| Objective:A randomized and controlled method of compound tablet and game rule treatment of hyperthyroidism subclinical hyperthyroidism Graves efficacy study factors, by different drugs, different doses, different treatment efficacy of screening in the clinical treatment of subclinical hyperthyroidism Graves the best regimen. Through the test of thyroid autoantibodies and comparative analysis before and after the treatment, as well as the immune chemokine receptor expression in peripheral blood, with the cross-analysis of clinical symptoms and therapeutic index, discussing the compound tablets in the treatment of hyperthyroidism subclinical hyperthyroidism Graves Pathogenesis and treatment of the mechanism of subclinical hyperthyroidism, which provided new ideas and material to the clinical practices and mechanism of the drug.Method:This part of clinical research had used randomized controlled and methods, a compound tablet and the game governing the control of hyperthyroidism, each set high, medium and low dose group, set up two courses, each dose group (4 months) treatment, different treatment for each dose group of clinical indicators and laboratory indicators of recorded time, after the end of the experiment on the statistical analysis of each factor to the cross. Some mechanism studies, the same set of three different doses of drugs, for two courses of study, radioimmunoassay chemi luminescent method of time for thyroid autoantibodies aTG, aTPO, TRAb detection recording, and in some flow cytometry Case synchronized immunization chemokine receptors CCR3, CCR5 expression in peripheral blood was detected after the end of the experiment, each of the indicators and clinical research part of the cross each of the factors analyzed.Results:1. Curative effect analysis of clinical symptomsTwo medium-dose groups after 2 months treatment, in addition to goiter and exophthalmos, the other symptom scores decreased significantly; The symptom scores significantly decreased after 4 months treatment, the decreasing rate of the treatment points in 4 months was better than 2months. Between the two groups, the points of experimental group after 4 months in palpitation, irritability, exophthalmos, and goiter was much less than the comparison group. Two high-dose groups after 2 months treatment, except for goiter and exophthalmos, the other symptom scores decreased significantly; The symptom scores significantly decreased after 4 months treatment, the decreasing rate of the treatment points in 4 months was better than 2months. Between the two groups, the points of experimental group after 4 months in palpitation, irritability, exophthalmos, and goiter was much less than the comparison group.2. The analysis of TSH values before and after the therapyGroups for 2 months and 4 months after the TSH was significantly increased compared with that before treatment there were significant differences and a very significant difference. No significant difference between the two groups, with group comparison between different treatments, treatment for 4 months than the average TSH treatment for 2 months markedly improved.2 months after treatment in both groups compared with TSH values increased significantly during treatment, compared with before treatment, Fufangjiakang tablet group had significant differences in treatment group, race was significant.4 months after treatment in both groups than before treatment TSH value is increased, there was a significant statistical difference.3. The analysis of thyroid autoantibodies changesâ‘ Af ter the treatment of Fufangjiakang tablets medium and high dose groups, the aTG negative rate was significantly higher than before treatment, in comparison with the low dose group and race group,which had significant difference.â‘¡After the treatment of Fufangjiakang tablets high dose groups, the TPOAb negative rate was significantly higher than before treatment, in comparison with the medium and low dose group and race group, which had significant difference.â‘¢After the treatment of Fufangjiakang tablets medium dose groups, the TRAb negative rate was significantly higher than before treatment, which had significant difference, in comparison with the race group, the Fufangjiakang tablets group had a higher negative rate.4. The relativity between thyroid autoantibodies and clinical symptoms.The results showed that thyroid autoantibodies aTG, aTPO and TRAb has increasingly the trend from positive to negative with subclinical hyperthyroidism disease mitigation and recovery, that is to say, there were a certain relativity between the thyroid autoantibodies and clinical symptoms. The degree of clinical symptoms had a positive correlation with serum TRAb. The higher the proportion of negative TRAb, the lighter the symptoms, suggesting TRAb could be considered as one of the objective indicators of severity assessment.5. The relativity between thyroid autoantibodies and TSHExperimental results showed that, aTG, aTPO and TSH changes are not fully synchronized, after the treatment of the race administration medium and high dose groups, the TSH values increased significantly, while the negative rate of aTG and aTPO had no difference.After the treatment of the both medium does groups,the TSH value TRAb-negative rate improved significantly,which indicated that there were positive correlation between negative TRAb and increased TSH values.6. Chemokine receptor expression of immune cells analysis.The results showed that there were no difference in CCR5 expression of CD4+T cells before and after treatment in the two groups. The CCR3 expression of CD4+T cells of Compound tablet group significantly decreased after treatment, there were significant differences. The race treatment group decreased (P>0.05) after treatment, but there was no significant difference between the two groups in comparison,. the experimental group had a higher decreased rate7. The relativity between chemokine receptor expression of immune cells and TSH.The results showed that after treatment, although the compound tablets hyperthyroidism TSH significantly increased compared with before treatment and CD4+T cells in CCR3 expression significantly decreased after treatment with the same anisotropy, the competition increased TSH results of treatment group treatment group before and after treatment with the game CD4+T cells express CCR3 no difference in the results are not consistent. Tipsâ‘ CD4+T cells in CCR3 expression and TSH did not change in a close relationship. Before and after treatment CCR5 CD4+T cells the expression of no difference, indicating the change with the TSH is not relevant.â‘¡Fufangjiakang tablets may be CD4+T cells in CCR3 expression has some regulatory role.8. The relativity between chemokine receptor expression of immune cells and thyroid autoantibodiesThe CCR5 expression of CD4+T cells had no difference before and after treatment,which indicated no relativity with the thyroid autoantibodies. The TRAb of Fufangjiakang tablets medium dose group decreased significantly after treatment, as well as the CCR3 expression of CD4+T cells, race administration had no change before and after treatment. It not only indicated that the CCR3 expression of CD4+T cells in peripheral blood had positive correlation with TRAb value and no correlation with aTG value, but also indicated that Fufangjiakang tablets may have some immune and inflammatory regulation or inhibition.Conclusion:1. Fufangjiakang tablets has curative effect in the treatment of Graves hyperthyroidism subclinical hyperthyroidism.The curative effect is related with the dose and course of the treatment.The best usage of Fufangjiakang tablets as follows:a five piece,2 times a day,keeping 4 months. 2. Fufangjiakang tablets has a therapeutic effect to the thyroid autoantibodies.3. TSH and TRAb values may be used for the treatment indicators of subclinical hyperthyroidism Efficacy of to judge the extent of the disease.4. Th2 cells, chemokines and their receptors is one of the mechanisms in subclinical hyperthyroidism Graves disease sustained5. Regulating or inhibiting the thyroid autoantibodies and the CCR3 expression of CD 4+T cells may be one of the mechanisms in the treatment of hyperthyroidism subclinical hyperthyroidism Graves with compound tablet.6. Fufangjiakang tablets has a certain immune regulated effect. |
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