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目的:观察瘿瘤合剂联合甲巯咪唑治疗格雷夫斯病的临床疗效及其对患者甲状腺功能、相关细胞因子水平的影响。方法:将174例格雷夫斯病患者随机分为治疗组和对照组,每组87例。对照组予甲巯咪唑治疗,治疗组予瘿瘤合剂联合甲巯咪唑治疗,疗程为12周。评价两组患者的中医证候积分及中医证候疗效,检测并比较两组患者的甲状腺功能指标及相关免疫细胞因子水平的变化。结果:1治疗后,治疗组和对照组的中医证候疗效总有效率分别为94.3%和88.5%,组间临床疗效比较,差异有统计学意义(P<0.05)。2治疗后,两组患者的中医证候积分均显著降低(P<0.05),且治疗组患者的积分低于对照组(P<0.05)。3治疗后,两组患者的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平显著降低(P<0.05),促甲状腺素(TSH)水平显著升高(P<0.05),且治疗组患者的FT3、FT4水平低于对照组(P<0.05)。4治疗后,治疗组患者的肿瘤坏死因子-α(TNF-α)水平显著降低(P<0.05),白介素-10(IL-10)、CD4+CD25+T细胞亚群水平显著升高(P<0.05);对照组患者的TNF-α水平显著降低(P<0.05)。结论:瘿瘤合剂联合甲巯咪唑可有效改善格雷夫斯病患者的临床症状及甲状腺功能,其疗效优于单用甲巯咪唑,或有调节免疫细胞因子的作用。
Objective: To observe the clinical curative effect of Kaoju mixture and methimazole on Graves’ disease and its effect on thyroid function and related cytokines in patients. Methods: A total of 174 patients with Graves’ disease were randomly divided into treatment group and control group, 87 cases in each group. The control group was treated with methimazole, and the treatment group was treated with Tiaoyu mixture and methimazole for 12 weeks. Evaluation of TCM syndrome scores and TCM syndrome curative effect of two groups of patients, detection and comparison of thyroid function index and related immunocytokine levels in two groups of patients. Results: After treatment, the total effective rates of TCM syndromes in treatment group and control group were 94.3% and 88.5%, respectively. There was significant difference between the two groups in clinical curative effect (P <0.05). After treatment, the scores of TCM syndromes in both groups were significantly lower (P <0.05), and the scores in the treatment group were lower than those in the control group (P <0.05). (P <0.05), the level of thyroid-stimulating hormone (TSH) was significantly increased (P <0.05), and the levels of free triiodothyronine (FT3) and free thyroxine (FT4) , And FT3 and FT4 levels in the treatment group were lower than those in the control group (P <0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α) and IL-10 and CD4 + CD25 + T cells in treatment group were significantly decreased (P <0.05) <0.05). The level of TNF-α in the control group was significantly lower (P <0.05). Conclusion: The combination of Tiaomin Mixture and Methimazole can effectively improve the clinical symptoms and thyroid function of patients with Graves’ disease, and its curative effect is better than that of single use of methimazole, or regulate the effect of immune cytokines.