fa تأثیر عصاره شبدر ایرانی (Trifolium resupinatum L.) بر هورمون‌های تیروئیدی در کم‌کاری تحت‌بالینی تیروئید: کارآزمایی بالینی دوسوکور پزشکی- داخلی Internal Medicine پژوهشي اصیل Original Research <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">زمینه</span></span></span></span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">&nbsp;و هدف:</span></span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">کم‌کاری تحت‌بالینی تیروئید از اختلالات شایع غدد درون‌ریز است که عملکردهای متابولیکی انسان را تحت‌تأثیر قرار می‌دهد. شبدر ایرانی (</span></span><i><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">Trifolium resupinatum L.</span></span></i><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) گیاهی با خواص درمانی سنتی است. این مطالعه آثار عصاره هیدروالکلی این گیاه را در پروفایل هورمون‌های تیروئیدی در بیماران مبتلابه کم‌کاری تحت‌بالینی ارزیابی کرده است.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">مواد و روش‌‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">: </span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ابتدا عصاره هیدروالکلی گیاه شبدر تهیه و ترکیبات فعال آن با </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">GC</span></span><span dir="LTR" style="font-size:10.0pt">-</span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">MS</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">شناسایی شد. سپس، 51 بیمار در دو گروه قرار گرفتند: گروه مداخله (25=</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">n</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) که عصاره را (500 میلی‌گرم/ روز) همراه لووتیروکسین دریافت کردند و گروه کنترل (26=</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">n</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) که داروی لووتیروکسین را با پلاسبو گرفتند. سه ماه بعد، سطوح سرمی </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">TSH</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">T3</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">T4</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">با متد </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">ELISA</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">اندازه‌گیری شد. آنالیز آماری با نرم‌افزار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نسخه 25 انجام شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">یافته‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">: </span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در آنالیز </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">GC-MS</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ترکیبات فنولی بخش عمده عصاره را تشکیل می‌دادند. افزایش معنادار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">T4</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0/001></span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) و همچنین کاهش معنادار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">TSH</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0/04=</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) در گروه مداخله، در مقایسه با گروه کنترل دیده شد، ولی در </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">T3</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تغییر معناداری مشاهده نشد (0/42=</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">).</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:-.15pt">نتیجه‌گیری: </span></span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">عصاره هیدروالکلی شبدر ایرانی با تعدیل سطوح</span></span> <span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">TSH</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">T4</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، می‌تواند در کنار لووتیروکسین، درمان کمکی مناسبی در بیماران مبتلا به کم‌کاری تحت‌بالینی باشد.</span></span></span></span></span></span></span> <div> <hr align="left" class="msocomoff" size="1" width="33%" ></div> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Background and Aim:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Subclinical hypothyroidism represents a prevalent endocrine disorder affecting metabolic homeostasis. <i>Trifolium resupinatum L. </i>is a medicinal plant traditionally valued for its therapeutic properties. This study aimed to evaluate the effects of its hydroalcoholic extract on thyroid hormone profiles in patients with subclinical hypothyroidism.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3">Materials and Methods: </span></span></span></b><span style="font-size:9.0pt"><span style="font-family:Optima">Hydroalcoholic extract was prepared from dried <i>T. resupinatum</i> samples, and bioactive compounds were identified via GC-MS analysis. In a randomized clinical trial, 51 patients were allocated into two groups. The intervention group (n=25) received extract (500 mg/day) alongside levothyroxine, while the control group (n=26) received levothyroxine plus placebo. Following three months of treatment, serum TSH, total T3, and total T4 levels were measured using ELISA. Statistical analyses were conducted using SPSS software (version 25).</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Results:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">GC-MS analysis identified phenolic compounds as principal constituents of the extract. Extract administration significantly elevated total T4 levels (P<0.001) and reduced TSH concentrations (P=0.04), compared to controls. No significant changes in total T3 were observed (P=0.42).</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:-.1pt">Conclusion:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Hydroalcoholic extract of <i>T. resupinatum</i> demonstrates potential as an adjunctive therapy with levothyroxine for managing subclinical hypothyroidism by modulating TSH and T4 levels, thereby improving thyroid function.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:90%"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:90%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:-.15pt">Keywords:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Hydroalcoholic extract, Hypothyroidism, Medicinal plants, Thyroid hormones, <i>Trifolium resupinatum L. </i></span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span> کم‌کاری تیروئید, Trifolium resupinatum L.؛ عصاره هیدروالکلی, هورمون‌های تیروئیدی,گیاهان دارویی Hypothyroidism, Trifolium resupinatum L., Hydroalcoholic extract, Thyroid hormones, Medicinal plants 0 0 http://sjku.muk.ac.ir/browse.php?a_code=A-10-1623-18&slc_lang=fa&sid=1 Pezhman Sharifi پژمان شریفی pezhman.sh7@gmail.com 5400319475328460073690 5400319475328460073690 No Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز تحقیقات گوارش و کبد، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران Sima Tozandehjani سیما توزنده جانی stozande@ttu.edu 5400319475328460073691 5400319475328460073691 No Texas Tech University, School of Veterinary Medicine, USA دانشگاه تگزاس تک، دانشکده دامپزشکی، ایالات متحده آمریکا Mohammad Aziz Rasouli محمد عزیز رسولی rasouli1010@gmail.com 5400319475328460073692 5400319475328460073692 No Clinical Research Development Center, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز توسعه تحقیقات بالینی، بیمارستان کوثر، دانشگاه علوم پزشکی کردستان، سنندج، ایران Khaled Emamzanbili خالد امام زنبیلی khaledemam1399@gmail.com 5400319475328460073693 0009-0005-7261-3409 No Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز تحقیقات گوارش و کبد، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران Shahnaz Ghafouri شهناز غفوری drghafoorish76@gmail.com 5400319475328460073694 5400319475328460073694 Yes Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز تحقیقات گوارش و کبد، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران