雷公藤多甙联合糖皮质激素治疗 Graves眼病的疗效观察

摘要

Objective To observe the effect of glucocorticoids combined with Glucosida Tripterygii TOTA in the treatment of Graves ophthalmopathy(GO).Methods Fifty GO patients were randomly divided into observation group (n =28)and control group(n=22)according to the mantissa of their admission number .The both groups took antithyroid drugs to keep the thyroid function in the normal range.After a pulse therapy of high-dose of methylprednisolone sodium succinate ,the observational group was treated with small to medium dose of prednisone acetate tablets (30 mg/d)combined with Glucosida Tripterygii TOTA while the control group was treated with sufficient prednisone acetate tablets [1 mg/kg・ d].The course of treatment was 16 weeks.The curative effects and recurrent rate were compared between the two groups .Results There were no significant differences in total effectiveness between the two groups .Af-ter 1 year,the rate of recurrence and adverse reactions were significantly lower in the observation group than that in the control group (P<0.05).Conclusion Side-effect and recurrent rate of Glucosida Tripterygii TOTA combined with small dose of prednisone acetate tablets are less than that of single high dose of prednisone acetate tablets in the treatment of GO .%目的：观察雷公藤多甙片联合糖皮质激素治疗 Graves 眼病（Graves ophthalmopathy，GO）的疗效。方法甲状腺功能已控制正常的 GO 患者50例，按随机数字表法分为观察组28例和对照组22例。两组患者均给予甲强龙冲击治疗，之后观察组患者继予中小剂量醋酸泼尼松片（30 mg／d）联合雷公藤多甙片（15 mg，tid）治疗，对照组给予足量醋酸泼尼松片1 mg／（kg・ d）治疗，两组疗程均为16周。比较两组 GO 疗效及1年后复发率。结果两组治疗总有效率差异无统计学意义（P ＞0．05）。1年后观察组 GO 复发率及不良反应明显低于对照组，差异有统计学意义（P ＜0．05）。结论雷公藤多甙联合中小剂量醋酸泼尼松片治疗 GO 复发率低，副作用少，优于单用足量醋酸泼尼松片。