宁瘿方联合小剂量甲巯咪唑治疗Graves病疗效及对患者促炎细胞因子的影响  

Efficacy of Ningying decoction combined with low-dose methimazole in the treatment of newly diagnosed Graves’disease and its effect on pro-inflammatory cytokines in patients

作　　者：黄昱钦 李青春 柳国斌[2] 陶枫[1] 王雪菲 陈易 HUANG Yuqin;LI Qingchun;LIU Guobin;TAO Feng;WANG Xuefei;CHEN Yi(Department of Endocrinology,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属市中医医院内分泌科,上海200071 [2]上海中医药大学附属曙光医院,上海201203

出　　处：《陕西中医》2025年第4期476-480,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：上海市科技计划项目(23Y11921500);上海市嘉定区卫健委中医药科研面上项目(2024-KY-ZYY-06)。

摘　　要：目的:评估宁瘿方联合小剂量甲巯咪唑方案在新诊断Graves病中的临床疗效及对患者促炎细胞因子的影响。方法:本研究共招募了120例初次诊断为Graves病的患者,将患者随机分为两组,每组60例。试验组接受宁瘿方联合小剂量甲巯咪唑(10 mg)治疗,对照组则接受常规剂量甲巯咪唑(20~40 mg)治疗。所有患者均连续治疗12周,治疗期间监测甲状腺功能指标(FT3、FT4、TSH)、甲状腺相关抗体(TRAb、TPOAb、TgAb)、促炎细胞因子白介素-1β(IL-1β)和白介素-6(IL-6)、抑郁及焦虑自评量表(SDS、SAS)得分以及36项简短健康问卷(SF-36)得分,并评估肝功能和血常规等安全性指标。结果:共有9例患者脱落,最终纳入统计分析的患者共111例。治疗12周后,试验组总有效率显著高于对照组(P<0.05)。两组甲状腺功能指标改善情况相似(P>0.05);试验组甲状腺相关抗体显著下降,SDS、SAS、SF-36评分均改善,IL-1β、IL-6水平下降,且肝功能损伤及粒细胞减少不良事件发生率更低(均P<0.05)。结论:在新诊断Graves病的治疗中,宁瘿方联用小剂量甲巯咪唑方案临床疗效及安全性优于常规剂量的甲巯咪唑单药治疗,且可降低促炎细胞因子IL-1β、IL-6水平。Objective:To evaluate the clinical efficacy and safety of Ningying decoction combined with low-dose methimazole in the treatment of newly diagnosed Graves’disease,as well as its effects on pro-inflammatory cytokines in patients.Methods:A total of 120 patients newly diagnosed with Graves’disease were recruited for this study and randomly divided into two groups,with 60 patients in each group.The experimental group received Ningying decoction combined with low-dose methimazole(10 mg),while the control group received a conventional dose of methimazole(20~40 mg).All patients were treated continuously for 12 weeks,during which thyroid function indicators(FT3,FT4,TSH),thyroid-related antibodies(TRAb,TPOAb,TgAb),pro-inflammatory cytokines including interleukin-1β(IL-1β)and interleukin-6(IL-6),as well as self-reported depression and anxiety scales(SDS,SAS)scores and the 36-item Short Form Health Survey(SF-36)scores were monitored.Additionally,safety indicators including liver function and complete blood count were assessed.Results:A total of 9 patients dropped out,and ultimately,111 patients were included in the statistical analysis.After 12 weeks of treatment,the total effective rate of experimental group was significantly higher than that of control group(P<0.05).The improvement of thyroid function indexes in the two groups was similar(P>0.05).Thyroid related antibodies were significantly decreased,SDS,SAS and SF-36 scores were improved,IL-1β and IL-6 levels were decreased,and the incidence of liver function injury and granulopenia adverse events were lower in experimental group(all P<0.05).Conclusion:In the treatment of newly diagnosed Graves’disease,the combination of Ningying decoction with low-dose methimazole demonstrates superior clinical efficacy and safety compared to conventional-dose methimazole monotherapy,and it can reduce the levels of pro-inflammatory cytokines IL-1β and IL-6.

关 键 词：GRAVES病 宁瘿方 甲巯咪唑 促甲状腺抗体受体 白介素-1Β 白介素-6 

分 类 号：R581.3[医药卫生—内分泌]