中药复方对桥本甲状腺炎患者细胞因子和抗体的影响

Effects of Traditional Chinese Medicine compound on cytokines and antibodies of patients with Hashimoto's thyroiditis

目的通过观察桥本甲状腺炎患者服用中药复方颗粒剂后甲状腺相关抗体和细胞因子的变化,探索对甲状腺功能正常的桥本甲状腺炎患者治疗的必要性。方法甲状腺功能正常的桥本甲状腺炎患者166例,随机分为中药组(n=55)、安慰剂组(n=54)和优甲乐组(n=57),治疗90 d,比较治疗前后和组间患者外周血甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、CD195阳性百分比(CD195%)和CD30阳性百分比(CD30%)变化。结果 CD30%和CD195%:与治疗前比较,中药组治疗后显著下降(P<0.01),安慰剂组和优甲乐组治疗后轻度上升(P>0.05)。TPOAb与TgAb水平:中药组治疗后明显降低,与安慰剂组和优甲乐组比较差异有统计学意义(P<0.01)。抗体与细胞因子相关性:经Spearman相关性分析发现,仅TgAb与CD30%和CD195%呈负相关,TPOAb与CD30%和CD195%均无相关性。结论中药复方能够降低过高的TPOAb和TgAb,并且可以抑制CD30和CD195的阳性表达。提示中药能够调整甲状腺局部紊乱的免疫状态。

Objective To explore the necessity of treating Hasimoto thyroiditis patients with normal thyroid function by observing the changes of antibodies and cytokines relevant to thyroiditis after taking compound granules of Traditional Chinese Medicine. Methods A total of 166 Hasimoto thyroiditis patients with normal thyroid function were randomly divided into the Traditional Chinese Medicine group （TCM group, n =55）, placebo group （ n =54）, and EUTHYROX group （ n =57）. Changes of TPOAb, TgAb, CD195%, and CD30% in peripheral blood of patients before and after treatment were compared. Results CD30% and CD195% of the TCM group significantly decreased after treatment （P〈0.01）, while CD30% and CD195% of placebo group and EUTHYROX group mildly increased after treatment （P〉0.05） . TPOAb and TgAb levels of the TCM group significantly decreased after treatment and the differences of three groups were statistically significant （P 〈0.01）. Spearman correlation analysis showed that TgAb negatively correlated with CD30% and CD195%, while TPOAb did not correlate with CD30% and CD195%. Conclusion Traditional Chinese Medicine compound can decrease high levels of TPOAb and TgAb and inhibit positive expressions of CD30 and CD195, which indicates Traditional Chinese Medicine can regulate locally disordered immune status of thyroid.