Razvi Salman, Vaidya Bijay, Perros Petros, Pearce Simon H S
Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Eur J Endocrinol. 2006 Jun;154(6):783-6. doi: 10.1530/eje.1.02169.
Block-replace and titration antithyroid drug regimens both give similar rates of medium- to long-term remission of hyperthyroid Graves' disease. Recent meta-analysis, however, has suggested that titration regimens may be preferable owing to a higher rate of adverse events seen in the block-replace arms of published comparative studies. This article critically re-evaluates the evidence upon which these meta-analyses were based. We suggest that there is little objective evidence that is pertinent to current clinical practice to separate block-replace from titration antithyroid drug regimens and that both remain satisfactory approaches to the medical management of hyperthyroid Graves' disease.
间歇替代疗法和滴定法抗甲状腺药物治疗方案在甲状腺功能亢进型格雷夫斯病的中长期缓解率方面相似。然而，近期的荟萃分析表明，由于已发表的比较研究中，间歇替代疗法组不良事件发生率较高，滴定法方案可能更可取。本文对这些荟萃分析所依据的证据进行了批判性重新评估。我们认为，几乎没有与当前临床实践相关的客观证据能够区分间歇替代疗法和滴定法抗甲状腺药物治疗方案，而且这两种方法仍然都是治疗甲状腺功能亢进型格雷夫斯病的令人满意的方法。
