131碘和甲亢欣联合治疗格雷夫斯病的临床应用

目的了解131碘和中药甲亢欣口服液联合治疗格雷夫斯病的临床疗效.方法147例格雷夫斯病患者分为3组,131碘组49例,他巴唑组49例,甲亢欣联合131碘组49例;131碘组和甲亢欣联合131碘组的131碘剂量为每克甲状腺组织3.70～5.55 MBq(100～150μCi),一次性给药(以甲状腺24小时内最高吸131碘率校正);他巴唑组15～30mg/d,2个月后根据甲状腺激素变化情况减量;甲亢欣联合131碘组使用甲亢欣口服液,口服131碘后第2天服用,每日3次,每次20 ml,共服2周;治疗后6个月观察治疗总有效率、多汗、乏力、失眠、烦躁和四肢震颤等主要症状及体质量和甲状腺激素水平.结果他巴唑组、131碘组、甲亢欣联合131碘组治疗后6个月的有效率分别为85.7%、57.1%、91.7%;131碘组、甲亢欣联合131碘组有效率高于他巴唑组(P＜0.01);甲亢欣联合131碘组治疗后1个月和3个月多汗、乏力、失眠、烦躁和四肢震颤症状的改善优于131碘组(P＜0.05),未发现明显不良反应;131碘组、甲亢欣联合131碘组游离三碘甲状腺原氨酸、游离甲状腺素明显低于他巴唑组(P＜0.05);131碘组、甲亢欣联合131碘组促甲状腺素明显高于他巴唑组(P＜0.05).结论131碘治疗甲亢疗效肯定,中西医结合即甲亢欣联合131碘能提高甲亢的治疗效果,无明显不良反应.

Combined treatment of Graves'''' disease with radioiodine and a Traditional Chinese Medicine herb preparation Jiakangxin

Objective To investigate the effect of radioiodine with Jiakangxin solutions(JKX) on hyperthyroidism. Methods One hundred and forty-seven cases of Graves' disease were divided into radioiodine group(49 cases), tapazol group(49 cases), and JKX with radioiodine(49 cases) at random. The effects were evaluated by total effective rate, using principal symptoms, body mass, thyroid hormones after 6 months. Results The total effective rates of radioiodine, tapazol and JKX with radioiodine groups were 85.7%, 57.1%, 91.7%, respectively. The radioiodine group and JKX with radioiodine group had better total effect than tapazol group(P< 0.05). JKX with radioiodine had better effect in improved principal symptoms(hidrosis, inertia, hyposomnia, dysphoria and limbs jitter) than radioiodine group after 6 mouths' therapy(P< 0.01). Free triiodothyronine and free thyroxine in radioiodine group and JKX with radioiodine group were lower than those in tapazol group(P< 0.05). Thyroid stimulate hormone in radioiodine group and JKX with radioiodine group was higher than that in tapazol group(P< 0.05). Conclusion The effect on hyperthyroidism treatment by radioiodine was satisfactory. The combination of Chinese herb preparation JKX with Western medicine radioiodine could enhance the curative effect of hyperthyroidism without obvious side effects.