| Purpose:Dicuss on clinical efficacy of Different Syndrome of Graves disease-(GD) treating by Ying-Qi-Ling(YQL), to define the adapting syndrome of YQL. Study on the effect of cytokines balance by YQL, and discuss the regulation mmune mechanism of YQL, for offering proof of treating GD by Traditional Chinese Medicine(TCM).Methods:1 Inclusion criteria·accord to diagnostic criteria of GD;·choice the first subjected to and Untreated GD patients aged from 18 to 65years;·heart, liver and kidney function was normal. Have the stable life. Abide by the treatment.·according to the syndrome differentiation of TCM, gather the GD patients with the deficiency of heart or liver both qi and yin as deficiency syndrome group, the hyperactivity of liver and stomach fire as excess syndrome group and deficiency mingling with excess group. Deficiency syndrome manifests thyroid goiter, flustered and palpitation, aversion to heat and profuse sweating, restlessness and easy to angry, tremoring hand, insomnia and dreaminess, short and breath, hypodynamia, eye balls extruding, dryness and irritative sensation in eyes, distension and pain of eyes, dry mouth and thirst, reduced intake of food, vague pain of stomach and abdomen, postcibal distension, loose stool, reddish tongue with scanty fur, taut and thin pulse or thin and into two groups. Combination of TCM and western medicine groups is treated groups including 105 patients, divided into excess syndrome group including 40 patients, deficiency syndrome group including 30 patients and deficiency mingling with excess group including 35 patients, treating with YQL 5 tablets tid. Western medicine groups is control group including 42 patients, treating with methimazole 5mg tid. The dosage will be reduced after the state of hyperthyroidism were controlled. These groups treated for three months.4 Therapeutic effect evaluation·general symptoms: flustered and palpitation, aversion to heat and profuse sweating, restlessness and easy to angry, tremoring hand, insomnia and dreaminess, short and breath, hypodynamia, loose stool, emaciation, restlessness and easy to angry; physical signs include the frequency of stool, heart rate, body weight, thyroidal fibrillation, vascular murmur, manifestations of tongue and pulse, etc.·patients with symptoms of eyes need be measured the size of eye-tubercle by exophthalmometer in department of ophthalmology.·patients with thyroid goiter need be measured the size of the thyroid by B-mode ultrasonography.·detect the value of interferon-γ, interleukin-4, free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin antibody, thyroperoxidase antibody.Above observation record one time before and after treatment.Result:·YQL can significantly improved the general symptoms in GD treated groups(P<0.05). Especially YQL improved restlessness and easy to angry, insomnia and dreaminess, short and breath, hypodynamia of three syndrome types, better than those in the control group of methimazole(P<0.05); For the more, YQL improved significantly tremoring hand in the patients of Excess syndrome and aversion to heat and profuse sweating in the patients of Deficiency syndrome better than those in the control group of methimazole(P<0.05).·YQL can significantly reduced the thyroid goiter in GD treated groups(P<0.05), better than those in the control group of methimazole(P<0.05).·YQL can diminished the size of eye-tubercle in GD treated groups, better than that in the control group of methimazole(P<0.05). into two groups. Combination of TCM and western medicine groups is treated groups including 105 patients, divided into excess syndrome group including 40 patients, deficiency syndrome group including 30 patients and deficiency mingling with excess group including 35 patients, treating with YQL 5 tablets tid. Western medicine groups is control group including 42 patients, treating with methimazole 5mg tid. The dosage will be reduced after the state of hyperthyroidism were controlled. These groups treated for three months.4 Therapeutic effect evaluation·general symptoms: flustered and palpitation, aversion to heat and profuse sweating, restlessness and easy to angry, tremoring hand, insomnia and dreaminess, short and breath, hypodynamia, loose stool, emaciation, restlessness and easy to angry; physical signs include the frequency of stool, heart rate, body weight, thyroidal fibrillation, vascular murmur, manifestations of tongue and pulse, etc.·patients with symptoms of eyes need be measured the size of eye-tubercle by exophthalmometer in department of ophthalmology.·patients with thyroid goiter need be measured the size of the thyroid by B-mode ultrasonography.·detect the value of interferon-γ, interleukin-4, free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin antibody, thyroperoxidase antibody.Above observation record one time before and after treatment.Result:·YQL can significantly improved the general symptoms in GD treated groups(P<0.05). Especially YQL improved restlessness and easy to angry, insomnia and dreaminess, short and breath, hypodynamia of three syndrome types, better than those in the control group of methimazole(P<0.05); For the more, YQL improved significantly tremoring hand in the patients of Excess syndrome and aversion to heat and profuse sweating in the patients of Deficiency syndrome better than those in the control group of methimazole(P<0.05).·YQL can significantly reduced the thyroid goiter in GD treated groups(P<0.05), better than those in the control group of methimazole(P<0.05).·YQL can diminished the size of eye-tubercle in GD treated groups, better than that in the control group of methimazole(P<0.05). ·YQL can adjust the thyroxin level in GD treated groups(P<0.05), not better than that in the control group of methimazole(P>0.05).·YQL can degrade the level of the thyroglobulin antibody and the thyroperoxidase antibody in the blood serum, better than those in the control group of methimazole(P<0.05).·YQL can degrade the level of the interferon-γand interleukin-4 in the blood serum, upgrade back the ratio of interferon-γ/interleukin-4, better than those in the control group of methimazole(P<0.05). Interferon-γhas positive correlation with free triiodothyronine and free thyroxine. Interleukin-4 and interferon-γ/interleukin-4 have uncorrelation with free triiodothyronine and free thyroxine. Interferon-γand interleukin-4 have positive correlation with the thyroid goiter and the size of eye-tubercle, and have uncorrelation with the thyroglobulin antibody and the thyroperoxidase antibody. Interferon-γ/interleukin-4 have negative correlation with the thyroid goiter and the size of eye-tubercle, and have uncorrelation with the thyroglobulin antibody and the thyroperoxidase antibody,·YQL can enhance the therapeutic effect better than control group of methimazole(P<0.05). YQL is more effective to deficiency group than excess syndrome group and deficiency mingling with excess group (P<0.05) .Conclusion :YQL has good therapeutic effect to improve clinical symptoms, reduce thyroid goiter, and diminish the size of eye-tubercle in GD. YQL is more effective to deficiency group than other syndrome. YQL has the role of immunoregulation. YQL regulates the Th1/Th2 cytokine balance, through degrading the level of the interferon-γand interleukin-4, upgrading back the ratio of interferon-γ/interleukin-4 in the blood serum, produce the cellular immune function. YQL regulate the humoral immune disorder in GD immune imbalance through degrading the level of the thyroglobulin antibody and the thyroperoxidase antibody in the blood serum. |
PDF Full Text Request