【摘要】：目的探討冬蟲夏草菌粉(百令膠囊)對(duì)Graves病(GD)患者機(jī)體免疫狀態(tài)的調(diào)理作用。方法 84例GD患者隨機(jī)分為對(duì)照組(n=42)和治療組(n=42),對(duì)照組根據(jù)甲狀腺功能水平給予適量甲巰咪唑,治療組則在相似治療劑量的基礎(chǔ)上加用百令膠囊(2 g/次,3次/d),連續(xù)6個(gè)月。觀察入組時(shí),服藥1個(gè)月、3個(gè)月及6個(gè)月后受試者的甲狀腺功能(FT3、FT4、TSH)、甲狀腺過氧化物酶抗體(TPO-Ab)水平、抗TSH受體抗體(TR-Ab)水平以及T淋巴細(xì)胞亞群(CD3~+,CD4~+,CD8~+及CD4~+/CD8~+)水平。結(jié)果 (1)治療6個(gè)月后,兩組甲狀腺功能均較治療前下降,差異無統(tǒng)計(jì)學(xué)意義(P0.05);(2)治療組的自身抗體TPO-Ab及TR-Ab水平較治療前均有下降(P均0.001);與對(duì)照組相比,治療組抗體滴度顯著下降(P均0.001);(3)療程可影響TR-Ab的水平,但對(duì)TPO-Ab水平無明顯作用;(4)治療6個(gè)月后,與對(duì)照組相比,治療組的CD4~+細(xì)胞水平下降(P=0.003),CD8~+細(xì)胞水平上升(P=0.046),CD4~+/CD8~+比值下降(P=0.027)。結(jié)論百令膠囊不僅可以明顯改善GD患者體液免疫功能,即降低甲狀腺自身抗體TPO-Ab和TR-Ab水平,同時(shí)還可以調(diào)節(jié)細(xì)胞免疫水平即T細(xì)胞亞群比例,使CD4~+/CD8~+比值下降,從而使GD患者整體自身免疫紊亂狀況得到有效改善。
[Abstract]:Objective to investigate the effect of Bering capsule on immune state of (GD) patients with Graves disease. Methods Eighty-four patients with GD were randomly divided into two groups: control group (n = 42) and treatment group (n = 42). The control group was given a proper amount of methimazole according to the thyroid function level, and the treatment group was treated with bailing capsule (2 g / time 3 times / d) for 6 months. The thyroid function (FT _ 3T _ 4T _ 4TSH), thyroid peroxidase antibody (TPO-Ab), anti TSH receptor antibody (TR-Ab) and T lymphocyte subsets (CD3 ~ + CD4 ~ + CD8 ~ and CD4- / CD8-) were observed at 1 month, 3 months and 6 months after administration. Results (1) after 6 months of treatment, the thyroid function of the two groups was lower than that of the control group (P0.05); (2). The levels of autoantibody TPO-Ab and TR-Ab in the treatment group were lower than those before treatment (P both 0.001), and compared with the control group, there was no significant difference between the two groups. The titer of antibody decreased significantly (P 0.001); (3) in the treatment group, but it had no effect on the level of TPO-Ab. (4) after 6 months of treatment, the level of CD4 ~ cells decreased (P0. 003) and the level of CD8 ~ cells increased (P0. 046) and the ratio of CD4 ~-/ CD8 ~-decreased (P0. 027) in the treatment group compared with the control group. Conclusion bailing capsule can not only obviously improve the humoral immune function of GD patients, that is, decrease the levels of thyroid autoantibody TPO-Ab and TR-Ab, but also regulate the cellular immune level, that is, T cell subgroup ratio, and make the ratio of CD4 to / CD8~ decrease. As a result, the overall self-immune disorder of GD patients was effectively improved.
【作者單位】： 山東大學(xué)齊魯醫(yī)院內(nèi)分泌科;
【基金】：國家自然科學(xué)基金(81370943,81670706)
【分類號(hào)】：R259

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