优甲乐联合揿针治疗桥本甲减抑郁状态的临床研究

Clinical Study of Levothyroxine Combined with Embedded Press-Needle Therapy for Hypothyroidism with Depressive State Induced by Hashimoto’s Thyroiditis

摘要: 目的：探讨左甲状腺素钠片(优甲乐)联合揿针疗法治疗桥本甲状腺炎致甲状腺功能减退(桥本甲减)伴抑郁状态的临床疗效，为减轻患者焦虑抑郁症状、疏通身体经脉，调节脏腑功能提供依据。方法：选取2025年01月~2025年10月黑龙江省某三甲医院内分泌科桥本甲减合并抑郁状态患者，将60例符合中西医诊断标准的患者按随机数字表法分为对照组(n = 30，优甲乐单药治疗及健康指导)与试验组(n = 30，优甲乐联合揿针治疗及健康指导)，疗程6周。本研究采用评估者单盲设计，对结局指标评估人员实施盲法，比较两组治疗前后甲状腺功能指标(FT3、FT4、TSH)、血清甲状腺激素抗体水平(TgAb、TPOAb)、中医证候积分、汉密尔顿抑郁量表(HAMD-17)评分、统计心理弹性量表(CD-RISC)评分，并记录不良反应。结果：两组甲状腺功能及抗体水平均有所改善，改善程度无显著差异(P > 0.05)，治疗后两组中医证候积分、汉密尔顿抑郁量表评分、统计心理弹性量表评分较本组治疗前明显改善(P < 0.05)；两组组间比较显示，试验组治疗后中医证候积分、汉密尔顿抑郁量表评分、统计心理弹性量表评分较对照组改善更明显，比较差异有统计学意义(P < 0.05)。且两组均未发生严重不良反应。结论：优甲乐联合揿针疗法可在有效纠正甲状腺功能的基础上，更显著缓解桥本甲减患者的抑郁状态。为临床提供了安全有效的中西医结合治疗新策略。

Abstract: Objective: To explore the clinical efficacy of levothyroxine sodium tablets (Euthyrox) combined with embedded press-needle therapy in the treatment of hypothyroidism complicated with depressive state caused by Hashimoto’s thyroiditis, so as to provide evidence for alleviating patients’ anxiety and depressive symptoms, dredging meridians and collaterals, and regulating visceral functions. Methods: Patients diagnosed with Hashimoto’s hypothyroidism combined with depressive state were recruited from the Department of Endocrinology of a Grade A Tertiary Hospital in Heilongjiang Province from January 2025 to October 2025. A total of 60 patients meeting both Western and Chinese medicine diagnostic criteria were divided into a control group (n = 30, monotherapy with Euthyrox plus health guidance) and an experimental group (n = 30, Euthyrox combined with embedded press-needle therapy plus health guidance) by random number table method, with a treatment course of 6 weeks. This study adopted a single-blind design for outcome assessors, with blinding implemented for personnel evaluating outcome indicators. Thyroid function indicators (FT3, FT4, TSH), serum thyroid autoantibody levels (TgAb, TPOAb), Traditional Chinese Medicine (TCM) syndrome scores, 17-item Hamilton Depression Rating Scale (HAMD-17) scores and Connor-Davidson Resilience Scale (CD-RISC) scores of the two groups were compared before and after treatment, and adverse reactions were recorded. Results: Thyroid function and autoantibody levels were improved in both groups with no statistically significant intergroup differences (P > 0.05). After treatment, the TCM syndrome scores, HAMD-17 scores and CD-RISC scores of both groups were significantly improved compared with baseline (P < 0.05). Intergroup comparison showed that the experimental group achieved more remarkable improvements in TCM syndrome scores, HAMD-17 scores and CD-RISC scores than the control group, with statistically significant differences (P < 0.05). No severe adverse reactions occurred in either group. Conclusion: On the basis of effectively correcting thyroid function, Euthyrox combined with embedded press-needle therapy can significantly relieve depressive state in patients with Hashimoto’s hypothyroidism and gradually reduce the dosage of Euthyrox. It provides a safe and effective novel integrated Chinese and Western medicine therapeutic strategy for clinical practice.