夏枯草颗粒联合甲巯咪唑对Graves病患者自身抗体及细胞因子的影响

Effect of Xiakucao Granules Combined with Thiamazole on the Autoantibody and Cytokines in Patients with Graves Disease

探讨夏枯草颗粒联合甲巯咪唑对毒性弥漫性甲状腺肿(Graves病,GD)患者自身抗体及细胞因子的影响。选取GD患者80例为研究对象,随机分为观察组和对照组,2组均给予高热量、高维生素、低碘等基础治疗,对照组口服甲巯咪唑片10 mg/次,3次/d,根据病情可适当调整剂量15~40 mg/d,观察组在对照组基础上联合夏枯草颗粒1袋/次,2次/d,2组治疗12周后进行疗效评价。2组采集治疗前后清晨空腹外周静脉血,采用电化学发光分析仪测定血清游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺素(TSH)水平及抗甲状腺球蛋白抗体(TGAb)、促甲状腺素受体抗体(TRAb)、抗甲状腺微粒体抗体(TMAb)水平,放射免疫法测定过氧化物酶抗体(TPOAb)水平;ELISA法测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)水平。研究发现治疗后观察组FT_3、FT_4明显低于对照组,TSH较对照组明显升高(p<0.05);治疗后观察组TGAb、TPOAb、TMAb显著低于对照组(p<0.05);观察组治疗后TNF-α显著低于对照组,IL-10显著高于对照组(p<0.05),而IL-6、IFN-γ无明显差异(p>0.05)。表明夏枯草颗粒联合甲巯咪唑可有效降低GD患者自身抗体水平,调节异常免疫功能,减轻炎性反应,改善甲状腺功能。

The aim of this study was to explore the effect of Xiakucao granules combined with thiamazole on the autoantibody and cytokines in patients with Graves disease（GD）.A total of 80 patients with GD were included in the study,which were randomly divided into the observation group and the control group.The patients in the two groups were given basic treatments,such as high calorie,high vitamin,and low iodine.The patients in the control group were orally administrated with thiamazole tablets,10 mg/time,3 times/d,and the dosage could be adjusted to 15~40 mg/d according to the condition.On this basis,the patients in the observation group were given Xiakucao granules,1 bag/time,2 times/d.After 12-week treatment,the efficacy of the 2 groups was evaluated.The morning fasting peripheral venous blood before and after treatment in the two groups was collected.ECL was used to detect the serum FT_3,FT_4,TSH,TGAb,TRAb,and TMAb.RIA was used to detect TPOAb.ELISA was used to detect the level of TNF-α,IL-6,IL-10,and IFN-γ.The results showed that FT_3 and FT_4levels after treatment in t he observation group were significantly lower than those in th e con trol group,while TSH level was significantly higher than that in the control group（p〈0.05）.TGAb,TPOAb,and TMAb levels after treatment in the observation group were significantly lower than those in the control group（p〈0.05）.TNF-α level after treatment in the observation group was significantly lower than that in the control group,but IL-10 level was significantly higher than that in the control group（p〈0.05）,while the difference of IL-6 and IFN-γ levels between the two groups was not statistically significant（p〉0.05）.This study indicated that Xiakucao granules combined with thiamazole could effectively reduce the autoantibody level in patients with GD,regulate the abnormal immune function,alleviate the inflammatory reaction,and improve the thyroid function.