目的 探讨金水宝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2015年5月—2017年5月上海市闵行区中心医院收治的70例桥本甲状腺炎患者为研究对象，所有患者按照随机数字表法分为对照组和治疗组，每组各35例。对照组口服左甲状腺素钠片，起始剂量为25～50 μg，1次/d，根据甲状腺功能情况调整用量，维持剂量为25～150 μg，1次/d。治疗组在对照组基础上口服金水宝胶囊，3粒/次，3次/d。两组患者均治疗24周。观察两组的临床疗效，比较两组的甲状腺激素、抗体水平和血清炎症因子水平。结果 治疗后，对照组和治疗组的总有效率分别为71.43%、85.71%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组游离三碘状腺素（FT₃）、游离甲状腺素（FT₄）水平均显著升高，促甲状腺素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；并且治疗后治疗组FT₃、FT₄水平均显著高于对照组，TSH、TPOAb、TGAb水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）水平均明显降低，白细胞介素-10（IL-10）水平均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组CRP、TNF-α、IL-2水平均明显低于对照组，IL-10水平明显高于对照组，两组比较差异具有统计学意义（P<0.05）。结论 金水宝胶囊联合左甲状腺素钠片治疗桥本甲状腺炎具有较好的临床疗效，可改善患者甲状腺功能，调节血清炎症因子水平，安全性较好，具有一定临床应用价值。

Objective To investigate the clinical effect of Jinshuibao Capsules combined with Levothyroxine Sodium Tablets in treatment of hashimoto thyroiditis. Methods Patients (70 cases) with hashimoto thyroiditis in Central Hospital of Minhang District of Shanghai from May 2015 to May 2017 were randomly divided into control and treatment groups, and each group had 35 cases. Patients in the control group were po administered with Levothyroxine Sodium Tablets, starting dosage 25-50 μg, once daily, and the dosage was adjusted according to the thyroid function, and the maintenance dose was 25-150 μg, once daily. Patients in the treatment group were po administered with Jinshuibao Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical efficacies were evaluated, and thyroid hormone, antibody levels, and serum levels of inflammatory cytokines in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.43% and 85.71%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of FT₃ and FT₄ in two groups were significantly increased, but the levels of TSH, TPOAb and TGAb in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, TNF-α and IL-2 in two groups were significantly increased, but the levels of IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the inflammatory cytokines levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jinshuibao Capsules combined with Levothyroxine Sodium Tablets has clinical curative effect in treatment of hashimoto thyroiditis, can improve the thyroid function and regulate the levels of serum inflammatory factors, with good safety, which has a certain clinical application value.