疏肝清热方对桥本甲状腺炎患者干预的临床观察及CCR5、CD30的表达与相关性研究  

Liver-discharging and Heat-clearing Therapy for Patients with Hashimoto's Thyroiditis and Orrelation Study on Expressions of CCR5 and CD30

作　　者：钟欣婵 郑敏[1] 张丹[1] 杨宏杰[1] 李昀昊[1] 范朝华[1] 张强[1] 王燕燕[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《辽宁中医杂志》2016年第1期76-79,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市教育委员会科研创新项目(2012JW49)

摘　　要：目的:观察疏肝清热方对桥本甲状腺炎(HT)患者甲状腺过氧化酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)、促甲状腺素受体抗体(TR-Ab)、促甲状腺激素(TSH)以及临床症状的影响,评价疏肝清热方的临床疗效,研究外周淋巴细胞CCR5、CD30在HT患者中的表达,探讨疏肝清热方干预Th1/Th2的机制。方法:甲状腺功能正常或亚临床甲状腺功能减退的HT患者80例,随机分为中药组和优甲乐组各40例,健康对照组20例。中药组单纯服用中药复方颗粒剂,优甲乐组单纯服用小剂量优甲乐25μg,1次/d。结果:中药组治疗后TPO-Ab水平较治疗前明显下降(P≤0.01),与优甲乐组比较有显著性差异(P≤0.05),中药组治疗后中医证候积分下降明显(P≤0.01),与优甲乐组比较有显著性差异(P≤0.05),HT患者的CD30%和CCR5%的表达均高于健康对照组(P≤0.01),与TPO-Ab、Tg-Ab、TRAb呈正相关。结论:疏肝清热方可以改善HT患者的抗体水平及临床症状,CCR5、CD30可作为评价HT的指标,Th1和Th2细胞可能共同参与了HT的发病。Objective： By observing the effect of liver- discharging and heat- clearing therapy for the levels of TPO- Ab,Tg- Ab,TG- Ab,TSH and clinical symptoms of patients with Hashimoto＇ s thyroiditis,we evaluated the clinical effect. By researching the expressions of CCR5 and CD30 on peripheral lymphocytes in HT,we discussed the intervention mechanism of the therapy by Th1 / Th2 cells. Methods： 80 normal thyroid function or sub- clinical hypothyroidism patients with HT were randomly divided into two groups（ n = 40） and healthy controls（ n = 20）. The treatment group took Chinese herbal compound granules. The control group used a small doses of Euthyrox（ 25 μg）,once a day. Results： After therapy,the levels of TPO- Ab and TCM syndrome integral of treatment group were significantly increased（ P≤0. 01）,which compared with control group was significant（ P≤0. 05）.The proportion of CCR5 and CD30 cells were higher in HT group than that of the healthy control group（ P≤0. 01） and positively correlated with thyroid auto antibodies. Conclusion： The results suggested that the liver- discharging and heat- clearing therapy can improve the level of thyroid auto antibodies and clinical symptoms. CCR5 and CD30 can be used as the evaluation indexes of HT and may be involved in pathogenesis of HT.

关 键 词：桥本甲状腺炎 中医药疗法 TH1/TH2 CCR5 CD30 流式细胞术 

分 类 号：R581.4[医药卫生—内分泌]