雷公藤多苷与甲巯咪唑、激素冲击联合治疗对甲亢浸润性突眼患者疗效、甲状腺功能、免疫功能的影响#  

Effect of tripterygium glycosides combined with methimazole and hormone shock on the efficacy,thyroid function,and immune function of patients with hyperthyroidism infiltrating exophthalmos

作　　者：冯贝贝 程慧茹 路艺凡 Feng Bei-bei;Cheng Hui-ru;Lu Yi-fan(Department of Gastroenterology and Endocrinology,Jinshui District General Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市金水区总医院消化与内分泌科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第7期1480-1483,共4页

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20201118)。

摘　　要：目的:探讨雷公藤多苷与甲巯咪唑、激素冲击联合治疗对甲亢浸润性突眼患者疗效、甲状腺功能、免疫功能的影响。方法:选取郑州市金水区总医院2022年1月至2023年6月收治的甲亢浸润性突眼患者86例,随机数字表法分西药组和中药联合组,各43例。西药组采用甲巯咪唑(口服,10 mg·次^(-1),3次·d^(-1))+激素冲击(甲泼尼龙琥珀酸钠,静脉滴注,1000 mg·次^(-1),隔天1次,连续冲击治疗3次为1个疗程,1 m为1个疗程)治疗,中药联合组在西药组的基础上联合雷公藤多苷(口服,20 mg·次^(-1),3次·d^(-1))治疗。治疗3 m后,比较两组临床疗效、症状改善情况,采用放射免疫法检测血清甲状腺受体抗体(Thyroid receptor antibody,TRAb)、甲状腺球蛋白抗体(Thyroglobulin antibodies,TGAb)、甲状腺过氧化酶抗体(Thyroid peroxidase antibody,TPOAb)、白细胞介素-6(Interleukin-6,IL-6)、转化生长因子(Transforming growth factor-β1,TGF-β1)水平,采用酶联免疫法检测血清甲状旁腺激素(Parathyroid hormone,PTH)、类胰岛素一号生长因子(Insulin-like growth factor-1,IGF-1)及其结合蛋白(Insulin-like growth factor binding protein-3,IGFBP-3)水平,采用Attune NxT流式细胞仪检测血清淋巴细胞表面抗原分化簇(Cluster of differentiation,CD)3^(+)、CD4^(+)、CD4^(+)/CD8^(+)。结果:治疗后,中药联合组临床总有效率为88.37%,高于西药组的69.77%(P<0.05);与治疗前相比,治疗后两组眼球突出度、眼压、睑裂高度均明显降低,体质量明显升高,其中中药联合组改善更为显著(P<0.05);与治疗前相比,治疗后两组血清PTH、TGAb、TPOAb、TRAb、TGF-β1、IGF-1、IL-6、IGFBP-3水平均明显降低,血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显升高,其中中药联合组改善更为显著(P<0.05)。结论:雷公藤多苷联合治疗具有更好的临床疗效,可减轻眼部炎症,改善临床症状和甲状腺功能,提升机体免疫功能。Objective:To investigate the effects of tripterygium glycosides combined with methimazole and hormone shock on the efficacy,thyroid function,and immune function of patients with hyperthyroidism infiltrating exophthalmos.Methods:A total of 86 patients with hyperthyroidism infiltrating exophthalmos admitted to Jinshui District General Hospital of Zhengzhou City from January 2022 to June 2023 were selected and divided into the western medicine group and the Chinese medicine combined group by random number table method(n=43).The western medicine group was treated with methimazole(Orally,10 mg·d^(-1),3 times·d^(-1))and hormone shock therapy(methylprednisolone sodium succinate,intravenous infusion,1000 mg·time^(-1),once every other day,continuous impact treatment for 3 times was 1 course,1 month was 1 course),and the Chinese medicine combined group was treated with tripterygium glycosides(Orally,20 mg·d^(-1),3 times·d^(-1))based on the western medicine group.After three months of treatment,the clinical efficacy and symptom improvement were compared between the two groups,the radioimmunoassay was used to detect the serum levels of thyroid receptor antibody(TRAb),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),interleukin-6(IL-6)and transforming growth factor(TGF-β1),enzyme-linked immunoassay was used to detect the serum levels of parathyroid hormone(PTH),insulin-like growth factor-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3),Attune NxT flow cytometry was used to detect the serum levels of cluster of differentiation(CD)3^(+),CD4^(+),CD4^(+)/CD8^(+).Results:After treatment,the total clinical effective rate of the Chinese medicine combined group was 88.37%,which was higher than that of the western medicine group(69.77%,P<0.05).Compared with pretreatment,the ocular protrusion,exophthalmosis,ocular pressure,and eyelid cleft height in the two groups after treatment were significantly lower,the body mass was significantly higher,and the Chinese medicine combined group was more significan

关 键 词：甲亢 浸润性突眼 雷公藤多苷 甲巯咪唑 激素冲击 免疫功能 疗效 

分 类 号：R581.1[医药卫生—内分泌]