目的：探讨海藻玉壶汤对桥本甲状腺炎疗效及对甲状腺自身免疫性抗体、Th1/Th2相关细胞因子的影响。方法：将94例桥本甲状腺炎患者按随机数字表法分为观察组和对照组各47例。对照组患者服用硒酵母片和左旋甲状腺素钠片进行治疗，观察组在此基础上服用海藻玉壶汤，两组疗程均为3个月。比较两组中医症状积分、治疗总有效率，以及甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPO-Ab)、游离三碘甲状腺原氨酸(FT₃)、游离四碘甲状腺原氨酸(FT₄)、促甲状腺激素(TSH)、白细胞介素-10(IL-10)、白细胞介素-12(IL-12)、γ干扰素(IFN-γ)水平，并观察不良反应情况。结果：治疗后两组甲状腺肿大、咽部异物感、胸闷胁痛、乏力评分，以及血清TGAb、TPO-Ab、TSH、IL-12、IFN-γ水平均较治疗前降低，且观察组低于对照组(均P<0.05)；两组血清FT₃、FT₄、IL-10水平均较治疗前升高，且观察组高于对照组(均P<0.05)；观察组治疗总有效率95.74%，对照组82.98%，观察组疗效优于对照组(P<0.05)；两组均未出现不良反应事件。结论：海藻玉壶汤联合常规西药治疗桥本甲状腺炎疗效较好，可降低甲状腺自身抗体水平并恢复甲状腺功能，其机制可能是通过下调Th1型细胞因子、上调Th2型细胞因子以改善甲状腺功能。

Objective:To explore the effect of Haizao Yuhu Decoction(海藻玉壶汤) in treatment of Hashimoto thyroiditis and its effect on thyroid autoimmune antibodies and Th1/Th2 related cytokines. Methods:A total of 94 patients with Hashimoto thyroiditis were divided into the observation group and the control group by using random number table method,with 47 cases in each group. The control group was treated with selenium yeast tablets and levothyroxine sodium tablets,and the observation group was treated with Haizao Yuhu Decoction on the basis of the treatment of the control group. The course of treatment in both groups was three months. Chinese medicine symptom score and total effective rate,thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPO-Ab),free triiodothyronine(FT₃),free tetraiodothyronine(FT₄),thyroid stimulating hormone(TSH),interleukin-10(IL-10),interleukin-12(IL-12),interferon-γ(INF-γ) content were compared between the two groups,and the adverse reactions were observed. Results:After treatment,scores of goiter,foreign body sensation in pharynx,chest tightness and hypochopathy,fatigue,and serum levels of TGAb,TPO-Ab,TSH,IL-12 and IFN-γ in both groups were lower than those before treatment,and the indexes of the observation group were lower than those of the control group(all P<0.05). Serum FT₃,FT₄ and IL-10 levels in two groups were higher than those before treatment,and the indexes of the observation group were lower than those of the control group(all P<0.05). The total effective rate was 95.74% in the observation group and 82.98% in the control group(P<0.05). There were no adverse events in both groups. Conclusions:Haizao Yuhu Decoction combined with conventional western medicine has a good effect in the treatment of Hashimoto thyroiditis. It can reduce the level of thyroid autoantibodies and restore thyroid function. The mechanism may be involved in improving thyroid function by down-regulating Th1 cytokine and up-regulating Th2 cytokine.