“甲亢方”治疗阴虚火旺型Graves病临床疗效及对免疫功能的影响  

Clinical Efficacy of Jiakang Prescription in the Treatment of Graves’Disease of Yin Deficiency Resulting in Vigorous Fire Type and Its Effect on Immune Function

作　　者：潘凯瑶 李东玲 刘峰 季兵 PAN Kai-Yao;LI Dong-Ling;LIU Feng;JI Bing(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Dept.of Endocrinology,Clifford Hospital,Guangzhou 511496 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东祈福医院内分泌科,广东广州511496

出　　处：《广州中医药大学学报》2023年第9期2190-2198,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20231259);广州市卫健委资助项目(编号:20202A011031)。

摘　　要：【目的】探讨“甲亢方”联合常规西药治疗阴虚火旺型Graves病(也称弥漫性毒性甲状腺肿)临床疗效及其对免疫功能的影响。【方法】将57例阴虚火旺证Graves病患者随机分为对照组29例和治疗组28例。对照组给予常规抗甲状腺药物(甲巯咪唑)治疗,治疗组在对照组的基础上加服“甲亢方”治疗,连续治疗12周。观察2组患者治疗前后中医证候积分、甲状腺功能指标[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]、甲状腺自身免疫指标[促甲状腺素受体抗体(TRAb)、抗甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)]、血清免疫球蛋白G(IgG)和白细胞介素4(IL-4)的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)治疗12周后,治疗组的总有效率为96.43%(27/28),对照组为86.21%(25/29),组间比较,治疗组的临床疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.05),且治疗组的下降幅度明显优于对照组(P<0.05)。(3)治疗后,2组患者的TSH、FT3、FT4等甲状腺功能指标均较治疗前明显改善(P<0.05),且治疗组的改善幅度均明显优于对照组(P<0.05)。(4)治疗后,2组患者的TRAb、TgAb、TPOAb等甲状腺自身免疫指标均较治疗前明显改善(P<0.05),且治疗组的改善幅度均明显优于对照组(P<0.05)。(5)治疗后,2组患者血清IgG、IL-4水平均较治疗前明显下降(P<0.05),且治疗组的下降幅度均明显优于对照组(P<0.05或P<0.01)。(6)治疗组的不良反应发生率为7.14%(2/28),明显低于对照组的44.83%(13/29),差异有统计学意义(P<0.05)。【结论】“甲亢方”联合常规西药治疗Graves病临床疗效确切,能够有效降低中医证候积分,缓解临床不适症状,改善甲状腺功能,减轻炎症反应,促进免疫功能恢复,且不良反应少,安全性高。Objective To investigate the clinical efficacy of the Jiakang Prescription in combination with conventional western medicine for the treatment of Graves’disease with yin deficiency resulting in vigorous fire type and to observe its effect on immune function.Methods Fifty-seven cases of Graves’disease patients with yin deficiency resulting in vigorous fire type were randomly divided into 29 cases in the control group and 28 cases in the treatment group.The control group was given conventional anti-thyroid medicine Methimazole Tablets,while the treatment group was treated with Jiakang Prescription on the basis of treatment for the control group.Both groups were treated for 12 weeks.Before and after the treatment,the patients in both groups were observed in terms of traditional Chinese medicine(TCM)syndrome scores,thyroid function indexes of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),and free thyroxine(FT4),thyroid autoimmune indexes of thyrotropin receptor antibody(TRAb),anti-thyroglobulin antibody(TgAb),and thyroid peroxidase antibody(TPOAb),serum immunoglobulin G(IgG)and interleukin 4(IL-4).After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 12 weeks of treatment,the overall effective rate of the treatment group was 96.43%(27/28)and that of the control group was 86.21%(25/29),and the intergroup comparison showed that the clinical efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores of patients in both groups were significantly decreased compared with those before treatment(P<0.05),and the degree of the decrease in the treatment group was significantly superior to that in the control group(P<0.05).(3)After treatment,the thyroid function indices such as TSH,FT3 and FT4 in both groups were significantly improved compared with those before treatment(P<0.05),and the improvement in the treatment group was significantly superior to that in the control group(P<0.05).(4)A

关 键 词：甲亢方 GRAVES病 甲状腺功能 免疫功能 炎症反应 

分 类 号：R259.811[医药卫生—中西医结合]