"Evaluation of the therapeutic effect of ""YunKe""and prednisone on moderate and severe thyroid associated ophthalmopathy" / 中国基层医药

ABSTRACT

Objective To evaluate the therapeutic efficacy of YunKe and prednisone on moderate and severe thyroid associated ophthalmopathy(TAO).Methods 1 08 hyperthyroidism patients with moderately severe TAO were randomly divided into YunKe group,hormone group and the control group.All of the patients were given anti -thyroid medication(ATD)treatment.By thyroid hormone level upper limit every times higher than normal for a sulfhydryl imidazole 5mg/day to calculate daily dosage,based on thyroid hormone level adjusted a sulfhydryl imidazole dose every two weeks,make thyroid hormone levels in the normal range.YunKe setintravenous push note YunKe per day A +B agent four groups (including cloud 20mg),each treatment medicine for five days in A row,interval of 25 days to the next period of treatment,medication six procedures.Hormone grouporal prednisone for 6 months,monthly dose in the order 1 mg·kg -1 ·d -1 ,0.75mg·kg -1 ·d -1 ,0.5mg·kg -1 ·d -1 ,0.25mg·kg -1 ·d -1 ,0.1 25mg·kg -1 ·d -1 , 0.062 5mg·kg -1 ·d -1 ,1 time a day,took at 8 o'clock in the morning.The control group treated ATD.Before and 6 months after treatment,all of the patients were checked the TNF -αand TRab,CT scan to measure degree of exophthalmus.Six months after treatment,respectively,on the basis of TAO classification (NOSPECS)and TNF -α, TRab level changes to determine the efficacy of treatment.Data entry Excel 2003 statistical software,used SPSS 1 9.0 statistical software to analyze data.Non parametric tests of three groups of data with Kruskal Wallis test.Not matching the two independent samples nonparametric test with the Mann -Whitney test,with P <0.05 for the difference was statistically significant.Results The markedly effective rate,effective rate and ineffective rate of YunKe group were 36.1 %,47.2% and 1 6.7% respectively,which of the hormone group were 20.0%,37.1 % and 42.9%,which of the control group were 1 3.9%,22.2% and 63.9%.The efficacy among the three groups had statistically significant differences (Kruskal -Wallis χ2 =1 0.736,P =0.005 ).The lighter exophthalmos,tge curative effect was better (Mann -Whitney Z =-4.599,P <0.001 ).The changes of TNF alpha,TRab levels among the three groups had significant differences(YunKe group,the TNF alpha,TRab levels markedly reduced 75.0% and 80.6%,respectively, which of the hormone group were 37.1 % and 34.3%,which of the control group were 1 9.4% and 27.8%,TNF χ2 =23.527,P <0.001 ;TRab χ2 =23.831 ,P <0.001 ).Conclusion The therapeutic efficacy of YunKeon TAO is better than prednisone,but the long -term effect deserves more investigation.