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目的观察分析中西医结合疗法对Graves病(GD)患者自然杀伤T细胞(NKT)及其分泌的细胞因子表达水平的影响。方法选取2013年7月至2014年6月GD患者30例为研究对象,采用清肝解郁方加减结合西药治疗6个月,治疗前后抽取静脉血10 ml,采用放射免疫分析法(RIA)及流式细胞仪检测,观察比较患者治疗前后血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(Tg Ab)、白细胞介素(IL)-2、IL-6、IL-10、IL-12、肿瘤坏死因子(TNF)-α及外周血CD3+CD56+自然杀伤T细胞(NKT)数量。结果治疗后患者FT3、FT4及TPOAb、Tg Ab抗体水平明显低于治疗前(P均<0.01),TSH明显高于治疗前(P<0.01);治疗前CD3+CD56+NKT样细胞占淋巴细胞百分比为(1.37±0.43)%,治疗后为(2.47±0.39)%,治疗前后比较差异有统计学意义(t=9.187,P<0.01);治疗后患者IL-2水平高于治疗前,IL-6、IL-10、IL-12、TNF-α水平均低于治疗前,差异均有统计学意义(P均<0.01)。结论采用中西医结合治疗GD,能够调节患者免疫功能紊乱情况及免疫调节细胞失衡情况,对GD患者特异性免疫干预治疗效果显著。
Objective To observe and analyze the effect of integrated traditional Chinese and Western medicine on natural killer T cells (NKT) and the secretion of cytokines in patients with Graves disease (GD). Methods Thirty patients with GD were selected from July 2013 to June 2014. The patients were treated with Qinggan Jieyu Decoction combined with Western medicine for 6 months. Venous blood samples (10 ml) were collected before and after treatment. Radioimmunoassay (RIA) and flow The cytotoxicity of free triiodothyronine (FT3), serum free thyroxine (FT4), thyrotropin (TSH), anti-thyroid peroxidase antibody (TPOAb) (Tg Ab), interleukin (IL) -2, IL-6, IL-10, IL-12, tumor necrosis factor (TNF) -α and peripheral blood CD3 + CD56 + natural killer T (NKT) . Results The levels of FT3, FT4, TPOAb and Tg Ab in patients after treatment were significantly lower than those before treatment (all P <0.01), and TSH was significantly higher than before treatment (P <0.01). Before treatment, CD3 + CD56 + NKT- (1.37 ± 0.43)% after treatment, (2.47 ± 0.39)% after treatment, the difference was statistically significant before and after treatment (t = 9.187, P <0.01); after treatment, the level of IL- The levels of IL-6, IL-10, IL-12 and TNF-α were all lower than those before treatment (all P <0.01). Conclusion The treatment of GD with traditional Chinese and western medicine can adjust the immunological dysfunction and the imbalance of immunoregulatory cells in patients with GD, and has a significant effect on the treatment of GD with specific immune intervention.