活血消瘿方对结节性甲状腺肿患者血清VEGF、IGF-1、TGF-β1的影响
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摘要
目的观察活血消瘿方对结节性甲状腺肿患者血清VEGF、IGF-1、TGF-β1水平的影响,探讨活血消瘿方治疗结节性甲状腺肿的作用机制。方法选取符合纳入标准的42例患者作为病例组(服用活血消瘿方),疗程共24周,同时在门诊体检人群中随机选取42名与之相匹配的健康成人作为对照组。观察活血消瘿方治疗前后结节性甲状腺肿患者的VEGF、IGF-1、TGF-β1血清学变化,并与对照组比较。结果结节性甲状腺肿患者治疗前血清VEGF、IGF-1水平高于对照组(P <0. 05),血清TGF-β1的水平低于对照组(P <0. 05)。经活血消瘿方治疗后,血清VEGF、IGF-1水平在治疗后12周时有所下降,但无统计学意义(P> 0. 05),血清TGF-β1水平在治疗后12周时明显升高(P <0. 01);治疗后24周时血清VEGF、IGF-1水平明显下降,与对照组比较有统计学意义(P <0. 05),血清TGF-β1水平在治疗后24周时有所下降,但仍明显高于治疗前水平(P <0. 01),亦高于对照组(P <0. 05)。结论活血消瘿方可以通过下调结节性甲状腺肿患者血清VEGF、IGF-1水平及适度上调血清TGF-β1水平来发挥治疗作用。
Objective To observe the effect of Huoxue Xiaoying Prescription on serum levels of vascular endothelial growth factor( VEGF),insulin-like growth factor 1( IGF-1) and transforming growth factor-beta 1( TGF-β1) in patients with nodular goiter,and to explore the mechanism of Huoxue Xiaoying Prescription in treating nodular goiter. Methods Forty-two patients who met the inclusion criteria were selected as the case group( taking Huoxue Xiaoyu Decoction) for a total of 24 weeks. At the same time,42 healthy adults matched with the outpatients were randomly selected as the control group. The serum changes of VEGF,IGF-1 and TGF-β1 in patients with nodular goiter before and after treatment with Huoxue Xiaoyu Decoction were observed and compared with the control group. Results Serum levels of VEGF and IGF-1 in patients with nodular goiter before treatment were higher than those in the control group( P < 0. 05),and serum levels of TGF-β1 were lower than those in the control group( P < 0. 05). After treatment with Huoxue Xiaoying Prescription,the serum levels of VEGF and IGF-1 decreased at 12 weeks after treatment,but there was no statistical significance( P > 0. 05).The serum levels of TGF-β1 increased significantly at 12 weeks after treatment( P < 0. 01); the serum levels of VEGF and IGF-1 decreased significantly at 24 weeks after treatment,compared with the control group( P < 0. 05). The level of serum TGF-β1 decreased at 24 weeks after treatment,but it was still significantly higher than that before treatment( P < 0. 01),and also higher than that in the normal group( P < 0. 05). Conclusion Huoxue Xiaoying Prescription can achieve ideal therapeutic effect by lowering serum levels of VEGF and IGF-1 and increasing serum levels of TGF-β1 moderately in patients with nodular goiter.
Objective To observe the effect of Huoxue Xiaoying Prescription on serum levels of vascular endothelial growth factor( VEGF),insulin-like growth factor 1( IGF-1) and transforming growth factor-beta 1( TGF-β1) in patients with nodular goiter,and to explore the mechanism of Huoxue Xiaoying Prescription in treating nodular goiter. Methods Forty-two patients who met the inclusion criteria were selected as the case group( taking Huoxue Xiaoyu Decoction) for a total of 24 weeks. At the same time,42 healthy adults matched with the outpatients were randomly selected as the control group. The serum changes of VEGF,IGF-1 and TGF-β1 in patients with nodular goiter before and after treatment with Huoxue Xiaoyu Decoction were observed and compared with the control group. Results Serum levels of VEGF and IGF-1 in patients with nodular goiter before treatment were higher than those in the control group( P < 0. 05),and serum levels of TGF-β1 were lower than those in the control group( P < 0. 05). After treatment with Huoxue Xiaoying Prescription,the serum levels of VEGF and IGF-1 decreased at 12 weeks after treatment,but there was no statistical significance( P > 0. 05).The serum levels of TGF-β1 increased significantly at 12 weeks after treatment( P < 0. 01); the serum levels of VEGF and IGF-1 decreased significantly at 24 weeks after treatment,compared with the control group( P < 0. 05). The level of serum TGF-β1 decreased at 24 weeks after treatment,but it was still significantly higher than that before treatment( P < 0. 01),and also higher than that in the normal group( P < 0. 05). Conclusion Huoxue Xiaoying Prescription can achieve ideal therapeutic effect by lowering serum levels of VEGF and IGF-1 and increasing serum levels of TGF-β1 moderately in patients with nodular goiter.
引文
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[12] BACH LA. Endothelial cells and the IGF system[J]. J Mol Endocrinol,2015,54(1):1-13.
[13]王鹏程,吕文纲.土鳖虫质量控制及药理作用研究进展[J].山东中医杂志,2016,35(9):846-848.
[14]崔源源,刘剑刚,赵福海,等.莪术主要化学成分预防支架后再狭窄药理作用的研究进展[J].中国中药杂志,2015,40(7):1230-1234.
[15]魏薇.中药王不留行的研究进展[J].中国医药指南,2014,12(16):87-88.
[16]颜美玲,杨柳,侯阿娇,等.柴胡化学成分及药理作用研究进展[J].中医药信息,2018(5):103-109.
[2] LIU G,ZHANG W,JIANG P,et al. Role of nitric oxide and vascular endothelial growth factor in fluoride-induced goitrogenesis in rats[J]. Environ Toxicol Pharmacol,2012,34(2):209-217.
[3] LIU YJ,QIANG W,SHI J,et al. Expression and significance of IGF-1 and IGF-1R in thyroid nodules[J]. Endocrine,2013,44(1):158-164.
[4] KAJDANIUK D,MAREK A,MAREK B,et al. Transcriptional activity of TGFβ1 and its receptors genes in thyroid gland[J]. Endokrynol Pol,2016,67(4):375-382.
[5]施秉银.甲状腺结节的诊断与处理[M]//陈家伦.临床内分泌学.上海:上海科学技术出版社,2011:443-447.
[6]滕卫平.甲状腺结节和分化型甲状腺癌诊治指南[J].中华内分泌代谢杂志,2012,28(10):779-797.
[7]陈如泉.陈如泉教授医论与临床经验选萃[M].北京:中国医药科技出版社,2007:110-111.
[8]孙宇,马建,徐洪涛,等.杜丽坤教授治疗结节性甲状腺肿[J].吉林中医药,2015,35(4):342-343.
[9]曾明星,陈继东,左新河,等.结节性甲状腺疾病中医病名辨析[J].北京中医药,2017,36(6):525-528.
[10]吴淑琼,左新河,陈如泉,等.活血消瘿片治疗结节性甲状腺肿的临床价值[J].武汉大学学报(医学版),2010,31(3):394-397.
[11]尹彩霞,邓媛媛,黄彬,等.血管内皮生长因子在缺血性脑损伤后血管新生中的作用[J].华西药学杂志,2016,31(1):103-107.
[12] BACH LA. Endothelial cells and the IGF system[J]. J Mol Endocrinol,2015,54(1):1-13.
[13]王鹏程,吕文纲.土鳖虫质量控制及药理作用研究进展[J].山东中医杂志,2016,35(9):846-848.
[14]崔源源,刘剑刚,赵福海,等.莪术主要化学成分预防支架后再狭窄药理作用的研究进展[J].中国中药杂志,2015,40(7):1230-1234.
[15]魏薇.中药王不留行的研究进展[J].中国医药指南,2014,12(16):87-88.
[16]颜美玲,杨柳,侯阿娇,等.柴胡化学成分及药理作用研究进展[J].中医药信息,2018(5):103-109.