Xie Chunyan, He Chaozhu, Gao Jun, Jia Shulei
School of Nursing, Nanchang University.
Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China.
Medicine (Baltimore). 2020 Sep 18;99(38):e22282. doi: 10.1097/MD.0000000000022282.
Hyperthyroidism is a condition in which the thyroid gland is overreactive and produces excess amounts of thyroid hormone. Tripterygium glycosides, traditional Chinese medicine has been widely used in the treatment of rheumatoid arthritis, nephrotic syndrome, hyperthyroidism and other diseases due to its anti-inflammatory and immunosuppressive effects. Evidence-based research is becoming popular especially with the application of Chinese traditional medicine. This paper systematically reviews and evaluates existing clinical data on the efficacy and safety of Tripterygium glycosides in the treatment of hyperthyroidism.
PubMed, Cochrane library and EMBase, Chinese biomedical literature database (CBM), Chinese journal full-text database (CNKI), Wan fang digital periodical full-text database and China Science and Technology Journal Database (VIP) were searched based on the defined inclusion and exclusion criteria. Data extraction, research quality assessment and meta-analysis were conducted with RevMan5.3 software. Trial sequential analysis (TSA) was used to evaluate information size and treatment benefits.
Seventeen randomized controlled clinical trials with 1536 participants were included in the systematic review. In the meta-analysis, there were two subgroups: Tripterygium glycosides combined with thiamazole and prednisone group; Tripterygium glycosides combined with thiamazole group. The study results revealed that the degree of exophthalmos, FT3, FT4, BGP, and AKP decreased while TSH, SOD, GSH-PX increased after the addition of Tripterygium glycosides. This study results suggested that Tripterygium glycosides combined with western medicine are an effective therapy for hyperthyroidism.
This study indicates that Tripterygium glycosides enhances the effect of thiamazole and prednisone in the treatment of hyperthyroidism and without increasing the risk of adverse events.
甲状腺功能亢进症是一种甲状腺过度活跃并产生过量甲状腺激素的病症。雷公藤多苷作为一种传统中药，因其抗炎和免疫抑制作用，已被广泛用于治疗类风湿性关节炎、肾病综合征、甲状腺功能亢进症等疾病。循证研究正变得越来越普遍，尤其是在中药的应用方面。本文系统回顾并评估了雷公藤多苷治疗甲状腺功能亢进症的疗效和安全性的现有临床数据。
根据既定的纳入和排除标准，检索了PubMed、Cochrane图书馆、EMBase、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方数字期刊全文数据库和中国科技期刊数据库（VIP）。使用RevMan5.3软件进行数据提取、研究质量评估和荟萃分析。采用试验序贯分析（TSA）评估信息量和治疗效益。
系统评价纳入了17项随机对照临床试验，共1536名参与者。在荟萃分析中，有两个亚组：雷公藤多苷联合甲巯咪唑和泼尼松组；雷公藤多苷联合甲巯咪唑组。研究结果显示，添加雷公藤多苷后，突眼程度、FT3、FT4、BGP和AKP降低，而TSH、SOD、GSH-PX升高。本研究结果表明，雷公藤多苷联合西药是治疗甲状腺功能亢进症的有效疗法。
本研究表明，雷公藤多苷增强了甲巯咪唑和泼尼松治疗甲状腺功能亢进症的效果，且不增加不良事件风险。
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