目的 探討不同劑量百令膠囊聯(lián)合左甲狀腺素鈉片治療橋本甲狀腺炎的臨床療效。方法 選取2014年7月—2017年1月涿州市醫(yī)院收治的橋本甲狀腺炎患者120例作為研究對(duì)象，按隨機(jī)數(shù)余數(shù)法將患者分為左甲狀腺素鈉組（對(duì)照組）、小劑量百令膠囊聯(lián)合左甲狀腺素鈉組（治療A組）、大劑量百令膠囊聯(lián)合左甲狀腺素鈉組（治療B組），每組各40例。對(duì)照組口服左甲狀腺素鈉片，12.5～100 μg/次（根據(jù)甲狀腺功能調(diào)整藥物劑量，確保甲狀腺功能處于正常范圍內(nèi)），1次/d。治療A組在對(duì)照組基礎(chǔ)上口服百令膠囊，1.0 g/次，3次/d。治療B組在對(duì)照組基礎(chǔ)上口服百令膠囊，3.0 g/次，3次/d。3組均連續(xù)治療6個(gè)月。觀察3組臨床療效，比較3組的甲狀腺功能、甲狀腺自身抗體水平、甲狀腺體積和峽部厚度。結(jié)果 治療后，治療A、B組總有效率高于對(duì)照組，且治療B組總有效率高于治療A組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組游離三碘甲狀腺原氨酸（FT3）、游離甲狀腺素（FT4）水平顯著上升，促甲狀腺素（TSH）水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療A、B組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，治療B組這些觀察指標(biāo)的改善程度明顯優(yōu)于治療A組，組間比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組甲狀腺球蛋白抗體（TGAb）、甲狀腺過(guò)氧化物酶抗體（TPOAb）水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療A、B組這些觀察指標(biāo)的下降程度明顯優(yōu)于對(duì)照組，組間比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組甲狀腺體積、峽部厚度顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療A、B組這些觀察指標(biāo)明顯低于對(duì)照組，治療B組這些觀察指標(biāo)明顯低于治療A組，組間比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 大劑量百令膠囊聯(lián)合左甲狀腺素片治療橋本甲狀腺炎療效優(yōu)于小劑量百令膠囊聯(lián)合左甲狀腺素片和單純應(yīng)用左甲狀腺素片治療，可明顯改善患者甲狀腺功能，降低甲狀腺自身抗體水平，具有一定的臨床推廣應(yīng)用價(jià)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.

保定市科學(xué)技術(shù)研究與發(fā)展指導(dǎo)計(jì)劃項(xiàng)目（17ZF112）