瘿瘤合剂联合甲巯咪唑对格雷夫斯病患者甲状腺功能及相关细胞因子的影响

Effect of “Yingliu Mixture” Combined with Methimazole on Thyroid Function and Relevant Cell Factors for Patients with Graves' Disease

目的:观察瘿瘤合剂联合甲巯咪唑治疗格雷夫斯病的临床疗效及其对患者甲状腺功能、相关细胞因子水平的影响。方法:将174例格雷夫斯病患者随机分为治疗组和对照组,每组87例。对照组予甲巯咪唑治疗,治疗组予瘿瘤合剂联合甲巯咪唑治疗,疗程为12周。评价两组患者的中医证候积分及中医证候疗效,检测并比较两组患者的甲状腺功能指标及相关免疫细胞因子水平的变化。结果:1治疗后,治疗组和对照组的中医证候疗效总有效率分别为94.3%和88.5%,组间临床疗效比较,差异有统计学意义(P<0.05)。2治疗后,两组患者的中医证候积分均显著降低(P<0.05),且治疗组患者的积分低于对照组(P<0.05)。3治疗后,两组患者的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平显著降低(P<0.05),促甲状腺素(TSH)水平显著升高(P<0.05),且治疗组患者的FT3、FT4水平低于对照组(P<0.05)。4治疗后,治疗组患者的肿瘤坏死因子-α(TNF-α)水平显著降低(P<0.05),白介素-10(IL-10)、CD4+CD25+T细胞亚群水平显著升高(P<0.05);对照组患者的TNF-α水平显著降低(P<0.05)。结论:瘿瘤合剂联合甲巯咪唑可有效改善格雷夫斯病患者的临床症状及甲状腺功能,其疗效优于单用甲巯咪唑,或有调节免疫细胞因子的作用。

Objective： To observe the effect of ＂Yingliu Mixture＂combined with methimazole in treating patients with Graves＇ disease and its influence on the thyroid function and the relevant cell factors. Methods： One hundred and seventy-four patients with Graves＇ disease were randomized into the treatment group and control group with 87 cases in each group. The patients in the control group were treated by methimazole and the patients in the treatment group were treated by ＂Yingliu Mixture＂combined with methimazole,with a course of 12 weeks. The Chinese medical syndrome scores and the effect on Chinese medical syndrome were evaluated,and the indexes of thyroid function and the levels of relevant cell factors were detected and compared. Results： 1 After treatment,the total effective rates on Chinese medical syndrome of the treatment group and control group were 94. 3% and 88. 5% respectively,with statistical difference between the two groups（ P〈0. 05）.2After treatment,the Chinese medical syndrome scores of both groups were obviously decreased（ P〈0. 05）,and the scores of the treatment group were lower than those of the control group（ P〈0. 05）. 3 After treatment,the levels of serum free thyroid original three iodine glycine（ FT3） and free thyroxin（ FT4） in both groups were significantly decreased（ P〈0. 05）and the level of thyroid stimulating hormone（ TSH） was increased（ P〈0. 05）,and the levels of FT3 and FT4in the treatment group were lower than those in the control group（ P〈0. 05）. 4After treatment,the level of tumor necrosis factor-α（ TNF-α）of treatment group was markedly decreased（ P〈0. 05） and the levels of interleukin-10（ IL-10） and CD4＋CD25＋T cell were obviously increased（ P〈0. 05）; the level of TNF-α of control group was decreased（ P〈0. 05）. Conclusion： ＂Yingliu Mixture＂combined with methimazole can improve the clinical symptoms and thyroid function in the treatment of Graves ＇disease,of which the curative effect was better than methimazole only,and may adjust the action of immune cell factors.