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目的:研究中西医结合治疗对Graves病患者外周血T、B淋巴细胞亚群及部分协同刺激分子表达的影响。方法:运用流式细胞术测定20例Graves病初发患者、11例他巴唑治疗患者(西药组)、16例他巴唑合用中药五岳抗甲丸治疗患者(中西医结合组)及16例正常对照外周血淋巴细胞CD19、CD40、CD80、CD3、CD4、CD8、CD28等分子的表达水平。结果:Graves病初发患者CD19+、CD40+、CD19+CD40+、CD80+细胞比率高于正常对照组(P<0.01或P<0.05),CD3+CD8+细胞比率降低(P<0.05),CD3+CD4+/CD3+CD8+比值高于正常对照(P<0.05);西药组患者CD80+细胞恢复正常,CD3+CD4+细胞比率及CD3+CD4+/CD3+CD8+比值高于正常对照(P<0.05,P<0.01),而CD3+CD8+及CD8+CD28+细胞比率低于正常对照(P<0.01,P<0.05);除CD80+细胞比率高于正常对照外,中西医结合组所测各种分子的表达同正常对照组比较,差异无统计学意义;同西药组比较,中西医结合组CD3+CD4+细胞降低(P<0.01),CD3+CD8+及CD8+CD28+细胞比率升高(P<0.01,P<0.05),CD3+CD4+/CD3+CD8+比值降至正常水平(P<0.01)。结论:Graves病患者体液免疫处于较高水平,存在细胞免疫调节失衡,中西医结合治疗较单纯西药治疗更有利于患者免疫状态的恢复。
Objective: To study the effect of integrated traditional Chinese and western medicine on the expression of T, B lymphocyte subsets and some costimulatory molecules in peripheral blood of Graves’ disease patients. Methods: Flow cytometry was used to detect 20 patients with initial Graves disease, 11 patients treated with methimazole (western medicine group), 16 patients treated with anticonvulsant therapy with Chinese traditional medicine Wuyuezhengmai (Integrative Medicine Group) and 16 patients The expression of CD19, CD40, CD80, CD3, CD4, CD8, CD28 and other molecules in normal control peripheral blood lymphocytes. Results: The rates of CD19 +, CD40 +, CD19 + CD40 + and CD80 + cells in patients with Graves’ disease were higher than those in normal controls (P <0.01 or P <0.05) (P <0.05). The ratio of CD3 + CD4 + cells and CD3 + CD4 + / CD3 + CD8 + of western medicine group were higher than that of the normal control group (P <0.05, P <0.01) The ratio of CD3 + CD8 + and CD8 + CD28 + cells was lower than that of the normal controls (P <0.01, P <0.05). Except that the ratio of CD80 + cells was higher than that of the normal controls, (P <0.01), CD3 + CD8 + and CD8 + CD28 + cells (P <0.01, P <0.05), CD3 + CD4 + / CD3 + CD8 + ratio decreased to the normal level (P <0.01). Conclusion: The humoral immunity in patients with Graves’ disease is at a high level, and there is an imbalance of cellular immune regulation. The combination of TCM and Western medicine treatment is more beneficial to the recovery of immune status than the Western medicine alone.