A methimazole resistant patient with Graves' disease (GD): A case report of mid-term management with herbal decoctions mainly composed of Anemarrhena Bunge
A methimazole resistant patient with Graves' disease (GD): A case report of mid-term management with herbal decoctions mainly composed of Anemarrhena Bunge
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DOI：
10.1016/j.ctim.2018.05.015
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发表时间：
2018-08-01
影响因子：
3.6
通讯作者：
Kim, Tae-Hun
中科院分区：
文献类型：
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作者：
Kim, Jiman;Kim, Tae-Hun
Graves病(GD)是导致甲状腺功能亢进的最常见原因。抗甲状腺药物，包括他巴唑，是治疗这种疾病最常用的选择。但几十年来，没有增加任何额外的药物选择。知母已被用于许多草药煎剂中，用于治疗有甲亢样症状的患者，如出汗、热耐受和焦虑。本研究以1例甲亢患者为研究对象，经他巴唑治疗后甲亢复发，单用中药汤剂治疗，甲状腺功能恢复正常，T3、T4恢复正常13个月，促甲状腺激素(TSH)维持8个月，TSH结合抑制性免疫球蛋白(TSH)阴性13个月(治疗前TSH、TbII分别为0.01IU/mL、10.94IU/L；治疗14个月后TSH水平复常率为0.75mU/L，治疗9个月后复常率为0.8IU/L。患者没有报告与这种治疗有关的任何不良反应。含有知母的中草药汤剂可能对对他巴唑类药物耐药的患者有效，这一发现需要进一步研究。
Graves' disease (GD) is the most common cause of hyperthyroidism. Anti-thyroid drugs, including methimazole, are the most commonly selected treatment option for this condition. But for decades, no additional drug option has been added. Anemarrhena Bunge has been used in many herbal decoctions for patients who had hyperthyroidism -like symptoms, such as sweating, heat intolerance, and anxiety. In this case study, a patient with GD who had once achieved therapeutic goals with methimazole but then re-developed hyperthyroidism was treated with only herbal decoctions, and achieved euthyroidism, normalization of T3, T4 levels for 13 months and maintenance of thyroid stimulating hormone (TSH) levels for 8 months and TSH binding inhibitory immunoglobulins (TBII)-negative status for 13 months (TSH and TBII level before treatment: 0.01 mu IU/mL, 10.94 IU/L; TSH level normalization after 14 months from the initiation of the treatment: 0.75 mu IU/mL, TBII level normalization after 9 months from the initiation of the treatment: 0.8 IU/L). The patient did not report any adverse effects related to this treatment. A herbal decoction with Anemarrhena Bunge might be effective in patients who are resistant to methimazole treatments, a finding which needs further investigation in future.