目的 探讨不同剂量百令胶囊联合左甲状腺素钠片治疗桥本甲状腺炎的临床疗效。方法 选取2014年7月—2017年1月涿州市医院收治的桥本甲状腺炎患者120例作为研究对象，按随机数余数法将患者分为左甲状腺素钠组（对照组）、小剂量百令胶囊联合左甲状腺素钠组（治疗A组）、大剂量百令胶囊联合左甲状腺素钠组（治疗B组），每组各40例。对照组口服左甲状腺素钠片，12.5～100 μg/次（根据甲状腺功能调整药物剂量，确保甲状腺功能处于正常范围内），1次/d。治疗A组在对照组基础上口服百令胶囊，1.0 g/次，3次/d。治疗B组在对照组基础上口服百令胶囊，3.0 g/次，3次/d。3组均连续治疗6个月。观察3组临床疗效，比较3组的甲状腺功能、甲状腺自身抗体水平、甲状腺体积和峡部厚度。结果 治疗后，治疗A、B组总有效率高于对照组，且治疗B组总有效率高于治疗A组，组间比较差异有统计学意义（P<0.05）。治疗后，3组游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平显著上升，促甲状腺素（TSH）水平显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗A、B组这些观察指标的改善程度明显优于对照组，治疗B组这些观察指标的改善程度明显优于治疗A组，组间比较差异具有统计学意义（P<0.05）。治疗后，3组甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）水平显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗A、B组这些观察指标的下降程度明显优于对照组，组间比较差异具有统计学意义（P<0.05）。治疗后，3组甲状腺体积、峡部厚度显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗A、B组这些观察指标明显低于对照组，治疗B组这些观察指标明显低于治疗A组，组间比较差异具有统计学意义（P<0.05）。结论 大剂量百令胶囊联合左甲状腺素片治疗桥本甲状腺炎疗效优于小剂量百令胶囊联合左甲状腺素片和单纯应用左甲状腺素片治疗，可明显改善患者甲状腺功能，降低甲状腺自身抗体水平，具有一定的临床推广应用价值。

Objective To explore the clinical effect of different doses of Corbrin Capsules combined with Levothyroxine Sodium Tablets in treatment of Hashimoto's thyroiditis. Methods Patients (120 cases) with Hashimoto's thyroiditis in Zhuozhou City Hospital from July 2014 to January 2017 were randomly divided into the levothyroxine sodium group (control group), small dose of Corbrin Capsule combined with levothyroxine sodium group (treatment A group), and large dose of Corbrin Capsule combined with levothyroxine sodium group (treatment B group), and each group had 40 cases. Patients in the control group were po administered with Levothyroxine Sodium Tablets, 12.5-100 μg/time (According to the thyroid function, the dose was adjusted to ensure that thyroid function was in a normal range), once daily. Patients in the treatment A group were po administered with Corbrin Capsules on the basis of the control group, 1.0 g/time, three times daily. Patients in the treatment B group were po administered with Corbrin Capsules on the basis of the control group, 3.0 g/time, three times daily. Patients in three groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and thyroid function, thyroid autoantibody levels, thyroid volume and isthmus thickness in three groups were compared. Results After treatment, the clinical efficacies in the treatment A and treatment B groups were higher than those in the control group, and the clinical efficacies in the treatment B groups was higher than those in the treatment A group, and there was difference between two groups (P < 0.05). After treatment, the levels of FT3 and FT4 in three groups were significantly increased, but the levels of TSH in three groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment A and treatment B groups were significantly better than those in the control group, and the observational indexes in the treatment B group were significantly better than those in the treatment A group, with significant difference among three groups (P < 0.05). After treatment, the levels of TGAb and TPOAb in three groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment A and treatment B groups were significantly lower than those in the control group, and the observational indexes in the treatment B group were significantly lower than those in the treatment A group, with significant difference among three groups (P < 0.05). After treatment, the thyroid volume and the isthmus thickness in three groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment A and treatment B groups were significantly lower than those in the control group, and the observational indexes in the treatment B group were significantly lower than those in the treatment A group, with significant difference among three groups (P < 0.05). Conclusion Large dose of Corbrin Capsules combined with Levothyroxine Sodium Tablets has clinical curative effect in treatment of Hashimoto's thyroiditis, can significantly improve thyroid function, decrease thyroid autoantibody level, which has a certain clinical application value.

保定市科学技术研究与发展指导计划项目（17ZF112）