲状腺素水平均高于治疗前，差异均有统计学意义（均P<0.05）。治疗前及治疗12周后2组间甲状腺功能指标、血糖、血脂指标水平差异均无统计学意义（均P>0.05）。观察组治疗12周后神疲懒言和治疗8、12周后食少评分及治疗8、12周后中医症状积分总分［8.0(4.5,12.0)分比11.0(10.0,15.5)分、8.0(4.5,12.0)分比9.0(8.0,15.0)分］均低于对照组，差异均有统计学意义（均P<0.05）。治疗12周后，2组血常规、肝肾功能指标水平均在正常范围、心电图正常，无明显不良反应。结论  耳穴贴压联合左甲状腺素钠片治疗能够改善桥本甲状腺炎甲状腺功能减退患者的临床症状，但在改善甲状腺功能方面较单用左甲状腺素钠片未显出更多优势。

• Objective    To observe the clinical effect of auricular acupoint pressing combined with levothyroxine sodium tablets on the treatment of Hashimoto′s thyroiditis(HT) and hypothyroidism. Methods  From March 2021 to March 2022, 40 patients with HT and hypothyroidism admitted to the Department of Endocrinology, Beijing Hepingli Hospital were selected. They were divided into observation group and control group by random number table method, with 20 cases in each group. The control group was treated with levothyroxine sodium tablets, while the observation group was treated with cowherb seed auricular acupoint pressing combined with levothyroxine sodium tablets. The changes of thyroid function, blood glucose, blood lipid index and traditional Chinese medicine symptom score were observed before and after treatment. Adverse reactions, such as allergy of the application site, liver and kidney function and abnormal electrocardiogram during the treatment period were recorded. Results  After 12 weeks of treatment, the levels of thyroid stimulating hormone in the two groups were lower than those before treatment, and the levels of free triiodothyronine and free thyroxine were higher than those before treatment (all P<0.05). There was no statistically significant difference in the indexes of thyroid function index, blood glucose and blood lipid between the two groups before and after 12 weeks of treatment(all P>0.05). The observation group was lower than the control group in terms of the two sub-scores of mental fatigue and lazy speech after 12 weeks of treatment, food deficiency after 8 and 12 weeks of treatment and the total scores of traditional Chinese medicine symptom scores after 8 and 12 weeks of treatment［8.0(4.5,12.0) vs 11.0(10.0,15.5), 8.0(4.5,12.0) vs 9.0(8.0,15.0)］(all P<0.05). After 12 weeks of treatment, the levels of blood routine and the indexes of liver and kidney function in the two groups remained normal, with no significant adverse reactions observed.Conclusion  Auricular acupoint pressing combined with levothyroxine sodium tablets can improve the clinical symptoms of patients with HT and hypothyroidism, but there is no more advantages in improving thyroid function over the use of levothyroxine sodium tablets alone.