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针灸治疗桥本甲状腺炎:一项随机对照试验的研究方案。

Acupuncture for Hashimoto thyroiditis: study protocol for a randomized controlled trial.

机构信息

The Department of Acupuncture, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.

Department of Encephalology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Trials. 2021 Jan 21;22(1):74. doi: 10.1186/s13063-021-05036-8.

Abstract

BACKGROUND

The incidence rate of Hashimoto thyroiditis (HT) has gradually increased in recent years. There has been no specific etiological treatment for HT. Even though with normal level of thyroid hormone, the patients may still suffer from various clinical symptoms, such as anterior neck discomfort, fatigue, and mood swings, which seriously impair their quality of life. Acupuncture has long been used in the treatment of thyroid diseases, but there has been no related standardized clinical study as of today. This study aims to assess the feasibility, efficacy, and safety of acupuncture for HT.

METHODS

This is a randomized, black-controlled assessor-blinded pilot trial. A total of 60 patients will be recruited and divided into the experimental group (n = 30) or the control group (n = 30). The experimental group will undergo acupuncture therapy (penetration needling of Hand-Yangming meridian, PNHM) for 16 weeks, followed by a 16-week follow-up period, and the control group will first go through an observation period for 16 weeks, followed by a 16-week compensation PNHM therapy. The primary outcome will be the change of the concentrations of anti-thyroperoxidase antibodies (TPOAb), antithyroglobulin antibodies (TgAb), and thyroid hormone, including total thyroxine (FT), free thyroxine (FT), and thyroid-stimulating hormone (TSH). The secondary outcome measurements include the thyroid-related quality of life questionnaire short-form (ThyPRO-39), The Mos 36-item Short Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HAD). Data collection will be performed before the start of the study (the baseline assessment) and at weeks 8, 16, 24, and 32.

DISCUSSION

The study is designed to assess the feasibility and effectiveness of PNHM in reducing the thyroid antibody level and improving the quality of life of HT patients with hypothyroidism or subclinical hypothyroidism. Results of this trial will assist further analyses on whether the acupuncture treatment can alleviate symptoms for patients with HT.

TRIAL REGISTRATION

Acupuncture-Moxibustion Clinical Trial Registry AMCTR-IOR-19000308 ( ChiCTR1900026830 ). Registered on 23 October 2019.

摘要

背景

近年来,桥本甲状腺炎(Hashimoto thyroiditis,HT)的发病率逐渐升高。目前针对 HT 尚无特异性病因治疗。即使甲状腺激素水平正常,患者仍可能出现各种临床症状,如颈前不适、疲劳和情绪波动,严重影响其生活质量。针灸在甲状腺疾病的治疗中已有较长的应用历史,但目前尚无相关的规范化临床研究。本研究旨在评估针灸治疗 HT 的可行性、疗效和安全性。

方法

这是一项随机、黑对照评估者盲法的初步试验。共纳入 60 例患者,分为实验组(n=30)和对照组(n=30)。实验组接受针灸治疗(手阳明经透刺,PNHM)16 周,随后进行 16 周的随访期,对照组先进行 16 周的观察期,然后进行 16 周的补偿性 PNHM 治疗。主要结局为抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TgAb)和甲状腺激素浓度的变化,包括总甲状腺素(FT)、游离甲状腺素(FT)和促甲状腺激素(TSH)。次要结局测量包括甲状腺相关生活质量问卷短表(ThyPRO-39)、36 项简明健康状况调查问卷(SF-36)和医院焦虑抑郁量表(HAD)。数据将在研究开始前(基线评估)和第 8、16、24 和 32 周进行收集。

讨论

本研究旨在评估 PNHM 降低甲状腺抗体水平和改善甲状腺功能减退或亚临床甲状腺功能减退 HT 患者生活质量的疗效。该试验的结果将有助于进一步分析针灸治疗是否能缓解 HT 患者的症状。

试验注册

针灸临床试验注册 AMCTR-IOR-19000308( ChiCTR1900026830 )。注册于 2019 年 10 月 23 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d854/7818748/0e281d228114/13063_2021_5036_Fig1_HTML.jpg

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