抑亢丸治疗毒性弥漫性甲状腺肿的疗效及对自身抗体和脂肪细胞因子的影响

目的: 探讨抑亢丸治疗毒性弥漫性甲状腺肿(Graves病,GD)的疗效及对自身抗体和脂肪细胞因子的影响。 方法: 92例GD患者随机按数字法分为观察组和对照组各46例。对照组采用甲巯咪唑10 mg/次,3次/d,并根据甲状腺功能指标调整剂量。观察组在对照组治疗的基础上加用抑亢丸,7.5 g/次,2次/d。疗程为12周。记录治疗前、治疗后4、8、12周主要症状、体征积分变化;检测治疗前后血清促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、血清甲状腺素(T4)、血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4);检测治疗前后抗甲状腺球蛋白抗体(TGAb)、抗甲状腺微粒体抗体(TMAb)、检测过氧化物酶抗体(TPOAb)水平;检测治疗前后血清游离脂肪酸(FFA)、脂联素(APN)瘦素(LP)及抵抗素(ADSF)水平。 结果: 观察组总有效率95.6%,优于对照组的82.6%(P<0.05);观察组主要症状、体征积分在8周和12周下降幅度优于对照组(P<0.01);治疗后观察组TSH水平高于对照组,T3,T4,FT3,FT4水平低于对照组(P<0.05或P<0.01);治疗后观察组TGAb、TMAb及TPOAb低于对照组(P<0.01);治疗后观察组FFA,APN和ADSF水平低于对照组(P<0.01),LP水平高于对照组(P<0.01)。 结论: 抑亢丸能明显改善GD临床症状,提高临床疗效,其机理可能与降低GD患者自身抗体水平,调节异常免疫有关;抑亢丸还能调节GD患者脂肪细胞因子水平,从而改善GD患者改善异常的糖脂代谢。

The Curative Effect of Yikang Pill on Graves Disease and Its Influences on Autoantibodies and Adipocytokines

Objective: The purpose is to study the curative effect of Yi Kang pill on Graves Disease (GD) and its influences on autoantibodies and adipocytokines. Method: Ninety-two cases of GD patients were randomly divided into control group (46 cases) and observation group (46 cases) according to digital method. Patients in the control group took methimazole, 10 mg/time, 3 times/day, adjusting the dosage according to the index of thyroid function. On the basis of treatment in the control group, patients in the observation group took Yikang pill, 7.5 g/time, 2 times/day. Treatment course was 12 weeks. The cardinal symptom and signs of integral change of before and after the treatment of 4, 8 and 12 weeks were recorded. Serum thyroid stimulating hormone (TSH), triiodothyronine (T3), serum thyroxine (T4), serum free triiodothyronine (FT3) and serum free thyroxine (FT4) were detected before and after the treatment. Levels of anti-thyroglobulin antibody (TGAb), thyroid microsomal antibody (TMAb) and thyroperoxidase antibodies (TPOAb) were detected before and after the treatment. Levels of serum free fatty acid (FFA), adiponectin (APN), leptin (LP) and resistin (ADSF) were detected before and after the treatment. Result: The total effect of the observation group was 95.6%, superior to 82.6% of the control group (P<0.05). The decline range of cardinal symptom and signs of integral change of observation group was of better than that of control group in eighth weeks and twelfth weeks after the treatment (P<0.01). After treatment, TSH level of observation group was higher than the control group, while levels of T3, T4, FT3 and FT4 were lower than the control group (P<0.05 or P<0.01). TGAb, TPOAb and TMAb of observation group were lower than the control group (P<0.01). Levels of FFA, APN and ASDF were lower than the control group (P<0.01), while the LP level higher than the control group (P<0.01). Conclusion: Yikang Pill can obviously improve clinical symptoms of GD patient, improving the clinical curative effect. Its mechanism may be related to decrease autoantibodies levels of GD patients and to adjust abnormal immune. Yikang Pill can also regulate adipocytokines level of GD patients, further improving abnormal glucolipid metabolism of GD patients.