左甲状腺素联合硒酵母治疗甲减患者的疗效及对患者TSH、TC、TG水平的影响研究
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摘要
目的分析左甲状腺素片联合硒酵母片治疗甲减患者的临床疗效与安全性及对患者促甲状腺素(TSH)、总胆固醇(TC)、三酰甘油(TG)水平的影响。方法将2017年4月至2018年4月因甲状腺功能减退进行治疗的83例患者作为研究对象,对所有患者进行随机分组对比研究。其中对照组单纯使用左甲状腺素片治疗;观察组在上述基础上加用硒酵母片行联合治疗。比较2组临床疗效及不良症状发生情况的差异;并分析治疗前后患者TSH、TC、TG等指标水平变化情况。结果观察组疗效显著高于对照组(P<0.05);治疗后2组甲状腺功能指标水平均显著降低,观察组改善程度较对照组更加明显(P<0.05);2组LDL-C、TC、TG等指标水平在治疗后显著降低,且观察组降低程度高于对照组(P<0.05);2组不良反应比较差异无统计学意义(P>0.05)。结论临床针对甲状腺功能减退症患者采用左甲状腺素片联合硒酵母片进行治疗具有显著疗效,在提高患者各项甲状腺指标水平的同时,还对其血脂水平有较好的改善作用,整个联合用药方案安全性较高,治疗后无严重不良反应,有临床推广应用价值。
Objective To analyze the clinical efficacy and safety of levothyroxine tablets combined with selenium yeast tablets in treatment of hypothyroidism and its effects on the levels of TSH, TC and TG of patients. Methods Eighty-three patients with hypothyroidism who were treated in our hospital from April 2017 to April 2018 were enrolled in the study. All the patients were randomly divided into control group and observation group.The patients in control group were treated by levothyroxine tablets,however,the patients in observation group,on the basis of control group,were treated by selenium yeast tablets. The clinical curative effects and incidence of adverse reactons was well as the levels of TSH, TC, TG were observed and compared between the two grousp.Results The curative effects in observation group were superior to those in control group(P<0.05). After treatment, the levels of thyroid function were significantly decreased in both groups, and the improvement degree in observation group was more significant than that in control group(P<0.05).After treatment the levels of LDL-C, TC, TG were significantly decreased, and the decrease degree in observation group was more significant than that in control group(P<0.05).In addition there was no significant difference in the incidence rate of adverse reaction between the two groups(P>0.05). Conclusion The levothyroxine tablets combined with selenium yeast tablets in treatment of hypothyroidism can obtain obvious theraeputtic effects,which can not only improve the levels of various thyroid indexes,but also can improve patient's blood lipid levels,with good safety,without serious adverse reactions,therfor, which has important clinical application value.
Objective To analyze the clinical efficacy and safety of levothyroxine tablets combined with selenium yeast tablets in treatment of hypothyroidism and its effects on the levels of TSH, TC and TG of patients. Methods Eighty-three patients with hypothyroidism who were treated in our hospital from April 2017 to April 2018 were enrolled in the study. All the patients were randomly divided into control group and observation group.The patients in control group were treated by levothyroxine tablets,however,the patients in observation group,on the basis of control group,were treated by selenium yeast tablets. The clinical curative effects and incidence of adverse reactons was well as the levels of TSH, TC, TG were observed and compared between the two grousp.Results The curative effects in observation group were superior to those in control group(P<0.05). After treatment, the levels of thyroid function were significantly decreased in both groups, and the improvement degree in observation group was more significant than that in control group(P<0.05).After treatment the levels of LDL-C, TC, TG were significantly decreased, and the decrease degree in observation group was more significant than that in control group(P<0.05).In addition there was no significant difference in the incidence rate of adverse reaction between the two groups(P>0.05). Conclusion The levothyroxine tablets combined with selenium yeast tablets in treatment of hypothyroidism can obtain obvious theraeputtic effects,which can not only improve the levels of various thyroid indexes,but also can improve patient's blood lipid levels,with good safety,without serious adverse reactions,therfor, which has important clinical application value.
引文
1 陈霞,谷雪梅,方明.左旋甲状腺激素片替代治疗冠心病合并亚临床甲减患者TSH、血脂及MPO、hs-CRP水平变化及意义.浙江医学,2016,38:822-825.
2 Fallahi P,Ferrari SM,Ruffilli I,et al.Advancements in the treatment of hypothyroidism with L-T4 liquid formulation or soft gel capsule: an update.Expert Opinion on Drug Delivery,2016,14:1.
3 周俊宇,师义.五海瘿瘤丸联合左旋甲状腺素钠片治疗甲状腺腺瘤的疗效及对血清甲状腺激素和免疫炎性因子的影响.现代中西医结合杂志,2017,26:2011-2014.
4 Akbaba G,Berker D,Isik S,et al.Changes in the before and after thyroxine treatment levels of adipose tissue,leptin,and resistin in subclinical hypothyroid patients.Wiener Klinische Wochenschrift,2016,128:1-7.
5 孙敬茹,韩梅,王露,等.左甲状腺素钠联合补硒治疗甲状腺功能减退的临床疗效及对甲状腺功能的影响.疑难病杂志,2017,16:52-55.
6 陆红,朱世论.左甲状腺素替代治疗对绝经后亚临床甲减患者心室结构和功能的影响.实用药物与临床,2016,19:955-958.
7 黄勇.硒酵母辅助左旋甲状腺素对慢性淋巴细胞性甲状腺炎伴甲减免疫调节的机制研究.河北医药,2016,38:1524-1526.
8 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.甲状腺疾病诊治指南——甲状腺功能减退症.中华内科杂志,2007,46:967-971.
9 刘云,陈媛媛,张西艺,等.左旋甲状腺素片治疗妊娠合并甲状腺功能减退的安全性及对妊娠结局影响.疑难病杂志,2016,15:405-408.
10 李珍,区岛良,李美花,等.左甲状腺素及甲巯咪唑联合治疗老年 Graves 病患者对甲状腺激素和骨密度等指标的影响.疑难病杂志,2017,16:56-59.
11 张贵萍.温补脾肾法联合左甲状腺素对亚临床甲减患者甲状腺功能及血脂水平的影响.现代中西医结合杂志,2017,26:1336-1338.
12 邓晓辉.温阳解毒消瘿方和小剂量左甲状腺素片联用对高碘地区结节性甲状腺肿患者的疗效影响.安徽医药,2017,18:653-655.
13 张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响.海南医学院学报,2018.
14 邢英,阿尔孜古丽·吐尔逊,郑嵘炅,等.甲状腺功能减退症患者血清心肌酶与心电图变化分析.山西医药杂志,2017,46:1720-1722.
15 Tong Z,Chen B,Zhou Y,et al.Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis.Bmj Open,2017,7:e016053.
16 边德志,刘艳梅,胥柯,等.左甲状腺素钠片对妊娠伴甲状腺功能减退患者的临床研究.中国临床药理学杂志,2017,33:304-307.
17 杨咏梅,金安林.左甲状腺素钠片在老年甲状腺功能减退症治疗中的临床应用.广西医科大学学报,2016,33:341-343.
18 周静,高晟,吴深涛.加味逍遥丸联合左甲状腺素钠片和二甲双胍治疗肝气郁结型多囊卵巢综合征合并甲状腺机能减退的疗效观察.现代药物与临床,2016,31:329-334.
19 杨颖博,田小燕,黄一茜.螺内酯联合雷公藤对合并亚临床甲减的早期2型糖尿病肾病患者尿微量白蛋白的影响.中国医药导刊,2016,18:610-611.
20 李艳萍,李宇洁,赵春霞,等.不同剂量左旋甲状腺素片对妊娠并甲状腺功能减低患者的安全性及对妊娠结局的影响.山西医药杂志,2017,46:2884-2886.
2 Fallahi P,Ferrari SM,Ruffilli I,et al.Advancements in the treatment of hypothyroidism with L-T4 liquid formulation or soft gel capsule: an update.Expert Opinion on Drug Delivery,2016,14:1.
3 周俊宇,师义.五海瘿瘤丸联合左旋甲状腺素钠片治疗甲状腺腺瘤的疗效及对血清甲状腺激素和免疫炎性因子的影响.现代中西医结合杂志,2017,26:2011-2014.
4 Akbaba G,Berker D,Isik S,et al.Changes in the before and after thyroxine treatment levels of adipose tissue,leptin,and resistin in subclinical hypothyroid patients.Wiener Klinische Wochenschrift,2016,128:1-7.
5 孙敬茹,韩梅,王露,等.左甲状腺素钠联合补硒治疗甲状腺功能减退的临床疗效及对甲状腺功能的影响.疑难病杂志,2017,16:52-55.
6 陆红,朱世论.左甲状腺素替代治疗对绝经后亚临床甲减患者心室结构和功能的影响.实用药物与临床,2016,19:955-958.
7 黄勇.硒酵母辅助左旋甲状腺素对慢性淋巴细胞性甲状腺炎伴甲减免疫调节的机制研究.河北医药,2016,38:1524-1526.
8 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.甲状腺疾病诊治指南——甲状腺功能减退症.中华内科杂志,2007,46:967-971.
9 刘云,陈媛媛,张西艺,等.左旋甲状腺素片治疗妊娠合并甲状腺功能减退的安全性及对妊娠结局影响.疑难病杂志,2016,15:405-408.
10 李珍,区岛良,李美花,等.左甲状腺素及甲巯咪唑联合治疗老年 Graves 病患者对甲状腺激素和骨密度等指标的影响.疑难病杂志,2017,16:56-59.
11 张贵萍.温补脾肾法联合左甲状腺素对亚临床甲减患者甲状腺功能及血脂水平的影响.现代中西医结合杂志,2017,26:1336-1338.
12 邓晓辉.温阳解毒消瘿方和小剂量左甲状腺素片联用对高碘地区结节性甲状腺肿患者的疗效影响.安徽医药,2017,18:653-655.
13 张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响.海南医学院学报,2018.
14 邢英,阿尔孜古丽·吐尔逊,郑嵘炅,等.甲状腺功能减退症患者血清心肌酶与心电图变化分析.山西医药杂志,2017,46:1720-1722.
15 Tong Z,Chen B,Zhou Y,et al.Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis.Bmj Open,2017,7:e016053.
16 边德志,刘艳梅,胥柯,等.左甲状腺素钠片对妊娠伴甲状腺功能减退患者的临床研究.中国临床药理学杂志,2017,33:304-307.
17 杨咏梅,金安林.左甲状腺素钠片在老年甲状腺功能减退症治疗中的临床应用.广西医科大学学报,2016,33:341-343.
18 周静,高晟,吴深涛.加味逍遥丸联合左甲状腺素钠片和二甲双胍治疗肝气郁结型多囊卵巢综合征合并甲状腺机能减退的疗效观察.现代药物与临床,2016,31:329-334.
19 杨颖博,田小燕,黄一茜.螺内酯联合雷公藤对合并亚临床甲减的早期2型糖尿病肾病患者尿微量白蛋白的影响.中国医药导刊,2016,18:610-611.
20 李艳萍,李宇洁,赵春霞,等.不同剂量左旋甲状腺素片对妊娠并甲状腺功能减低患者的安全性及对妊娠结局的影响.山西医药杂志,2017,46:2884-2886.