穿山龙对桥本甲状腺炎患者Th1/Th2型细胞因子表达的影响

Influence of Rhizoma Dioscoreae Nipponicae on expression of Th1/Th2 cytokines in patients with hashimoto's thyroiditis

目的:通过观察穿山龙治疗桥本甲状腺炎(HT)患者前后血清自身免疫性抗体:甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)及T淋巴细胞亚群的变化关系,探讨穿山龙治疗HT免疫学作用机制。方法:将48例HT患者随机分为治疗组和对照组,每组24例,对照组给予左旋甲状腺素片治疗调节甲状腺功能至正常并维持治疗,治疗组在此基础上联合应用穿山龙颗粒,早晚各1次,沸水冲服,连续治疗6个月。入组后先测定基线时的三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、TPOAb、TGAb、甲状腺B超(或合甲状腺细针穿刺)、T淋巴细胞亚群;随访6个月后再次测定上述指标。结果:治疗后,治疗组TGAb以及TPOAb水平低于对照组(P<0.05);治疗组CD4+T细胞亚群数值和CD4/CD8比值明显高于对照组(P<0.05)。结论:穿山龙能降低HT患者TPOAb和TGAb的滴度,其机制可能与T淋巴细胞亚群相关。穿山龙能提高CD4+T细胞亚群数值和CD4/CD8比值,改善Th1/Th2失衡状态,从而达到免疫调节功能,改善HT的免疫炎性反应。

Objective： To investigate the immune mechanism of Rhizoma Dioscoreae Nipponicae in treating patients with hashimoto＇s thyroiditis（HT） by observing the changes in serum autoimmune antibodies of HT patients treated by Dioscoreae Nipponicae such as tryroid peroxidase antibody（TPOAb）, thyroglobulin antibody（TGAb） and neoplasms T-lymphocyte. Methods： Forty-eight HT patients were randomly and averagely divided into treatment group and control group. Patients in control group were treated with Levothyroxine Tablets to regulate the thyroid function until it was normal, and then maintained the therapy. Patients in treatment group were treated with Rhizoma Dioscoreae Nipponicae Granule based on the therapy of Levothyroxine Tablets. The two treatments were lasted for 6 months. The baseline levels of T3, T4, FT3, FT4, TSH, TPOAb, TGAb, B ultrasonic of thyroids（thyroids fine needle aspiration cytological examination） and neoplasms T-lymphocyte were measured before treatment, and the above indicators were determined again after followed up for 6 months. Results： Compared with the control group, levels of TPOAb and TGAb of patients in treatment group were significantly decreased after treatment（P0.05）. Furthermore, the number of CD4＋T cell subsets and CD4/CD8 ratio in treatment group were significantly increased（P0.05）. Conclusion： Rhizoma Dioscoreae Nipponicae could decrease the titer of TPOAb and TGAb of hashimoto＇s thyroiditis, and the mechanism might be related to neoplasms T-lymphocyte. Rhizoma Dioscoreae Nipponicae could increase the number of CD4＋T cell subsets and the CD4/CD8 ratio, improve the imbalance of Thl/Th2 accordingly to full play the immunomodulatory function and improve the immuneinflammatory responses of hashimoto＇s thyroiditis.