目的 探讨平消胶囊联合左甲状腺素钠片治疗结节性甲状腺肿的临床疗效。方法 选取2017年10月—2019年12月焦作市人民医院收治的300例结节性甲状腺肿患者作为研究对象，按照随机数字表法将300例患者分为对照组和治疗组，每组各150例。对照组口服左甲状腺素钠片，50 μg/次，1次/d。治疗组在对照组患者治疗的基础上口服平消胶囊，1.5 g/次，3次/d。两组患者连续治疗3个月。观察两组的临床疗效，比较两组的结节直径、血清甲状腺激素和血清因子水平。结果 治疗后，治疗组的总有效率为94.00%，明显高于对照组的87.33%，差异有统计学意义（P<0.05）。治疗后，两组的结节直径显著缩小（P<0.05）；治疗后，治疗组的结节直径明显低于对照组（P<0.05）。治疗后，两组的促甲状腺激素（TSH）水平显著降低，且治疗组TSH水平降低的更明显（P<0.05），治疗后两组总三碘甲腺原氨酸（TT3）、游离型T3（FT3）水平无显著差异。治疗后，两组的血管内皮生长因子（VEGF）、转化生长因子-β₁（TGF-β₁）水平明显降低（P<0.05）；治疗后，治疗组的VEGF、TGF-β₁水平明显低于对照组（P<0.05）。结论 平消胶囊联合左甲状腺素钠片可提高结节性甲状腺肿的疗效，促进结节直径缩小，调节VEGF、TGF-β₁水平。

Objective To explore the clinical effect of Pingxiao Capsules combined with Levothyroxine Sodium Tablets in treatment of nodular goiter. Methods Patients (300 cases) with nodular goiter in Jiaozuo People's Hospital from October 2017 to December 2019 were randomly divided into control and treatment groups, and each group had 150 cases. Patients in the control group were po administered with Levothyroxine Sodium Tablets, 50 μg/time, once daily. Patients in the treatment group were po administered with Pingxiao Capsules on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and nodule diameter, the serum levels of thyroid hormone and serum factors were compared. Results After treatment, the total effective rate of the treatment group was 94.00%, which was significantly higher than that of the control group (87.33%), and there was difference between two groups (P<0.05). After treatment, the diameter of nodules in two groups was significantly reduced (P<0.05). And after treatment, the diameter of nodules in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the levels of TSH in two groups were significantly decreased, and the level of TSH in the treatment group was more significantly reduced (P<0.05). But after treatment, there was no significant difference in the levels of TT3 and FT3 between two groups. After treatment, the levels of VEGF and TGF-β₁ in two groups were significantly decreased (P<0.05). After treatment, the levels of VEGF and TGF-β₁ in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Pingxiao Capsules combined with Levothyroxine Sodium Tablets can improve the curative effect of nodular goiter, promote the reduction of nodule diameter, and regulate the levels of VEGF and TGF-β₁.

R984

河南省医学科技攻关计划联合共建项目（2018020852）