中西医结合治疗Graves病近远期疗效及安全性

Short-term and long-term effect and safety of integrated traditional Chinese and western medicine in patients with Graves disease

目的探讨中西医结合治疗Graves病(GD)的近远期疗效及安全性。方法将108例GD患者随机分为治疗组和对照组,各54例,对照组接受丙基硫氧嘧啶治疗,治疗组给予丙基硫氧嘧啶联合逍遥散(柴胡、白芍、薄荷、白术、当归等)加减治疗。比较2组近远期临床疗效及不良反应。结果治疗组总有效率为92.6%,显著高于对照组的77.8%(P<0.05);治疗后,2组各生化指标均显著改善,但治疗组FT3、FT4及TSH水平均优于对照组(P<0.05);治疗后2年,治疗组复发率显著低于对照组(P<0.05);治疗组不良反应发生率为7.4%,显著低于对照组的22.2%(P<0.05)。结论丙基硫氧嘧啶联合逍遥散加减行疏肝解郁治疗GD可减少西药所致的白细胞减少及肝功能异常等毒副作用,降低甲亢复发率和甲减发生率,提高机体免疫力。

Objective To explore the short-term and long-term effect and safety of integrated traditional Chinese and western medicine in patients with Graves disease （GD）. Methods 108 patients with GD in our hospital were divided into treatment group （n = 54） and control group （n = 54）. Control group was given propylthiouracil. Treatment group was given propylth- iouracil and the addition and subtraction of Xiaoyaosan （ Bupleurum, Radix Paeoniae Alba, mint, Atractylodes, Angelica）. The short-and long-term clinical effects and side effects were compared between the two groups. Result The total effect rate of treatment group was 92.6% and 77.8% of control group （ P 〈 0.05）. After treatment, the biochemical indices in both groups were improved, while the level of F13, FF4 and TSH in treatment group were significantly better than those in control group （ P 〈 0.05）. The recurrence rate in treatment group was remarkably lower than that in control group after two-year treatment （ P 〈 0.05）. The total side effect rate of treatment group was 7.4 %, which was significantly lower than 22.2 % of control group （ P 〈 0.05）. Conclusions Propyhhiouracil combined with the addition and subtraction of Xiaoyaosan for GD can contribute to improve short-term and long-term effect and reduce recurrence and side effect.