黄芪对Graves病患者外周血IL-1β、TNF-α和单个核细胞抗原表达的影响

Effects of Radix Astragali on IL-1β,TNF-α,and Antigen Expression of Peripheral Blood Mononuclear Cells in Patients with Graves Disease

目的探讨黄芪对Graves病患者外周血白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平及外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)表面抗原表达的影响,以了解黄芪对Graves病的治疗机制。方法将80例初诊Graves病患者分为甲巯咪唑组(MMI组)和MMI加黄芪组(联合组),每组40例,治疗1个月后观察两组症状和甲状腺功能改善情况,放射免疫测定外周血IL-1β、TNF-α水平,流式细胞仪检测PBMC表面抗原CD80、CD54及HLA-DR表达水平的变化。结果两组甲状腺功能改善程度相似,两组治疗前后甲状腺自身抗体TGAb、TPOAb均无明显变化。联合组怕热多汗和心悸等症状改善较单用MMI组更明显(P<0.05),两组治疗后外周血IL-1β、TNF-α及CD80均较治疗前有所改善(P<0.05,<0.01),但联合组IL-1β、TNF-α较MMI组降低更显著(P<0.05),且CD54也较治疗前明显下降(P<0.01),与MMI组同期比较差异有统计学意义(P<0.05)。结论黄芪可以显著改善Graves病患者多汗心悸等症状,并调节Graves病的免疫机能,可以在Graves病的辅助治疗中起一定作用。

Objective To study the effects of Radix Astragali on serum cytokines IL-1β,TNFα and antigen expression of peripheral blood mononuclear cells（PBMCs） in patients with Graves disease（GD） . MethodsEighty GD patients at their first visit were randomly assigned to the methimazole（MMI） group（Group A） and the MMI combined Radix Astragali group（Group B） ,40 in each. The improvement of clinical symptoms and thyroid functions were observed after one-month treatment. The serum IL-1β and TNF-α levels in the peripheral blood were determined using radioimmunoassay. The expression levels of surface antigen CD80,CD54,and HLA-DR of PBMCs were detected using flow cytometry. Results The improvement of the thyroid gland function was similar in the two groups. There was no obvious change in the levels of autoantibody TGAb or TPOAb of the two groups. Symptoms such as fear of heat,hidrosis,palpitation,and so on were more obviously improved in Group B than in Group A（P0.05） . The serum IL-1β,TNF-α,CD80 levels in the peripheral blood were all improved in the two groups after treatment when compared with before treatment（P0.05 or P0.01） . But the serum levels of IL-1β and TNF-α decreased more obviously in Group B than in Group A（P0.05） . The expression of CD54 decreased more obviously in Group B（P0.01） ,showing statistical difference when compared with Group A at the same time point（P0.05） . Conclusion Radix Astragali could significantly relieve the clinical symptoms such as hidrosis and palpitation,regulate the immune function of GD patients,playing an important role in the adjuvant therapy for GD.