中西医结合治疗甲状腺功能减退的疗效：系统评价和网络荟萃分析

IF 1.9 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Journal of Herbal Medicine Pub Date : 2025-09-09 DOI:10.1016/j.hermed.2025.101055

Ma Yixuan , Yang Wenhui , Wang Huizhen , Zhai Mingming

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引用次数: 0

摘要

目的系统评价中西医结合治疗甲状腺功能减退的疗效，为临床治疗提供参考，促进中西医结合治疗甲状腺功能减退的发展。方法检索中国知网、万方、中国医学信息网、PubMed、Web of Science、Cochrane Library等数据库自建库至2024年4月期间中西医结合治疗甲状腺功能减退症的随机对照试验（RCTs）。此外，使用Stata 17进行网络meta分析。结果共纳入59篇文献，涉及24项中医干预措施。贞芪扶正胶囊联合常规西药可显著提高临床总有效率和游离甲状腺素（FT4）；小影汤联合常规西药可显著降低促甲状腺激素（TSH）；针刺联合西药治疗显著提高游离三碘甲状腺原氨酸（FT3）；姜桂益应方联合右桂丸联合常规西药可显著降低甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）；油桂丸联合常规西药可显著降低甘油三酯（TG）；真武汤联合西药治疗可显著提高高密度脂蛋白胆固醇（HDL-C），降低总胆固醇(TC)/低密度脂蛋白胆固醇（LDL-C），降低中医证候评分（TCMSS）。不同干预措施的不良反应发生率和类型不同。结论中西医结合治疗甲状腺功能减退的疗效优于单用西药。最佳方案因临床情况而异，患者应据此选择治疗方案。然而，由于文献质量和数量有限，结论需要进一步验证。

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Efficacy of combined Chinese and Western medicine in the treatment of hypothyroidism: a systematic review and network meta-analysis

Objective

To systematically evaluate combined Chinese and Western medicine for hypothyroidism, provide a reference for clinical treatment, and promote integrative medicine development in hypothyroidism treatment.

Methods

Randomised controlled trials (RCTs) of combined Chinese and Western medicine for the treatment of hypothyroidism were searched from CNKI, WanFang, SinoMed, PubMed, Web of Science, Cochrane Library, etc., from database inception to April 2024. Additionally, Network Meta-analysis was performed using Stata 17.

Results

A total of 59 papers involving 24 Traditional Chinese Medicine (TCM) interventions were included. Zhenqi Fuzheng capsules combined with conventional western medicines had significantly improved the total clinical effectiveness rate and free thyroxine (FT4); Xiaoying decoction combined with conventional western medicines had significantly reduced thyroid-stimulating hormone (TSH); acupuncture combined with conventional western medicines had significantly improved free triiodothyronine (FT3); Jianggui Yiying Prescription combined with Yougui pills combined with conventional western medicines had significantly reduced thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb); Yougui pills combined with conventional western medicines had significantly reduced triglyceride (TG); Zhenwu decoction combined with conventional western medicines had significantly raised high-density lipoprotein cholesterol (HDL-C), reduced total cholesterol (TC)/low-density lipoprotein cholesterol (LDL-C), and lowered TCMSS (Traditional Chinese Medicine Syndrome Score).The incidence rates and types of adverse reactions varied among different intervention measures.

Conclusion

Combined Chinese and Western medicine showed greater efficacy than Western medicine alone for hypothyroidism. Optimal regimens vary by clinical condition, and patients should select treatments accordingly. However, conclusions require further validation due to limited literature quality and quantity.

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来源期刊

Journal of Herbal Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The Journal of Herbal Medicine, the official journal of the National Institute of Medical Herbalists, is a peer reviewed journal which aims to serve its readers as an authoritative resource on the profession and practice of herbal medicine. The content areas of the journal reflect the interests of Medical Herbalists and other health professionals interested in the clinical and professional application of botanical medicines. The objective is to strengthen the research and educational base of herbal medicine with research papers in the form of case studies, original research articles and reviews, monographs, clinical trials and relevant in vitro studies. It also publishes policy statements, opinion pieces, book reviews, conference proceedings and profession related information such as pharmacovigilance reports providing an information source for not only the Herbal Practitioner but any Health professional with an interest in phytotherapy.