海藻-昆布药对联合甲巯咪唑治疗初发Graves病疗效观察

Observation on the Curative Effect of Seaweed-Laminaria Combined with Methimazole in the Treatment of Primary Graves’Disease

目的探究海藻-昆布药对联合甲巯咪唑治疗初发Graves病的疗效及安全性。方法选取42例要求接受口服药治疗的初发Graves病患者,随机分成2组,试验组予海藻-昆布药对联合2/3常规剂量甲巯咪唑口服,对照组给予单纯常规剂量甲巯咪唑口服,观察2组4周前后甲状腺功能(FT3、FT4、TSH)、Graves病特异性自身抗体(TRAb)、甲状腺大小(超声评价)、中医证候积分、外周血流式检测、不良反应发生情况。结果2组治疗后与治疗前相比,剔除因不良反应停药改变方案后的总有效率均为100%。甲状腺功能、中医证候积分、TRAb有显著性降低(P<0.05);试验组甲状腺功能达标情况、中医证候积分、TRAb下降程度、甲状腺缩小程度均明显优于对照组(P<0.05)。试验组CD4^(+)CD25^(+)Treg、PD-1^(+)Treg、PD-L1^(+)Treg、PD-1^(+)/PD-L1^(+)Treg较治疗前明显升高(P<0.05)。结论:海藻-昆布药对联合甲巯咪唑治疗初发Graves病能够快速的改善甲状腺功能,改善症状,调节免疫平衡。

Objective To explore the efficacy and safety of seaweed-laminaria combined with methimazole in the treatment of primary Graves’disease.Methods 42 patients with Graves’disease were randomly divided into two groups.The experimental group was treated with seaweed-laminaria combined with 2/3 conventional dose of methimazole,while the control group was only given conventional dose of methimazole.After 4 weeks,the thyroid function(FT3,FT4,TSH),Graves’disease-specific autoantibodies(TRAb),thyroid size(ultrasound evaluation),TCM syndrome score,use Flow cytometry to identify PD-1 and PD-L1 on CD4^(+)CD25^(+)Treg and adverse reactions in the two groups were observed.Results After treatment,compared with before treatment,the total effective rate after excluding discontinuation of the drug due to adverse reactions and the regimen changing was 100%.Thyroid function,TCM syndrome score and TRAb were significantly decreased(P<0.05);the thyroid function,TCM syndrome score,TRAb decline degree and thyroid shrinkage degree of the experimental group were significantly better than those of the control group(P<0.05).CD4^(+)CD25^(+)Treg、PD-1^(+)Treg、PD-L1^(+)Treg、PD-1^(+)/PD-L1^(+)Treg degree of the experimental group were significantly better than those before treatment(P<0.05).Conclusion Seaweed-laminaria combined with methimazole in the treatment of newly diagnosed Graves’disease could quickly control thyroid function,improve symptoms,and regulate immune function.