平睛汤合针刺对活动期甲状腺相关眼病患者的临床疗效  

Clinical effects of Pingjing Decoction combined with acupuncture on patients with thyroid-associated ophthalmopathy in active stage

作　　者：索文栋 陈跃来 李红[1] SUO Wen-dong;CHEN Yue-lai;LI Hong(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中成药》2023年第1期81-85,共5页Chinese Traditional Patent Medicine

基　　金：上海市科学技术委员会科研计划项目(19140904600);上海市科学技术委员会医学引导类(中医)项目(18401900800);上海市中医药事业发展三年行动计划(2018-2020-CCCX-2002-08)。

摘　　要：目的考察睛汤合针刺对活动期甲状腺相关眼病患者的临床疗效。方法64例患者随机分为对照组和观察组,每组32例,在维持Graves病常规治疗基础上,对照组给予醋酸泼尼松龙,观察组给予平睛汤联合针刺,疗程24周。检测临床疗效、中医证候疗效和评分、MRD1、突眼度、视力、CAS评分、TED-QOL评分、甲状腺功能指标(FT3、FT4、TSH)、TRAb、甲状腺体积、炎性因子(IL-6、IL-17)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、安全性指标变化。结果观察组临床总有效率、中医证候总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、MRD1、突眼度、TED-QOL评分、CD8^(+)降低(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高(P<0.05),甲状腺体积缩小(P<0.05),以观察组更明显(P<0.05),而甲状腺功能指标无明显变化(P>0.05);观察组视力升高(P<0.05),CAS评分、TRAb、炎性因子降低(P<0.05),而对照组无明显变化(P>0.05)。2组均未发现严重不良反应。结论平睛汤联合针刺可安全有效地改善活动期甲状腺相关眼病患者临床症状,其机制可能与增强机体免疫功能、降低促甲状腺激素受体抗体水平有关。AIM To investigate the clinical effects of Pingjing Decoction combined with acupuncture on patients with thyroid-associated ophthalmopathy in active stage.METHODS Sixty-four patients were randomly assigned into control group(32 cases)for 24-week intervention of both prednisolone acetate and maintaining conventional treatment for Graves disease,and observation group(32 cases)for 24-week intervention of Pingjing Decoction,acupuncture and maintaining conventional treatment for Graves disease.The changes in clinical efficacy,TCM syndrome efficacy and scores,MRD1,exophthalmos degree,visual acuity,CAS score,TED-QOL score,thyroid function indices(FT3,FT4,TSH),TRAb,thyroid volume,inflammatory factors(IL-6,IL-17),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and safety indices were detected.RESULTS The observation group demonstrated higher total clinical effective rate and total TCM syndrome effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,MRD1,exophthalmos degree,TED-QOL score and CD8^(+)(P<0.05),increased CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)(P<0.05),and reduced thyroid volume(P<0.05),especially for the observation group(P<0.05),while no obvious changes in thyroid function indices were found(P>0.05);the observation group exhibited increased visual acuity(P<0.05),and decreased CAS score,TRAb and inflammatory factors(P<0.05),while those in the control group showed no obvious changes(P>0.05).No serious adverse reactions were observable in the two groups.CONCLUSION For the patients with thyroid-associated ophthalmopathy in active stage,Pingjing Decoction combined with acupuncture can safely and effectively improve clinical symptoms,whose mechanisms may contribute to the enhancement of body immune functions and reduction of thyroid stimulating hormone receptor antibody levels.

关 键 词：平睛汤 针刺 甲状腺相关眼病 活动期 

分 类 号：R287[医药卫生—中药学]