苦参对抗甲状腺药物致Graves病患者白细胞减少的影响

Effects of Sophora flavescens on Graves' disease patients with leucopenia induced by anti-thyroid drug

目的针对Graves病(GD)经抗甲状腺药物(ATD)治疗后出现白细胞减少患者,通过苦参治疗后观察疗效,并初步探讨其可能的作用机制。方法随机选取2014年1月至2015年10月我科收治的ATD致白细胞减少的GD患者共计30例作为研究对象,检测记录患者外周血白细胞(WBC)、粒细胞(NE)数量,及血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)含量,随后患者在继续ATD治疗同时联合苦参应用,10 d后再次检测外周血WBC、NE数量及血清中IL-1、IL-6含量。结果 GD患者ATD治疗后外周血WBC、NE数量、血清IL-1、IL-6含量分别为(3.45±0.25)×109/L、(1.72±0.21)×109/L、(0.29±0.06)ng/m L、(1.40±0.14)ng/m L,联合苦参治疗后患者外周血WBC、NE数量、血清IL-1、IL-6含量分别为(4.31±0.38)×109/L、(2.34±0.28)×109/L、(0.40±0.07)ng/m L、(1.67±0.08)ng/m L,差异均具有统计学意义(P<0.05或0.01)。血清IL-1、IL-6水平与外周血WBC、NE数量呈直线正相关(r=0.595,0.456;0.473,0.467,P<0.05或0.01)。结论苦参对ATD致GD白细胞减少患者的治疗能明显提升其WBC和NE数量,究其原因可能是通过促进体内免疫细胞因子IL-1、IL-6的表达进而刺激患者骨髓造血从而达到治疗效果。

Objective To observe the therapeutic effect of Sophora flavescens on Graves’ disease(GD) patients with leucopenia after treatment of anti-thyroid drug(ATD), and to make a preliminary discussion on the possible mechanism of its formation. Methods Thirty GD patients with leucopenia after ATD treatment from January 2014 to October 2015 in our department were randomly chosen to detect peripheral white blood cell(WBC), neutrophilic granulocyte(NE) counts and blood serum interleukin 1(IL-1), interleukin 6(IL-6) levels. After that, these patients were treated with Sophora flavescens and ATD for ten days, and WBC, NE counts, IL-1, IL-6 levels would be again checked out.Results After ATD treatment, peripheral WBC, NE counts and blood serum IL-1, IL-6 levels were(3.45±0.25)×109/L,(1.72 ± 0.21) × 109/L,(0.29 ± 0.06) ng/m L,(1.40 ± 0.14) ng/m L, respectively. After Sophora flavescens and ATD treatment,above indexes were(4.31±0.38)×109/L,(2.34±0.28)×109/L,(0.40±0.07) ng/m L,(1.67±0.08) ng/m L, respectively. The difference of each index showed statistical significance(P<0.05 or 0.01). Then, we found there was a positive correlation between IL-1, IL-6 levels and WBC, NE counts(r=0.595, 0.456; 0.473, 0.467, P<0.05 or 0.01 for all). Conclusion After ATD treatment, WBC and NE counts of partial patients decreased, while Sophora flavescens would obviously elevate WBC and NE counts of GD patients with leucopenia. The possible mechanism of its formation is that Sophora flavescens promote IL-1, IL-6 levels of these patients to stimulate the proliferation and differentiation of blood cells in the bone marrow.