title: Clinical efficacy of Yingliu mixture combined with metimazole for treating diffuse goitre with hyperthyroidism and its impact on related cytokines.
abstract: BACKGROUND
  Yingliu mixture was developed in 1990s by Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine, for treating diffuse goitre with hyperthyroidism (Graves' disease, GD). Former studies have shown Yingliu mixture combined with methimazole (Y-M) can effectively improve thyroid function and decrease thyrotropin-receptor antibody level. Furthermore, we researched its impact on related cytokines to prove that Y-M improve patients' immunity status.
  
  
  OBJECTIVE
  To observe the clinical efficacy of Y-M for treating GD.
  
  
  METHODS
  A total of 120 GD patients were randomly divided into two groups, the treatment and the control groups (n = 60). The treatment group's patients were treated with Y-M. The control group's patients were treated with methimazole alone. Yingliu mixture was orally administered, 25 mL three times daily. Methimazole was administered at 5-25 mg/day. After 12 weeks of the treatment, the cytokines, antibodies related to thyroid function, and Chinese medical syndromes were evaluated.
  
  
  RESULTS
  After the treatment, the free triiodothyronine and thyroxine levels in both groups decreased. The thyroid-stimulating hormone level increased in the treatment group. The thyrotropin-receptor antibody levels and TNF-α levels decreased in both groups. In the control group, IL-6 and IFN-γ levels were lower than that before the treatment. In the treatment group, CD4+and CD25+levels were higher than pretreatment levels, but IL-10 levels were reduced.
  
  
  METHODS
  the total CMS scores for both groups decreased.
  
  
  CONCLUSIONS
  The Y-M combination can improve thyroid function, and decrease autoantibodies, cytokines, and clinical symptoms, so its efficacy may surpass that of methimazole alone.
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Yilei
authors.initials: Y
authors.lastname: Cong
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Tengfei
authors.initials: T
authors.lastname: Wu
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Muhao
authors.initials: M
authors.lastname: Ma
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Juanhua
authors.initials: J
authors.lastname: Zeng
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Wenya
authors.initials: W
authors.lastname: Zhang
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Lian
authors.affiliation: a Department of Endocrinology , Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine , Shanghai , China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002681:China; D016207:Cytokines / Q000097:blood*; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008713:Methimazole / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D020127:Recovery of Function; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D013963:Thyroid Hormones / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D001323:Autoantibodies; D015415:Biomarkers; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D013963:Thyroid Hormones; C000614898:yingliu; D008713:Methimazole
keywords: Graves’ disease; cytokines; traditional Chinese medicine