Objective To evaluate the effect of traditional Chinese medicine combined with thyroid hormone on lipid regulation and maternal and neonatal health in pregnant patients with hypothyroidism.Methods Ninety-eight pregnant women with hypothyroidism treated at Second Hospital,Shaanxi University of Traditional Chinese Medicine from July 2022 to June 2023 were selected for the randomized controlled trial,and were divided into a control group and a combination group by the random number table method,with 49 cases in each group.The control group were 27-36(31.67±4.81)years old;their body mass index at admission was(22.43±3.67)kg/m2;their gestational age was(19.09±1.34)weeks.The combination group were 29-39(32.07±5.13)years old;their body mass index at admission was(22.19±3.28)kg/m2;their gestational age was(19.84±1.17)weeks.Both groups took levothyroxine sodium tablets at an initial dosage of 25 μg/d;they revisited every 4 weeks;if their level of thyroid-stimulating hormone(TSH)did not return to normal,they took the tablets 50-100 μg/d according to their resistance until their TSH level was normal;they were treated for 12 weeks.In addition,the combination group took Buzhong Wenyang Tang in the morning and at night one dosage per day for 12 weeks.After 12 weeks'treatment,the free thyroxine(FT4),TSH,thyroid peroxidase antibody(TPOAb)positive rates,serum total cholesterol(TC),triglycerides(TAG),low-density lipoprotein cholesterol(LDL-C),maternal and neonatal outcomes,neonatal development[assessed by the Bayley Scales of Infant Development(BSID)],and overall clinical efficacies in both groups were observed and analyzed.t and x2 tests were used.Results The overall clinical efficacy in the combination group was higher than that in the control group[85.71％(42/49)vs.67.35％(33/49)],with a statistical difference(x2=4.60,P＜0.05).After delivery,the levels of TSH and TPOAb and TPOAb positive rate in the combination group were lower than those in the control group[(1.97±0.46)IU/ml vs.(2.87±0.62)IU/ml,(8.12±1.47)IU/ml vs.(10.96±1.82)IU/ml,and 6.12％(3/49)vs.20.41％(10/49)],with statistical differences(t=8.16 and 8.50;x2=4.35;all P＜0.05).After delivery,the levels of TC,TAG,and LDL-C in the combination group were lower than those in the control group,with statistical differences(all P＜0.05).Three months after birth,the scores of Mental Developmental Index(MDI)and Psychomotor Developmental Index(PDI)in the combination group were higher than those in the control group[(86.94±5.86)vs.(80.27±5.14)and(85.72±5.15)vs.(80.98±5.23)],with statistical differences(both P＜0.05).There was no statistical difference in the incidence of adverse outcomes between the combination group and the control group[4.08％(2/49)vs.16.33％(8/49);x2=4.01;P＜0.05].Conclusion Buzhong Wenyang Tang combined with low-dose levothyroxine sodium for pregnant women with hypothyroidism can effectively improve their thyroid function and neonatal development,lower their lipid levels,optimize maternal and neonatal outcomes.
关键词
甲状腺功能减退症/妊娠期/补中温阳汤/低剂量左甲状腺素钠片/血脂水平/母婴结局
Key words
Hypothyroidism/Period of pregnancy/Buzhong Wenyang Tang/Low-dose levothyroxine sodium/Blood lipid levels/Maternal and neonatal outcomes
维普
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