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目的评价糖皮质激素联合抗甲状腺药物与单用抗甲状腺药物治疗Graves病的有效性及安全性。方法手工及电脑检索国内外糖皮质激素与抗甲状腺药物治疗Graves病的随机对照研究,采用Cochrane质量评价标准进行定量化质量评估,采用Rev Man 5.3进行系统统计分析。结果纳入10项研究,糖皮质激素与抗甲状腺药物联合组可有效降低FT3,FT4,T4水平,差异有统计学意义(P<0.01),对T3,TSH无明显差异。糖皮质激素联合抗甲状腺药物组不良反应发生率较低。结论糖皮质激素联合抗甲状腺药物治疗Graves病对FT3,FT4,T4水平的改善有较好的疗效,且安全性更高。
Objective To evaluate the efficacy and safety of glucocorticoid combined with anti-thyroid drugs and anti-thyroid drugs alone in the treatment of Graves disease. Methods: Randomized controlled trials of glucocorticoid and antithyroid drugs in the treatment of Graves’ disease at home and abroad were conducted by hand and computer. The quality of quantitative evaluation was assessed by Cochrane Quality Evaluation Standard. Statistical analysis was performed by using Rev Man 5.3. Results In 10 studies, the combination of glucocorticoid and antithyroid drugs could effectively reduce the levels of FT3, FT4 and T4, the difference was statistically significant (P <0.01), but there was no significant difference between T3 and TSH. Glucocorticoids combined anti-thyroid drug group had a lower incidence of adverse reactions. Conclusion Glucocorticoids and anti-thyroid drugs for the treatment of Graves’ disease have a good effect on the improvement of FT3, FT4 and T4 levels, and are more safe.