简介:Graves病(GD)是甲状腺功能亢进的最常见原因,可影响身体的多个系统。目前,目前常用的GD治疗方法有一系列的缺点。相比之下,中药已被证明可有效抑制GD的进展,并有望成为未来新药开发的重点方向。因此,进行了网络荟萃分析,比较了不同中药对疗效的影响,促甲状腺激素(TSH),游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4),甲状腺球蛋白抗体(TGAb),GD患者的甲状腺过氧化物酶抗体(TPOAb)和促甲状腺激素受体抗体(TRAb)。方法:PubMed,Embase,科克伦图书馆,WebofScience,万方,维普,和CNKI检索2023年12月19日中医对GD患者的随机对照试验。对纳入研究的质量进行了偏倚风险评估,数据采用R软件进行分析。结果:共纳入35篇文献,涉及2828例GD患者和百令胶囊等中药,金水宝胶囊,黄芪注射液,嘉康灵平板电脑,嘉康灵胶囊,雷公藤,散结消英汤,夏枯草(L.)口服液,P.vulgaris(L.)颗粒,谢火小英食谱,谢火养阴粉,益康丸和银佳丸。网络荟萃分析结果表明,对于GD患者,百灵胶囊,嘉康灵胶囊,雷公藤,P.vulgaris(L.)口服液和银杏丸较西药疗效好。夏枯草(L.)颗粒和益康丸可提高TSH水平。夏枯草(L.)颗粒,P.vulgaris(L.)口服液和益康丸可降低FT3水平。嘉康灵胶囊,P.vulgaris(L.)颗粒,P.vulgaris(L.)口服液和益康丸可降低FT4水平。夏枯草(L.)口服液可以降低TPOAb和TRAb的水平。此外,银佳丸对提高疗效最有帮助。益康丸对TSH的改善效果最好。夏枯草(L.)颗粒降低FT3的效果最好。夏枯草(L.)颗粒在减少FT4方面表现最好。夏枯草(L.)口服液对降低TPOAb和TRAb的作用最有利。结论:根据目前的研究,结论中药可以提高GD患者的疗效和TSH水平,并降低FT3、FT4、TPOAb和TRAb的水平。此外,银佳丸对提高疗效最有帮助。益康丸能最好地进步TSH。夏枯草(L.)颗粒对降低FT3的效果最好。夏枯草(L.)颗粒在减少FT4方面表现最佳。夏枯草(L.)口服液对减少TPOAb和TRAb的作用最有利。系统审查注册:https://www。crd.约克。AC.uk/PROSPERO/#recordDetails,标识符CRD42024521912。
Introduction: Graves\' disease (GD) is the most common cause of hyperthyroidism and can affect multiple systems of the body. Currently, commonly-used treatment methods for GD have a series of shortcomings. In contrast, traditional Chinese medicine has been proven to be effective in inhibiting the progression of GD and is expected to become a key direction for the development of new drugs in the future. Therefore, a network meta-analysis was performed to compare the impacts of different traditional Chinese medicines on the curative effect, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) and thyrotropin receptor antibody (TRAb) in patients with GD. Methods: PubMed, Embase, Cochrane Library, Web of Science, WanFang, Weipu, and CNKI were searched for the randomized controlled trials of traditional Chinese medicine on GD patients up to 19 December 2023. The quality of the included studies was evaluated regarding the risk of bias, and the data were analyzed by R software. Results: Thirty-five articles were included in the analysis, involving 2828 GD patients and traditional Chinese medicines including Bailing Capsule, Jinshuibao Capsule, Astragalus injection, Jiakangling Tablet, Jiakangling Capsule, Tripterygium Wilfordii, Sanjie Xiaoying Decoction, Prunella vulgaris (L.) Oral Liquid, P. vulgaris (L.) Granules, Xiehuo Xiaoying Recipe, Xiehuo Yangyin Powder, Yikang Pill and Yinjia Pellet. The results of network meta-analysis suggested that for GD patients, Bailing Capsule, Jiakangling Capsule, Tripterygium wilfordii, P. vulgaris (L.) Oral Liquid and Yinjia Pellet had better curative effect compared with Western medicine. Prunella vulgaris (L.) Granules and Yikang Pill could improve the TSH level. Prunella vulgaris (L.) Granules, P. vulgaris (L.) Oral Liquid and Yikang Pill could reduce FT3 level. Jiakangling Capsule, P. vulgaris (L.) Granules, P. vulgaris (L.) Oral Liquid and Yikang Pill could reduce the FT4 level. Prunella vulgaris (L.) Oral Liquid can reduce the level of TPOAb and TRAb. Besides, Yinjia Pellet was the most helpful in improving the curative effect. Yikang Pill could best improve TSH. Prunella vulgaris (L.) Granules had the best effect on reducing FT3. Prunella vulgaris (L.) Granules performed best in reducing FT4. Prunella vulgaris (L.) Oral Liquid had the most favorable effect on reducing TPOAb and TRAb. Conclusion: Based on the current research, it is safe to conclude that Chinese medicine can improve the curative effect and TSH level of patients with GD, and reduce the levels of FT3, FT4, TPOAb and TRAb. Besides, Yinjia Pellet is the most helpful in improving the curative effect. Yikang Pill can best improve TSH. Prunella vulgaris (L.) Granules have the best effect on reducing FT3. Prunella vulgaris (L.) Granules perform best in reducing FT4. Prunella vulgaris (L.) Oral Liquid has the most favorable effect on reducing TPOAb and TRAb. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024521912.