丹栀逍遥散对活动期甲状腺相关眼病患者血清Th1/Th2细胞因子调节的干预机制及临床疗效观察  

Intervention Mechanism and Clinical Effect of Danzhi Xiaoyao Powder on Serum Th1 and Th2 Cytokines in Patients with Active Thyroid Associated Ophthalmopathy

作　　者：范艳飞 岳靓 邓爱民 接力钢 宋丹丹 FAN Yanfei;YUE Liang;DENG Aimin;JIE Ligang;SONG Dandan(Peking University Shenzhen Hospital,Shenzhen 518036,China;不详)

机构地区：[1]北京大学深圳医院,广东深圳518036 [2]中国人民解放军南部战区总医院

出　　处：《中国医学创新》2020年第11期86-90,共5页Medical Innovation of China

基　　金：广东省中医药管理局项目(20152029)。

摘　　要：目的:观察丹栀逍遥散对活动期甲状腺相关眼病(TAO)患者血清Th1、Th2细胞因子的影响及临床疗效。方法:将60例甲状腺相关眼病患者按照随机数字表法分为观察组和试验组,每组30例。两组均给予基础治疗和强的松40 mg口服,试验组再给予丹栀逍遥散口服。评估两组治疗前后的突眼度、眼病活动评分(CAS)变化,检测甲状腺激素和相关抗体水平及血清白介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、干扰素γ(IFN-γ)、白介素-4(IL-4)、白介素-6(IL-6)水平。结果:两组治疗后突眼度、CAS与治疗前比较均有明显改善,且试验组均优于对照组(P<0.05);两组治疗后IL-2、IFN-γ、TNF-α均较治疗前显著下降,且试验组均显著低于对照组(P<0.05);研究结束时,对照组强的松累积用量为(2.69±1.14)g,试验组为(1.91±0.92)g,试验组显著少于对照组(P<0.05);对照组发生不良事件20例,试验组10例,试验组显著少于对照组(P<0.05)。结论:活动期TAO患者的内科治疗过程中,联合丹栀逍遥散可以有效改善症状、减少糖皮质激素用量,其机制可能是通过调整Th1/Th2平衡,下调IL-2、IFN-γ、TNF-α的表达实现的。Objective:To observe the influences and clinical effect of Danzhi Xiaoyao Powder on serum Th1 and Th2 cytokines in patients with active thyroid associated ophthalmopathy (TAO).Method:A total of 60 patients with active TAO were randomly divided into the control group and the test group according to the random number table.Two groups were given the basic treatment and Prednisone 40 mg orally,the test group was given Danzhi Xiaoyao Powder orally.The changes of exophthalmos and clinical activity score (CAS) were evaluated and the levels of serum thyroid hormone and related antibodies,as well as serum IL-2,TNF-α,IFN-γ,IL-4,IL-6 concentrations were detected by liquid phase micrography before and after treatment.Result:After treatment,the exophthalmos and CAS of two groups significantly decreased,and the test group were better than those of the control group (P<0.05).After treatment,the serum IL-2,IFN-γ and TNF-α in two groups decreased significantly,and the serum IL-2,IFN-γ and TNF-α in the test group were lower than those of the control group (P<0.05).At the end of the test,the total amount of prednisone in the control group was (2.69±1.14) g,and the test group was (1.91±0.92) g,and the test group was significantly less than that of the control group (P<0.05).There were 20 adverse events in the control group and 10 adverse events in the test group,and the number of adverse events in the test group was significantly lower than that in the control group (P<0.05).Conclusion:In the process of internal medicine of the active TAO,the combination of Danzhi Xiaoyao Powder may further improve the clinical symptoms and reduce the amount of glucocorticoid,the improvement may be achieved by adjusting the balance of Th1/Th2 and down-regulating the expression of IL-2,IFN-γand TNF-α.

关 键 词：甲状腺相关眼病 活动期评分 TH1/TH2细胞因子 丹栀逍遥散 糖皮质激素 

分 类 号：R581[医药卫生—内分泌] R771.3[医药卫生—内科学]