宋杨

【摘要】 目的：探討右归丸治疗妊娠合并亚临床甲状腺功能减退症的效果及对母婴结局的影响。方法：选取2017年1月-2020年1月本院收治的110例妊娠合并亚临床甲状腺功能减退症患者的临床资料进行回顾性分析。按照治疗方法的不同将患者分为观察组和对照组，每组55例。对照组给予常规药物治疗，观察组给予右归丸联合常规药物治疗。比较两组治疗前后的甲状腺功能指标，治疗效果、妊娠并发症及母婴不良结局。结果：治疗后，两组游离三碘甲腺原氨酸（FT3）及游离甲状腺素（FT4）比较，差异均无统计学意义（P>0.05）。治疗后，观察组血清促甲状腺素（TSH）低于对照组（P<0.05）。观察组治疗总有效率为96.36%高于对照组的85.45%（P<0.05）。观察组妊娠期高血压疾病发生率低于对照组（P<0.05）。观察组母婴不良结局发生率为14.55%低于对照组的49.09%，其中观察组羊水异常发生率为1.82%低于对照组的12.73%（P<0.05）。结论：右归丸联合常规药物治疗妊娠合并亚临床甲状腺功能减退症的效果较好，可有效调节甲状腺功能水平，母婴不良结局发生率较低，安全性较好，应用价值高。

【关键词】 亚临床甲状腺功能减退症 妊娠 右归丸 母婴不良结局

Effect of Yougui Wan in the Treatment of Pregnancy with Subclinical Hypothyroidism and Its Influence on the Maternal and Infant Outcomes/SONG Yang. //Medical Innovation of China， 2021， 18（07）： 0-076

[Abstract] Objective： To investigate the effect of Yougui Wan in the treatment of pregnancy with subclinical hypothyroidism and its effect on maternal and infant outcomes. Method： Clinical data of 110 cases of pregnant patients with subclinical hypothyroidism admitted to our hospital from January 2017 to January 2020 were retrospectively analyzed. According to different treatment methods， the patients were divided into observation group and control group， with 55 cases in each group. The control group was treated with conventional drug treatment， and the observation group was treated with Yougui Wan combined with conventional drug treatment. The thyroid function indexes of the two groups were compared before and after treatment. The treatment effect， pregnancy complications and maternal and infant adverse outcomes were compared between the two groups. Result： After treatment， there were no statistical significances in FT3 and FT4 between the two groups （P>0.05）. After treatment， serum thyrotropin （TSH） in observation group was lower than that in control group （P<0.05）. The total effective rate of the observation group was 96.36% higher than 85.45% of the control group （P<0.05）. The incidence of hypertension during pregnancy in observation group was lower than that in control group （P<0.05）. The incidence of maternal and infant adverse outcomes in the observation group was 14.55% lower than 49.09% in the control group， and the incidence of abnormal amniotic fluid in the observation group was 1.82% lower than 12.73% in the control group （P<0.05）. Conclusion： Yougui Wan combined with conventional drugs in the treatment of pregnancy with subclinical hypothyroidism has a good effect. It can effectively regulate the level of thyroid function， and the incidence of maternal and infant adverse outcomes is low， with good safety and high application value.

[Key words] Subclinical hypothyroidism Pregnancy Yougui Wan Maternal and infant adverse outcomes

First-authors address： Jiamusi Maternal and Child Health Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.07.018

由于甲状腺激素合成及分泌或生物效应不足引起的疾病称之为甲状腺功能减退症，属于一种代谢性疾病，其中血清促甲状腺素（TSH）升高，而游离三碘甲腺原氨酸（FT3）及游离甲状腺素（FT4）正常的情况被称之为亚临床甲状腺功能减退症[1-2]。虽然在妊娠合并亚临床甲状腺功能减退症患者中的临床症状并不是十分明显，但是其不良结果却较为严重，如果不加以有效的治疗，可影响母婴结局及生命安全。目前该疾病的治疗多采用药物治疗，其中左甲状腺素钠为临床常用药物，但用药剂量较大，且患者为妊娠期女性，用药应更为慎重。而该疾病经中医学辩证属于“水肿”“虚劳”等疾病范畴，而右归丸可温补肾阳，且应用较为广泛，副作用较为轻微[3-4]。故笔者给予右归丸联合常规药物左甲状腺素钠治疗，其效果较好，现报道如下。