柴芍二至散治疗Graves病临床观察

Clinical Effect of Chaishao Erzhi Powder in Treatment of Graves’ Disease

目的观察柴芍二至散治疗毒性弥漫性甲状腺肿(Graves病)的临床疗效及对谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、丙二醛(malondialdehyde,MDA)的影响,探讨其治疗Graves病的作用机制。方法将60例肝虚痰结型Graves病患者随机分为治疗组和对照组,每组各30例。对照组采用甲巯咪唑进行治疗,治疗组在对照组基础上加服柴芍二至散,两组疗程均为12周。比较两组中医证候疗效、甲状腺功能[游离三碘甲状腺原氨酸(free triiodothylamine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)]、血清促甲状腺受体抗体(thyrotropin receptor antibody,TRAb)、GSH-px、MDA水平。结果与对照组比较,治疗组血清中FT3、FT4、TRAb水平显著降低(P<0.05),TSH水平显著升高(P<0.05);两组血清GSH-px、MDA水平均优于治疗前(P<0.05),治疗组改善更明显(P<0.05);治疗组中医证候疗效明显优于对照组(P<0.05)。结论柴芍二至散治疗Graves病疗效显著,其机制可能与改善GSH-px、MDA的表达,调节机体抗氧化水平有关。

Objective To investigate the clinical effect and mechanism of action of Chaishao Erzhi Powder in the treatment of toxic diffuse goiter(Graves disease),as well as its effect on glutathione peroxidase(GSH-Px)and malondialdehyde(MDA).Methods A total of 60 patients with Graves disease with liver deficiency and phlegm stagnation were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group were given methimazole,and those in the treatment group were given Chaishao Erzhi Powder in addition to the treatment in the control group.The course of treatment was 12 weeks for both groups.The two groups were compared in terms of clinical outcome of traditional Chinese medicine(TCM)syndrome,thyroid function[free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone(TSH)],and serum levels of thyrotropin receptor antibody(TRAb),GSH-px,and MDA.Results Compared with the control group,the treatment group had significant reductions in the serum levels of FT3,FT4,and TRAb(P<0.05)and a significant increase in TSH level(P<0.05).Both groups had significantly improved serum levels of GSH-px and MDA after treatment(P<0.05),and the treatment group had significantly greater improvements than the control group(P<0.05).The treatment group had a significantly better clinical outcome of TCM syndrome than the control group(P<0.05).Conclusion Chaishao Erzhi Powder has a good clinical effect in the treatment of Graves disease,possibly by improving the expression of GSH-px and MDA and regulating the antioxidant level in the body.