[1]黄昱钦,李青春,柳国斌,等.宁瘿方联合小剂量甲巯咪唑治疗Graves病疗效及对患者促炎细胞因子的影响[J].陕西中医,2025,46(4):476-480.[doi:DOI:10.3969/j.issn.1000-7369.2025.04.009]
　HUANG Yuqin,LI Qingchun,LIU Guobin,et al.Efficacy of Ningying decoction combined with low-dose methimazole in the treatment of newly diagnosed Graves' disease and its effect on pro-inflammatory cytokines in patients[J].,2025,46(4):476-480.[doi:DOI:10.3969/j.issn.1000-7369.2025.04.009]
点击复制

宁瘿方联合小剂量甲巯咪唑治疗Graves病疗效及对患者促炎细胞因子的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年4期
页码:
476-480
栏目:
临床研究
出版日期:
2025-04-20

文章信息/Info

Title:
Efficacy of Ningying decoction combined with low-dose methimazole in the treatment of newly diagnosed Graves' disease and its effect on pro-inflammatory cytokines in patients
作者:
黄昱钦1; 李青春1; 柳国斌2; 陶 枫1; 王雪菲1; 陈 易1
(1.上海中医药大学附属市中医医院内分泌科,上海 200071; 2.上海中医药大学附属曙光医院,上海 201203)
Author(s):
HUANG Yuqin1; LI Qingchun1; LIU Guobin2; TAO Feng1; WANG Xuefei1; CHEN Yi1
(1.Department of Endocrinology,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China; 2.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
关键词:
Graves病;  宁瘿方;  甲巯咪唑;  促甲状腺抗体受体;  白介素-1β;  白介素-6
Keywords:
Graves' disease;  Ningying decoction;  Methimazole;  TRAb;  IL-1β;  IL-6
分类号:
R 581.3
DOI:
DOI:10.3969/j.issn.1000-7369.2025.04.009
文献标志码:
A
摘要:
目的:评估宁瘿方联合小剂量甲巯咪唑方案在新诊断Graves病中的临床疗效及对患者促炎细胞因子的影响。方法:本研究共招募了120例初次诊断为Graves病的患者,将患者随机分为两组,每组60例。试验组接受宁瘿方联合小剂量甲巯咪唑(10 mg)治疗,对照组则接受常规剂量甲巯咪唑(20～40 mg)治疗。所有患者均连续治疗12周,治疗期间监测甲状腺功能指标(FT3、FT4、TSH)、甲状腺相关抗体(TRAb、TPOAb、TgAb)、促炎细胞因子白介素-1β(IL-1β)和白介素-6(IL-6)、抑郁及焦虑自评量表(SDS、SAS)得分以及36项简短健康问卷(SF-36)得分,并评估肝功能和血常规等安全性指标。结果:共有9例患者脱落,最终纳入统计分析的患者共111例。治疗12周后,试验组总有效率显著高于对照组(P<0.05)。两组甲状腺功能指标改善情况相似(P>0.05); 试验组甲状腺相关抗体显著下降,SDS、SAS、SF-36评分均改善,IL-1β、IL-6水平下降,且肝功能损伤及粒细胞减少不良事件发生率更低(均P<0.05)。结论:在新诊断Graves病的治疗中,宁瘿方联用小剂量甲巯咪唑方案临床疗效及安全性优于常规剂量的甲巯咪唑单药治疗,且可降低促炎细胞因子IL-1β、IL-6水平。
Abstract:
Objective:To evaluate the clinical efficacy and safety of Ningying decoction combined with low-dose methimazole in the treatment of newly diagnosed Graves' disease,as well as its effects on pro-inflammatory cytokines in patients.Methods:A total of 120 patients newly diagnosed with Graves' disease were recruited for this study and randomly divided into two groups,with 60 patients in each group.The experimental group received Ningying decoction combined with low-dose methimazole(10 mg),while the control group received a conventional dose of methimazole(20～40 mg).All patients were treated continuously for 12 weeks,during which thyroid function indicators(FT3,FT4,TSH),thyroid-related antibodies(TRAb,TPOAb,TgAb),pro-inflammatory cytokines including interleukin-1β(IL-1β)and interleukin-6(IL-6),as well as self-reported depression and anxiety scales(SDS,SAS)scores and the 36-item Short Form Health Survey(SF-36)scores were monitored.Additionally,safety indicators including liver function and complete blood count were assessed.Results:A total of 9 patients dropped out, and ultimately,111 patients were included in the statistical analysis.After 12 weeks of treatment,the total effective rate of experimental group was significantly higher than that of control group(P<0.05).The improvement of thyroid function indexes in the two groups was similar(P>0.05).Thyroid related antibodies were significantly decreased,SDS,SAS and SF-36 scores were improved,IL-1β and IL-6 levels were decreased,and the incidence of liver function injury and granulopenia adverse events were lower in experimental group(all P<0.05).Conclusion:In the treatment of newly diagnosed Graves' disease,the combination of Ningying decoction with low-dose methimazole demonstrates superior clinical efficacy and safety compared to conventional-dose methimazole monotherapy,and it can reduce the levels of pro-inflammatory cytokines IL-1β and IL-6.

参考文献/References:

[1] 林果为,王吉耀,葛均波.实用内科学[M].北京:人民卫生出版社,2017:32.
[2] 中华医学会,中华医学会杂志社,中华医学会全科医学分会.甲状腺功能亢进症基层诊疗指南(实践版?2019)[J].中华全科医师杂志,2019,18(12):1129-1135.
[3] CHAKER L,COOPER D S,WALSH J P,et al.Hyperthyroidism[J].Lancet,2024,403(10428):768-780.
[4] SMITH T J,HEGEDUS L.Graves' disease[J].N Engl J Med,2016,375(16):1552-1565.
[5] SATO S H,NOH J Y,SATO S A,et al.Comparison of efficacy and adverse effects between methimazole 15 mg+inorganic iodine 38 mg/day and methimazole 30 mg/day as initial therapy for Graves' disease patients with moderate to severe hyperthyroidism[J].Thyroid,2015,25(1):43-50.
[6] 张伟杰,巴竺飞,于雅巍,等.131I治疗Graves甲亢伴粒细胞减少症的效果研究[J].标记免疫分析与临床,2023,30(8):1347-1350,1372.
[7] 赵秋芳,汪雪梅,李强,等.蒺藜皂苷对Graves眼病眼眶组织纤维化的作用机制研究[J].陕西中医,2024,45(11):1476-1480,1485.
[8] 段姗姗,王永恒,彭书旺,等.加味逍遥散联合甲巯咪唑片对Graves病气滞痰凝证患者的临床疗效[J].湖南中医药大学学报,2023,43(7):1283-1289.
[9] 岳宗相,赵晓梅,潘静,等.基于肝主疏泄论治甲状腺功能亢进症的临床思路与实践[J].新疆中医药,2024,42(1):75-78.
[10] ANTONELLI A,FALLAHI P,ELIA G,et al.Graves'disease:Clinical manifestations,immune pathogenesis(cytokines and chemokines)and therapy[J].Best Pract Res Clin Endocrinol Metab,2020,34(1):101388.
[11] 万霞,刘建平.临床试验中的随机分组方法[J].中医杂志,2007,57(3):216-219.
[12] 国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:22.
[13] 中华医学会内分泌学分会,中国医师协会内分泌代谢科医师分会,中华医学会核医学分会,等.中国甲状腺功能亢进症和其他原因所致甲状腺毒症诊治指南[J].中华内分泌代谢杂志,2022,38(8):700-748.
[14] 吴文源.焦虑自评量表[M].北京:中华医学电子音像出版社,2005:35.
[15] 吴文源.抑郁自评量表[M].北京:中华医学电子音像出版社,2005:28.
[16] 王婷,任艳军,孔静霞,等.甲状腺癌患者生命质量的测定量表及应用[J].中华内分泌代谢杂志,2015,31(12):1074-1077.
[17] 赵进东,李艳,方朝晖.中医药治疗甲状腺功能亢进症的临床研究进展[J].天津中医药大学学报,2022,41(3):390-396.
[18] 吴艳珂,祁烁,李哲,等.基于现代文献的甲状腺功能亢进症的中医证型及证素分布规律研究[J].中国医药科学,2022,12(18):30-34,114.
[19] 葛亚雪,陈晓珩,祁烁,等.基于中医传承辅助系统探讨丁治国教授治疗甲状腺功能亢进症的用药规律[J].中国医药导报,2023,20(28):20-25.
[20] AYUSTANINGWARNO F,ANJANI G,AYU A M,et al.A critical review of Ginger's(Zingiber officinale)antioxidant,anti-inflammatory,and immunomodulatory activities[J].Front Nutr,2024,11:1364836.
[21] 沈艳玲,刘承红,王世魁,等.黄芩苷通过ROS依赖性调节RhoA/ROCK通路保护氯化钴诱导心肌细胞损伤的实验研究[J].海南医学院学报,2024,30(7):481-488.
[22] TVRDA E,URAKA M,HALENAR M,et al.The effects of apricot kernels and pure amygdalin on the structural,oxidative,and inflammatory characteristics of rabbit testicular tissue[J].Front Biosci,2024,29(6):235.
[23] LEE Y S,MUN J G,KEE J Y,et al.Saikosaponin D inhibits lung metastasis of colorectal cancer cells by inducing autophagy and apoptosis[J].Nutrients,2024,16(12):1844.
[24] 魏晓菲,王晨丹.雷公藤甲素调控NLRP3/GSDMD/IL-1β途径改善六价铬对足细胞损伤的机制研究[J].陕西中医,2024,45(9):1172-1175,1185.
[25] WU B,WAN Y.Molecular control of pathogenic Th17 cells in autoimmune diseases[J].Int Immunopharmacol,2020,80:106187.
[26] 朱东宁,安庆.曲安奈德对特应性皮炎小鼠血清白细胞介素-33、白细胞介素-25、胸腺基质淋巴细胞生成素和Th1/Th2平衡影响的实验研究[J].陕西医学杂志,2023,52(1):7-11,27.
[27] HOLMBERG M,MALMGREN H,BERGLUND P F,et al.Psychiatric complications in Graves' disease[J].Eur Thyroid J,2024,13(1):e230247.

相似文献/References:

[1]杨春睿,钮晓红,金 磊.益阴抗甲方联合甲巯咪唑治疗Graves病合并甲状腺功能亢进疗效研究[J].陕西中医,2024,(12):1630.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.009]

备注/Memo

备注/Memo:
[基金项目]上海市科技计划项目(23Y11921500); 上海市嘉定区卫健委中医药科研面上项目(2024-KY-ZYY-06)
更新日期/Last Update: 2025-04-08