健脾消瘿汤治疗桥本甲状腺炎的临床研究
|
摘要
目的:观察健脾消瘿汤对桥本甲状腺炎患者抗过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)及γ干扰素/白细胞介素4(IFN-γ/IL-4)比值的影响。方法:将桥本甲状腺炎患者108例采用随机、对照、平行试验设计方法分为中药组36例、西药组36例、中药+西药组36例,中药组口服健脾消瘿汤早晚各1次,200 mL/次;西药组口服硒酵母胶囊早晚各2粒;中药+西药组给予健脾消瘿汤及硒酵母胶囊,服用方法同上,连续用药12周后观察治疗前后3组患者的临床症状、体征、TPOAb、TGAb及IFN-γ/IL-4比值改善情况。结果:与治疗前比较,中药组和中药+西药组TPOAb、TGAb下降,差异有统计学意义(P<0.01),西药组无明显下降(P>0.05);中药组和中药+西药组临床症状、体征和IFN-γ/IL-4比值较治疗前改善,差异有统计学意义(P<0.01)。组间比较,中药组、中药+西药组在降低TPOAb、TGAb及改善临床症状、体征方面均优于西药组(P<0.01),在降低IFN-γ/IL-4比值方面3组比较差异无统计学意义(P>0.05)。结论:健脾消瘿汤可明显降低桥本甲状腺炎患者自身抗体TPOAb、TGAb滴度,改善患者临床症状、体征,临床疗效优于硒酵母;同时可降低IFN-γ/IL-4比值,疗效与硒酵母相当。
Objective: To observe the influence of JianPi XiaoYing decoction on TPOAb, TGAb and IFN-γ/IL-4 on the patients with Hashimoto's thyroiditis(HT). Methods: All 108 HT patients were divided into 36 cases of the herbal group, 36 cases of the group of western medicine and 36 cases of the group of herbs and Western medicine by randomized, controlled, parallel experimental design method, the herbal group took JianPi XiaoYing decoction in the morning and evening, 200 mL each time; the group of Western medicine took selenium yeast capsules, two pills each time, in the morning and evening, the group of herbs and Western medicine were given JianPi XiaoYing decoction and selenium yeast capsules, the incidence of adverse reactions, the improvements of IFN-γ, IL-4, TGAb and TPOAb, body signs and clinical symptoms of the patients in three groups were observed before treating and after treating after they were treated for 12 weeks consecutively. Results: Compared with before treating, the levels of TGAb and TPOAb lowered in the herbal group and the group of herbs and Western medicine,and the difference had statistical meaning(P <0.01), there was no decrease in the group of Western mediicine(P>0.05); clinical symptoms, body signs and the ratio of IFN-γ/IL-4 improved compared with before treating, in the herbal group and the group of herbs and Western medicine and the difference showed statistical meaning(P<0.01).The comparisons between the groups, the herbal group, the group of herbs and Western medicine were superior to the group of Western medicine in reducing TGAb and TPOAb, improving clinical symptoms and body signs(P<0.01),the difference had no statistical meaning in the comparisons among three groups in the aspects of lowering IFN-γ/IL-4(P>0.05). Conclusion: JianPi XiaoYing decoction could notably decrease the titer of TGAb and TPOAb of HT patients, improve clinical symptoms and body signs, its clinical effects are superior to these of selenium yeast,simultaneously it could lower the ratio of IFN-γ/IL-4, its effects are equivalent to these of selenium yeast.
Objective: To observe the influence of JianPi XiaoYing decoction on TPOAb, TGAb and IFN-γ/IL-4 on the patients with Hashimoto's thyroiditis(HT). Methods: All 108 HT patients were divided into 36 cases of the herbal group, 36 cases of the group of western medicine and 36 cases of the group of herbs and Western medicine by randomized, controlled, parallel experimental design method, the herbal group took JianPi XiaoYing decoction in the morning and evening, 200 mL each time; the group of Western medicine took selenium yeast capsules, two pills each time, in the morning and evening, the group of herbs and Western medicine were given JianPi XiaoYing decoction and selenium yeast capsules, the incidence of adverse reactions, the improvements of IFN-γ, IL-4, TGAb and TPOAb, body signs and clinical symptoms of the patients in three groups were observed before treating and after treating after they were treated for 12 weeks consecutively. Results: Compared with before treating, the levels of TGAb and TPOAb lowered in the herbal group and the group of herbs and Western medicine,and the difference had statistical meaning(P <0.01), there was no decrease in the group of Western mediicine(P>0.05); clinical symptoms, body signs and the ratio of IFN-γ/IL-4 improved compared with before treating, in the herbal group and the group of herbs and Western medicine and the difference showed statistical meaning(P<0.01).The comparisons between the groups, the herbal group, the group of herbs and Western medicine were superior to the group of Western medicine in reducing TGAb and TPOAb, improving clinical symptoms and body signs(P<0.01),the difference had no statistical meaning in the comparisons among three groups in the aspects of lowering IFN-γ/IL-4(P>0.05). Conclusion: JianPi XiaoYing decoction could notably decrease the titer of TGAb and TPOAb of HT patients, improve clinical symptoms and body signs, its clinical effects are superior to these of selenium yeast,simultaneously it could lower the ratio of IFN-γ/IL-4, its effects are equivalent to these of selenium yeast.
引文
[1]范尧夫,刘克冕,张会峰,等.中西医结合治疗桥本甲状腺炎甲状腺功能减退的Meta分析[J].中国实验方剂学杂志,2016,22(3):221-224.
[2]滕卫平,曾正陪,李光伟,等.中国甲状腺疾病诊治指南[M].北京:中华医学会内分泌学分会,2008:53.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:230-231.
[4]陆灏珠,钟南山,陆再英,等.内科学[M].8版.北京:人民卫生出版社,2013:697-698.
[5]李苗,刘百灵,张晨,等.SEPS1基因多态性与汉族人群桥本甲状腺炎的遗传关联[J].西安交通大学学报:医学版,2017,38(2):235-241.
[6]赵闫丽,黄琦.桥本甲状腺炎Th1/Th2偏移的研究及治疗进展[J].浙江中医药大学学报,2014,38(1):107-109.
[7]王岚,钟建美.Th1/Th2细胞因子检测在自身免疫性甲状腺疾病中的诊断价值[J].医学检验与临床,2010,21(3):14-15.
[8]盛阳,吴深涛.吴深涛从“火郁发之”论治桥本甲状腺炎[J].中国中医药信息杂志,2013,20(9):88-89.
[9]刘印华,赵志强,李树义,等.黄芪多糖对免疫功能影响的体内实验研究[J].河北医药,2015,37(4):485-487.
[10]刘婧茹,王清.夏枯草胶囊对桥本甲状腺炎患者自身抗体及Th17细胞的影响[J].中国老年学杂志,2012,32(24):5413-5415.
[11]李双林.白花蛇舌草对寻常型银屑病外周血T细胞亚群、血清IL-8的影响[J].实用检验医师杂志,2010,2(2):93-95.
[12]程琪庆,程春松,刘智祖,等.白花蛇舌草和水线草的鉴别与药用进展比较[J].中草药,2017,48(20):4328-4338.
[13]徐波,张建超,付作明,等.地锦草总黄酮对小鼠免疫功能及细胞因子m RNA的表达影响[J].中兽医医药杂志,2010,29(5):22-26.
[14]刘奔,郭鹏荣,盛玉文,等.灵芝多糖对荷膀胱癌BLG细胞小鼠化疗后腹腔巨噬细胞的影响及相关免疫机制研究[J].中国全科医学,2015,18(24):2971-2975.
[15]蒋苗苗.灵芝多糖拮抗B16F10肿瘤上清对同基因小鼠脾淋巴细胞分逆IL-2、IFN-γ、TNF-α的抑制作用[D].承德医学院,2013.
[16]李国华,李晔,梅锅玲,等.灵芝三萜类化合物研究进展[J].中草药,2015,46(12):1858-1862.
[2]滕卫平,曾正陪,李光伟,等.中国甲状腺疾病诊治指南[M].北京:中华医学会内分泌学分会,2008:53.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:230-231.
[4]陆灏珠,钟南山,陆再英,等.内科学[M].8版.北京:人民卫生出版社,2013:697-698.
[5]李苗,刘百灵,张晨,等.SEPS1基因多态性与汉族人群桥本甲状腺炎的遗传关联[J].西安交通大学学报:医学版,2017,38(2):235-241.
[6]赵闫丽,黄琦.桥本甲状腺炎Th1/Th2偏移的研究及治疗进展[J].浙江中医药大学学报,2014,38(1):107-109.
[7]王岚,钟建美.Th1/Th2细胞因子检测在自身免疫性甲状腺疾病中的诊断价值[J].医学检验与临床,2010,21(3):14-15.
[8]盛阳,吴深涛.吴深涛从“火郁发之”论治桥本甲状腺炎[J].中国中医药信息杂志,2013,20(9):88-89.
[9]刘印华,赵志强,李树义,等.黄芪多糖对免疫功能影响的体内实验研究[J].河北医药,2015,37(4):485-487.
[10]刘婧茹,王清.夏枯草胶囊对桥本甲状腺炎患者自身抗体及Th17细胞的影响[J].中国老年学杂志,2012,32(24):5413-5415.
[11]李双林.白花蛇舌草对寻常型银屑病外周血T细胞亚群、血清IL-8的影响[J].实用检验医师杂志,2010,2(2):93-95.
[12]程琪庆,程春松,刘智祖,等.白花蛇舌草和水线草的鉴别与药用进展比较[J].中草药,2017,48(20):4328-4338.
[13]徐波,张建超,付作明,等.地锦草总黄酮对小鼠免疫功能及细胞因子m RNA的表达影响[J].中兽医医药杂志,2010,29(5):22-26.
[14]刘奔,郭鹏荣,盛玉文,等.灵芝多糖对荷膀胱癌BLG细胞小鼠化疗后腹腔巨噬细胞的影响及相关免疫机制研究[J].中国全科医学,2015,18(24):2971-2975.
[15]蒋苗苗.灵芝多糖拮抗B16F10肿瘤上清对同基因小鼠脾淋巴细胞分逆IL-2、IFN-γ、TNF-α的抑制作用[D].承德医学院,2013.
[16]李国华,李晔,梅锅玲,等.灵芝三萜类化合物研究进展[J].中草药,2015,46(12):1858-1862.