Of Tripterygium Glycosides In The Treatment Of Refractory Graves' Disease Clinical Research

Objective To observe the clinical efficacy and safety of the Tripterygium wilfordii treatment to refractory Graves disease, and primarily explore its mechanism.Object and methods1,Group:Choose 45 refractory GD patients who accord with the inclusion criteria, the course 3-11 years,18-63 years old, were randomly divided into two groups. The treatment group with 30 people, while the control group with 15 people. The TWP with methimazole group as the treatment group, and the simple methimazole group as the control group. The total course are both 16 weeks.2,Methods:The treatment group was given TWP (lmg/d/kg) and was also given methimazole to control thyroid function? The control group was given methimazole only to control thyroid function. Observing the efficacy of the treatment group with main clinical manifestations,methimazole reduced medication amount and time. Observing the possible efficacy mechanism with T-lymphocyte subsets and TRAb variety. And observing its safety meanwhile.Results1. Clinical manifestations The clinical manifestations of the two groups after treatment has both improved. The marked effect rate of the treatment group was 40%, while the effective rate was 60%, the total effective rate was 100%; The marked effect rate of the control group was 33.33%, the effective rate was 66.67%, the total effective rate was 100%. And comparison between the two groups had no significant difference in symptom improvement (P> 0.05).2. Reduced medication amount and time The total reduced medication amount of treatment group was 8.16±1.96mg, while the control group was 5.33±0.88mg. The first time of the treatment group was 0.93±0.69 month, while the control group was 1.75±0.87 month. The total reduced medication amount of treatment group was obslutely bigger than that of the control group, the first time of the reduced medication of the treatment group was obslutely sooner than that of the control group (Paverage<0.05).3. Determination of TRAb The total of turning to weak (+) after treatment in the treatment group was 8 cases, with the percent 26.67%, turned to (-) was 9 cases, with the percent 30%. While in the control group after treatment turning to weak (+) was 2 cases, with the percent 13.3%, turned to (-) was only 1 cases, with the percent 6.7%. The rate of TRAb turning to (-) of the treatment group was obslutely bigger than that of the control group. (Paverage<0.05)4. Determination of T lymphocyte subsets The CD4/CD8 of the treatment group after treatment was 1.30±0.98, while in the control group was 1.90±0.76, the CD4/CD8 of the treatment group was obslutely lower than that of the control group(P<0.05).5.Safety The ALT of 3 cases slightly increased in the treatment group, the side effect rate was 10%; and 2 cases in the control group, the side effect rate was 13.3%. They had no significant difference (P>0.05)Conclusion1.The refractory Graves disease treated by TWP with methimazole group could have a better short-term effect.2. The TWP with methimazole had a better short-term clinical efficacy in treating the refractory Graves disease than the simple methimazole group.3. The occurrence of GD may be related to decrease in the number of TS cells, low-cut function, so it can further confirm the occurrence of the refractory Graves disease from autoimmune disorders.4. The mechanism of Tripterygium wilfordii which treated the refractory Graves disease was probably immunosuppression. 5. The TWP with methimazole and the simple methimazole had a similar safety in treating the refractory Graves disease.