目的 探讨夏枯草颗粒联合地塞米松磷酸钠注射液治疗慢性淋巴细胞性甲状腺炎的临床疗效。方法 选取2020年2月—2021年5月天津市宁河区医院收治的92例慢性淋巴细胞性甲状腺炎患者作为研究对象，根据随机数字表法将92例患者分为对照组和治疗组，每组各46例。对照组在甲状腺两侧局部注射地塞米松磷酸钠注射液，每次每侧各2.5 mg，2次/周。治疗组在对照组治疗的基础上口服夏枯草颗粒，2 g/次，2次/d。两组治疗12周统计疗效。观察两组的临床疗效，比较两组患者治疗前后甲状腺最大长径和血清甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）、转化生长因子-β1（TGF-β1）、白细胞介素-17（IL-17）、白细胞介素-35（IL-35）水平。结果 治疗后，治疗组的总有效率（86.96%）明显高于对照组（69.57%），组间比较有显著差异（P＜0.05）。治疗后，两组患者的甲状腺最大长径均显著减少（P＜0.05），治疗组甲状腺最大长径较对照组减少更显著（P＜0.05）。治疗后，治疗组的TGAb、TPOAb水平均显著降低（P＜0.05），且治疗组的TGAb、TPOAb水平明显低于对照组，差异均有统计学意义（P＜0.05）。治疗后，两组的血清TGF-β₁、IL-17水平明显降低，IL-35水平明显升高（P＜0.05），治疗后治疗组的血清TGF-β₁、IL-17水平比对照组低，IL-35水平比对照组高（P＜0.05）。结论 夏枯草颗粒联合地塞米松磷酸钠注射液治疗慢性淋巴细胞性甲状腺炎的疗效确切，能使甲状腺缩小，降低甲状腺自身抗体水平，调节血清炎性因子水平，具有良好的安全性。

Objective To investigate the clinical efficacy of Xiakucao Granules combined with Dexamethasone Sodium Phosphate Injection in treatment of chronic lymphocytic thyroiditis. Methods Patients (92 cases) with chronic lymphocytic thyroiditis in Tianjin Ninghe Hospital from February 2020 to May 2021 were divided into control and treatment groups according to random number table method, and each group had 46 cases. Patients in the control group were injected with Dexamethasone Sodium Phosphate Injection on both sides of the thyroid gland, 2.5 mg for each side, once weekly. Patients in the treatment group were po administered with Xiakucao Granules on the basis of the control group, 2 g/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and the maximum length diameter of thyroid gland and the serum levels of TGAb, TPOAb, TGF-β₁, IL-17, and IL-35 in two groups were compared. Results After treatment, the total effective rate of the treatment group (86.96%) was significantly higher than that of the control group (69.57%). After treatment, the maximum length diameter of thyroid gland in two groups were significantly decreased (P < 0.05), and the maximum length diameter of thyroid gland in the treatment group was lower than that in the control group (P < 0.05). After treatment, the serum levels of TGAb and TPOAb in the treatment group were significantly lower than those before treatment, and the serum levels of TGAb and TPOAb in the treatment group were significantly lower than those in the control group after treatment (P < 0.05). After treatment, the serum levels of TGF-β₁, and IL-17 in two groups were significantly lower than those before treatment, but the serum level of IL-35 in two groups was significantly higher than those before treatment (P < 0.05). After treatment, the serum levels of TGF-β₁ and IL-17 in the treatment group were lower than those in the control group, but the serum level of IL-35 in the treatment group was higher than those in the control group (P < 0.05). Conclusion Xiakucao Granules combined with Dexamethasone Sodium Phosphate Injection is effective in treatment of chronic lymphocytic thyroiditis, can reduce the size of thyroid gland, reduce the level of thyroid autoantibody, regulate the serum level of inflammatory factors, with good safety.

R977

河北省中医药管理局科研计划项目(202139)